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isletcell's picture

Caring for Carcinoid foundation

Type: 
Web site
Description: 

Very good info for carcinoid and neuroendocrine paitents.

isletcell's picture

Carcinoid Cancer Foundation

Type: 
Web site
Description: 

Very good info for Neuroendocrine and Carcinoid paitents

LisaLama's picture

I Am Not My Breast Cancer

Type: 
Book
Description: 

This is a new book taken from an online Breast Cancer Support Group called First Person Plural. 800 women from 49 states and several other countries participated. The discussions were compiled into a book. The book is described on the cover with the following words: "Women talk openly about love and sex, hair loss and weight gan, Mothers and Daughters, and being a woman with Breast Cancer." I was one of the women who contributed and after reading the book, I have to say I am proud to be a part of this project.

Source: 
HarperCollins
Author/Speaker/Performer: 
Ruth Peltason
Publish date: 
2008
MaryJayee7's picture

Christians Overcoming Cancer

Type: 
Organization
Description: 

Christians Overcoming Cancer is a faith-based, non-profit organization passionate about helping Central Ohio cancer patients SUCCEED on their ROAD TO RECOVERY through Awareness, Emotional Support and Financial Relief.

We strive to educate low-to-moderate income men and women, especially those aged 18-45 in Central Ohio, of the importance of performing monthly self exams, early detection, seeking treatment immediately and gaining awareness.

We are an information resource for those who have been diagnosed with cancer or for those who provide support for a family member or friend while in treatment.

We support those diagnosed, through individual and group contact, with a 24 hour support network of individuals from various walks of life, willing to listen, attend treatment and help them understand the battle they face.

We offer various solutions to financial challenges individuals in treatment face as a result of seeking treatment or providing care for a family member.

Contact information: 
PO Box 307133 Columbus OH 43230 phone: 614-808-4447 info@christiansovercomingcancer.com

Fighting Cancer with the Help of Your Catholic Faith

Type: 
Book
Description: 

Very helpful book for me. I wish I had this book right after I found out about my cancer, but found it even more helpful after I found it. It does help me as I talk to others about what I am going through. The book is true by it saying that Cancer is a lonely disease. It is but with the help of this book. I learned to find peace with my illness and accepting cancer is a little easier even though I have still have fears of it coming back. I feel I can accept it if it chooses to come back.

Source: 
Our Sunday Visitor Publishing Division
Author/Speaker/Performer: 
Lorene Hanley Duquin
Publish date: 
2005
Catrinka's picture

Essiac Tea

Type: 
Web site
Description: 

Essiac, given its name by Rene Caisse ("caisse" spelled backwards), consists of four main herbs that grow in the wilderness of Ontario, Canada. The original formula is believed to have its roots from the native Canadian Ojibway Indians.

The four main herbs that make up Essiac are Burdock Root, Slippery Elm Inner Bark, Sheep Sorrel and Indian Rhubarb Root.

Many believe Rene Caisse is one of the greater heroines of the past century.

This modest Canadian nurse discovered a natural herbal forumla she took no money for it and died in relative obscurity.

The initial use of Essiac was encouraging, so much so that a group of doctors assisted her in setting up a test lab and clinic in Toronto. It has been used as an alternative treatment for cancer with success.

Catrinka's picture

Goji Berries

Type: 
Web site
Description: 

A berry found in the Hemalayins that was discovered by researchers who were studying tribes. It was found that a particular tribe had longevity and less disease and illness than surrounding tribes. A goji berry tree was found to be over their water supply and the berries were falling into the well. This was attributed to this tribes healthy state. Please visit the website and do some googling on your own to read more about this magnificent fruit.

asterius's picture

Patient Zero: a cancer blog

Type: 
Web site
Description: 

An online diary of one man's journey through head/neck cancer from diagnosis to remission w/ articles and resources for others suffering with cancer.

Children's Brain Tumor Foundation/Stacia Wagner

Type: 
Organization
Description: 

Children's Brain Tumor Foundation provides information, support and advocacy to pediatric brain and spinal cord tumors patients and their families beginning at diagnosis and throughout life. Their parent to parent program links parents nationwide. Their survivorship program offers local support groups and activities.

Contact information: 
274 Madison Ave. Suite 1004 New York NY 10016 phone: 866-228-HOPE fax: 212-448-1022 info@cbtf.org
gdpawel's picture

Why Community Oncology Can Benefit From Cell Function Analysis

Type: 
Article
Description: 

As increasing numbers and types of anti-cancer drugs are developed, oncologists become increasingly likely to misuse them in their practice. There is seldom a "standard" therapy which has been proven to be superior to any other therapy. When all studies are compared by meta-analysis, there is no difference. What may work for one, may not work for another.

Cancer chemotherapy could save more lives if pre-testing were incorporated into clinical medicine. The respected cancer journals are publishing articles that identify safer and more effective treatment regimens, yet few community oncologists are incorporating these synergistic methods into their clinical practice. Cancer patients suffer through chemotherapy sessions that do not integrate all possibilities.

Distinguishing between patients with a "high" or "low" risk for early recurrence after surgical resection and identifying those who may respond to correct adjuvant therapy have been topics of great interest for many years. Both genetic and functional assay analyses share a role in the development of "personalized" patient care.

A genomic test can help to find out if a cancer patient will likely have a recurrence after surgery. If a recurrence isn't likely, they don't need chemotherapy. Genetic tests have been developed for breast and lung cancers. Hopefully, there will be more tests for other types of cancer to guide physicians as to which "high" risk patient will likely have a recurrence if treated with surgery alone (1).

If the test finds a patient to be at "high" risk, it is impossible to design a single chemotherapy protocol that is effective against all types of cancer. The oncologist might need to administer several chemotherapy drugs at varying doses because tumor cells express survival factors with a wide degree of individual cell variability. A cell culture assay test, using a cell-death endpoint, can help see what treatments will not have the best opportunity of being successful (resistant) and identify drugs that have the best opportunity of being successful (sensitive).

The current clinical applications of in vitro chemosensitivity testing is ever more important with the influx of new "targeted" therapies. Given the technical and conceptual advantages of "functional profiling" of cell culture assays together with their performance and the modest efficacy for therapy prediction on analysis of genome expression, there is reason for renewed interest in these assays for optimized use of medical treatment of malignant disease (2).

The chemotherapy regimen chosen by most community oncologists is based on the type of cancer being treated. However, there are factors other than the type of cancer that can be used to determine the ideal chemotherapy drugs that should be used to treat an individual patient.

It is highly desirable to know what drugs are effective against particular cancer cells before these toxic agents are systemically administered. Pre-testing on "fresh" specimens of cancer cells to determine the optimal combination of chemotherapy drugs could be highly beneficial.

Following the collection of "fresh" cancer cells obtained at the time of biopsy or surgery, a cell culture assay is performed on the tumor sample to measure drug activity (sensitivity and resistance). This will pinpoint which drug(s) are most effective. The treatment program developed through this approach is known as assay-directed therapy.

At present, medical oncologists prescribe chemotherapy according to "fixed" schedules. These schedules are standardized drug regimens that correspond to specific cancers by type or diagnosis. These regimens, developed over many years of clinical trials, assign patients to the drugs which previously worked for some percentage of patients.

However, cancer is a disease whose hallmark is heterogeneity. It is well known that drugs which work for one patient often don't work for another and patients who fail to respond to first line chemotherapy with one regimen often respond to second or third line therapy with alternative drugs. Why not identify the right regimen before ever exposing a patient to a single course of chemotherapy? A failed attempt at chemotherapy is detrimental to the physical and emotional well being of patients, is financially burdensome, and may promote the onset of clinically acquired multi-drug resistance.

A "fresh" sample tumor can be obtained from surgery or biopsy (Tru-cut needle biopsies). Tissue, blood, bone marrow, and ascites and pleural effusions are possibilities, providing tumor cells are present, and only live cells should be used. At least one gram of fresh biopsy tissue is needed to perfom the tests, and a special kit is obtained in advance from the lab. Arrangements are made with the surgeon and/or pathologist for preparation and sending of the specimen.

Upgrading clinical therapy by using drug sensitivity assays measuring "cell death" of three dimensional microclusters of live "fresh" tumor cells can improve the conventional situation by allowing more drugs to be considered. The key to improving drug sensitivity tests is related to the number and types of drugs tested. The more anti-cancer drug types there are in the selective arsenal, the more likely the system is to prove beneficial.

In order to acquire sufficient data, tumors should be tested with at least two assay endpoints, and most often three, for sensitivity tests in any one patient. On average, up to twenty drugs and combinations at two concentrations in three different assay systems, is an effective way to avoid false-positive or false-negative data.

Assays based on "cell-death" occur in the entire population of tumor cells, as opposed to only in a small fraction of the tumor cells occurring in "cell-growth" assays. Drug "sensitivity" testing is merely a point a little farther along on the very same continuum upon which "resistance" testing resides, which has been proven to be accurate and reliable, as reported in numerous peer-reviewed publications.

Good review papers exist on cell culture assays and are increasingly appreciated and applied in the private sector by European clinicians and scientists. The literature on these assays have not been understood by many NCI investigators and by NCI-funded university investigators, because their knowledge has been based largely on an assay technique (cell-growth) that hasn't been used in most private labs for over fifteen years (3).

Data show conclusively that patients benefit both in terms of response and survival from drugs and drug combinations found to be "active" in the assay even after treatment failure with several other drugs, many of which are in the same class, and even with combinations of drugs found to have low or no activity as single agents but which are found in the assay to produce a synergistic and not merely an additive anti-tumor effect.

Patients receiving a drug that tested "sensitive" were 1.44 times [i.e. 44%] more likely to respond compared to all patients treated in studies, while patients testing "resistant" were 0.23 as likely to respond as all patients. Patients receiving treatment with drugs testing "sensitive" enjoyed a 6-fold advantage (1.44/0.23 = 6.23) over patients treated with drugs testing "resistant."

This data includes both patients with solid tumors (e.g., breast cancer, lung cancer) and hematological (blood system) tumors (e.g. leukemia, lymphoma). In the case of solid tumors only, the advantage to receiving sensitive versus resistant drugs was 9.3 fold. In the case of breast cancer, it was more than 10-fold. Furthermore, patients receiving "sensitive" drugs were shown in many studies to enjoy significantly longer durations of survival than patients treated with "resistant" drugs.

Patients treated with a "positive" (sensitive) drug would respond 79.1% of the time, while patients treated with a "negative" (resistant) drug would respond only 12.6% of the time. Once again, there would be a huge advantage to the patient to receive a "positive/sensitive" drug, compared to a "negative/resistant" drug (4).

Profiles from DNA and RNA expression analysis can help define patients at risk for early recurrence. Cell Culture Assays with "functional profiling" have a role in eliminating ineffective agents and avoid unnecessary toxicity and in directing "correct" therapy.

An ASCO tech review of drug sensitivity and resistance assays, concluded that the use of these assays for selection of chemotherapeutic agents for individual patients is not recommended outside the clinical trial setting (5).

However, Medicare contractor National Heritage Insurance Company spent six months reviewing everything about the cell culture assay, read all of ASCO arguments, and upon reviewing all available information, made the decision to reverse trend and go on record as formally approving the service and providing coverage.

They found that even back in 1999, the Medicare Advisory Panel concluded that cell culture assays tests offered clinical utility. After listening to detailed clinical evidence, the Medicare Coverage Advisory Committee found that these assay systems can aid physicians in deciding which chemotherapies work best in battling an individual patient's form of cancer (6).

Although Medicare had been reimbursing for cell culture drug "resistance" tests since 2000, it wasn't until the beginning of this year that they abandoned the artificial distinction between "resistance" testing and "sensitivity" testing and are providing coverage for the whole FDA-approved kit. The decision had been made that the assay is a perfectly appropriate medical service, worthy of coverage on a non-investigational basis (7).

References

1. J Thorac Cardiovasc Surg 2007;133:352-363. Chemotherapy Resistance and Oncogene Expression in NSCLC. http://jtcs.ctsnetjournals.org/cgi/content/abstract/133/2/352

2. J Clin Onco, 2006 ASCO Annual Meeting Proceedings Part 1. Vol 24, No. 18S (June 20 Supplement), 2006: 17117. Genfitinib-induced cell death in short term fresh tumor cultures predicts for long term patient survival in previously-treated NSCLC. Link

3. Eur J Clin Invest, Volume 37(suppl. 1):60, April 2007. Functional profiling with cell culture-based assays for kinase inhibitors and anti-angiogenic agents. http://weisenthal.org/Weisenthal_ESCIa.pdf

4. Weisenthal Cancer Group, Huntington Beach, CA and Departments of Clinical Pharmacology and Oncology, Uppsala University, Uppsala, Sweden. Current Status of Cell Culture Drug Resistance Testing (CCDRT) May, 2002. http://weisenthal.org/ccdrtrev.pdf

5. Journal of Clinical Oncology Reviews on Chemotherapy Sensitivity and Resistance Assays, September1,2004. http://weisenthal.org/jco_response.htm

6. Verbatim Transcript of Medicare Coverage Advisory Committee (MCAC) Meeting, November 15-16, 1999. http://weisenthal.org/hcfa_1.htm http://weisenthal.org/hcfa_2.htm http://weisenthal.org/hcfa_3.htm

7. Centers for Medicare & Medicaid Services http://www.medicarenhic.com/cal_prov/articles/chemoassaytest_0107.htm
http://www.highmarkmedicareservices.com/bulletins/partb/news06132007.html

Source: 
Human Tumor Assay Journal
Author/Speaker/Performer: 
Gregory D. Pawelski

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