Doctors at Memorial Sloan Kettering Cancer Cancer in New York combined IV chemotherapy with chemo infused directly into an artery leading to the liver to treat advanced colorectal cancer.

All patients had already been heavily treated with chemotherapy, and their liver tumors could not be surgically removed.  All had previously received oxaliplatin.

Thirty-nine patients received systemic IV Camptosar (irinotecan or CPT-11) along with hepatic arterial infusion (HAI) of floxuridine and dexamethasone.

Reviewing results, the doctors found that:

• 44 percent of patients had a partial shrinkage of their tumors
• Median time before liver tumors began to grow again was 8.6 months.
• Median time before progression of any colorectal cancer in the body was 6.5 months.
• Median survival time after beginning the chemo/HAI treatment was 20.1 months.
• Median overall survival after diagnosis of metastatic cancer was 32 months.
• 18 percent of patients were eventually able to have liver tumors removed surgically.

Serious side effects included low white cell counts (13 percent) and diarrhea (15 percent).  Rare problems were bleeding within the abdomen (2 percent) and a bleeding duodenal ulcer (2 percent.)

The research team concluded,

Hepatic arterial infusion with floxuridine and dexamethasone plus systemic irinotecan achieves a response rate of 44% and a median overall survival of 20 months in heavily pre-treated patients with colorectal hepatic metastases all receiving previous oxaliplatin; 18% of patients proceeded to surgical resection or ablation.

SOURCE: Gallagher et al, Annals of Oncology, Volume 18, Number 12, December 2007.

Proton pump inhibitors (PPIs) reduce production of acid in the stomach and are widely used to treat problems resulting from excess stomach acid.  They include such brand name drugs as Prilosec®, Prevacid®, Nexium®, and Protonix®.

Because they can lead to bacterial overgrowth in the intestinal tract and potentially change intestinal bile salts, there has been concern that proton pump inhibitors might increase the risk for colorectal cancer.

However, researchers in the Netherlands found no increased risk when  proton pump inhibitors were used in the five years before colorectal cancer diagnosis.  There was no greater risk if they used at all during that time or if they were used for more than a year.  However, the research did not look at longer exposure to PPIs.

In a case control study, the research team compared PPI use in 600 cases of colorectal cancer with a matched control group who didn’t have cancer.

Eva Van Soest and her team concluded,

The present study indicates no association between PPI use and the risk of colorectal cancer. Larger numbers of long-term PPI users are needed to confirm the absence of a risk-increasing effect of long-term PPI exposure.

SOURCE: Van Soest et al. American Journal of Gastroenterology, early online publication, December 7, 2007.

Democratic leaders in the House and Senate indicated they would work with Republicans to complete an omnibus spending bill close to President Bush’s budget cap while keeping most earmarks and trying to protect other Democratic spending priorities (Roll Call – 12/13/07).

President Bush has promised to veto any spending bill that would exceed the $933 billion limit set by the Administration. He proved this last month by vetoing the Labor, Health and Human Services and Education Appropriations bill, which included a 3.1 percent increase for the National Institutes of Health (NIH). Speaker Nancy Pelosi said it is “immoral that researchers are missing many opportunities to advance health science because of insufficient federal funding”, noting that “1,500 Americans die every day because of cancer.”

Though limits set by the Administration have been accepted, the battle between the House and the Senate rages on. There are some large differences between the two chambers, including very different ideas on the best way to trim down the package.

The silver lining is we may soon be able to continue funding our Government.

Stay tuned…

Despite considerable pain from their cancer, some patients refuse morphine and other opiate medicines.  Caregivers have often attributed this to a fear of becoming addicted to drugs, but an in depth study has found something different.

When first offered opiate drugs to control pain, patients often rejected them because they saw them only as “a comfort measure for the dying.”

During interviews, patients identified issues including anticipation of death, morphine as a last resort, and ‘no choice’ but to begin their use.  Opiods were more acceptable when health professionals had confidence in their value and when side effects were well-managed.

Dr. C.M. Reid and colleagues in the United Kingdom concluded,

Among cancer patients the idea that opioids represent a comfort measure for the dying and not legitimate analgesics may represent a greater barrier to their uptake than concerns about tolerance or addiction.

SOURCE: Reid et al. Annals of Oncology, early online publication December 10, 2007.

Congress has been brought to a grinding halt by hardening Democratic and Republican stances on taxes and spending just days before lawmakers begin leaving Washington for Christmas and New Year’s.

The two sides are, in some cases, refusing even to speak to each other about the massive omnibus and an Alternative Minimum Tax (AMT) bill…Read more here