Inherited colon cancer: a new syndrome identified

German researchers have found [significant clinical differences](http://gut.bmjjournals.com/cgi/content/abstract/54/12/1733) in patients with a family history of colorectal cancer and a well-known genetic mutation and those with similar family histories but no mutation.

The team from Munich compared two groups of patients with colorectal cancer, both of which met the Amsterdam criteria for hereditary non-polyposis colon cancer (HNPCC). The first group (25 families) had mutations in either the MLH1 or MSH2 gene as well as high microsatellite instability (MSI) in their tumors.

The second group of 16 families met the Amsterdam criteria for a strong family colorectal cancer history, but did not have MLH1 or MSH2 mutations, and their tumors did not show microsatellite instability.

In addition there were other clinical differences between the two groups:

+ Median age of onset of colorectal cancer was earlier in group 1 than group 2 (41 versus 55)
+ Median age for all tumors was earlier in group 1 (43 versus 56)
+ Group 1 had more additional colorectal tumors found at the same time (synchronous) as well as synchronous tumors outside their colons.
+ Group 1 was more likely to have additional tumors found later (metasynchronous) both in the colon and outside it.
+ Group 2 was more likely to have multiple adenomas, and it appeared that the time it took for adenomas to progress to cancer was longer for them.
+ Tumors in Group 1 were much more likely to be found high in the colon (proximal) versus nearer to the rectum (distal) than those in Group 2. (68% vs. 14%)

The research team concluded:

These data show that HNPCC includes at least two entities with clinical and molecular differences. This will have implications for surveillance programmes and for cancer research

The Amsterdam criteria is used to identify families with a particular inherited pattern of colorectal cancer — HNPCC or Lynch Syndrome.

+ One member diagnosed with colorectal cancer before age 50.
+ Two affected generations.
+ Three affected relatives, one of them a first-degree relative of the other two.
+ Familial adenomatous polyposis should be excluded.
+ Tumors should be verified by pathological examination.

Posted by Kate Murphy on November 26th, 2005
Posted in: Research & Treatment News | 2 Comments »

Women who have radiation therapy for pelvic cancers are at higher risk for bone fractures

Women who are treated with radiotherapy for anal, cervical, and rectal cancer have a higher risk of pelvic fractures according to a [new study in the *Journal of the American Medical Association*](http://jama.ama-assn.org/cgi/content/short/294/20/2587). More than 90% of the fractures were broken hips.

Using SEER (Surveillance, Epidemiology, and End Results) cancer registry data from 1986 through 1999, Dr. Nancy Baxter and a team at the University of Minnesota, analyzed fractures in nearly 6,500 women over the age of 65 who either received radiation to their pelvic area (2,855) or did not (3,573). They also looked at bones that had not been irradiated in the spine and arm.

After adjusting for other important factors, women who had received radiation for anal cancer were more than 3 times more likely to have pelvic fracture than those who didn’t have radiotherapy. Fourteen percent (14.0%) of them had broken pelvic bones compared to 7.5% of the non-radiation group. 8.2% of women with cervical cancer and radiation had pelvic fractures compared to 5.9% of those who did not. For rectal cancer 11.2% of the radiated group experienced fractures compared to 8.7% of others.

However, there was no difference in spine or arm fracture rate in any of the three groups.

The authors suggested that women who had received pelvic radiation might be targeted for therapy to prevent hip fractures such as bone density scanning, medication, or physical therapy to prevent falls.

They concluded:

Pelvic irradiation substantially increases the risk of pelvic fractures in older women. Given the high baseline risk of pelvic fracture, this finding is of particular concern.

Find more information about the study in a [*Reuters Health* article.](http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2005-11-22T212236Z_01_ARM276923_RTRUKOC_0_US-RADIOTHERAPY-BONE-FRACTURE.xml&archived=False) or on [*MedPage Today*](http://www.medpagetoday.com/HematologyOncology/OtherCancers/tb/2199)

Posted by Kate Murphy on November 24th, 2005
Posted in: Research & Treatment News | 1 Comment »

Ostomy support groups form a new association: UOAA

A new network of ostomy support groups — the United Ostomy Associations of America — has been formed to provide information, support, and advocacy for people with bowel and urinary diversion and the local groups that work with them. UOAA began operations on October 1, 2005 and has opened a [website](http://www.uoaa.org/) as part of their initial efforts. Members of UOAA will not be individuals, but organizations that serve and support people with ostomies.

The United Ostomy Associations of America, Inc. describes itself:

UOAA is a national network for bowel and urinary diversion support groups in the United States. Its goal is to provide a nonprofit association that will serve to unify and strengthen its member support groups, which are organized for the benefit of people who have, or will have intestinal or urinary diversions and their caregivers.

People with ostomies or concerns about a potential ostomy can [find a nearby support group](http://www.uoaa.org/supportgroups.shtml) among the affiliate members on the UOAA website.

The new website has an active [Discussion Board](http://www.uoaa.org/forum/index.php) where people can ask questions and receive help. Since October 1, there have been nearly 2,400 posts made to its forums by almost 500 participants.

Future plans call for a magazine [*The Phoenix*](http://www.uoaa.org/Phoenix.shtml) and an annual conference as well as providing support and information for local associations.

When the [United Ostomy Association (UOA)](http://www.uoa.org/) ceased operations on September 30, 2005 local support organizations were left without support of their own. Local groups provide support and education for people with ostomies and their caregivers. Some hold regular group meetings, some have provided hospital visitors or supportive phone calls to newly diagnosed patients. However, dwindling membership, reduced funding and increased costs of operation made [continuing UOA impossible.](http://www.uoa.org/new/files/end_of_an_era.pdf) UOA closed after 43 years of service.

An ostomy is a surgically created opening in the skin to divert either urine or feces from their normal route in the body.

Posted by Kate Murphy on November 22nd, 2005
Posted in: Research & Treatment News | 2 Comments »

PLWC: Live Chat on Coping with Cancer

*People Living with Cancer* will sponsor a live online chat wtih Lidia Schapira, MD on December 8, 2005 from 2 - 3 pm (EST).

[Dr. Shapiro](http://www.massgeneral.org/cancer/locator/search_clinician.asp?id=219) is a medical oncologist at the Massachusetts General Hospital Cancer Center. Topics to be covered during the chat include:

+ Seeking professional and community support
+ Coping with changes in relationships with family, friends, and co-workers
+ Coping with change: sexuality, body image, and self image
+ Coping with fear of recurrence
+ Coping differences among different ages and populations

To join the chat, go to People Living with Cancer 10 minutes before or anytime during the chat,
click the “JOIN NOW” link on the home page, and follow the instructions. PLWC
chats are free of charge, anonymous, and preregistration is not required.

*PLWC — People Living with Cancer* is the patient education website of the American Society of Clinical Oncology.

Posted by Kate Murphy on November 21st, 2005
Posted in: Research & Treatment News | No Comments »

PLWC : Q&A: Complementary and Alternative Medicine and Cancer

**People Living with Cancer** sponsors an *Ask the Experts* series where patients, caregivers, and friends can submit questions for answers in an online forum

November’s questions are about [complementary and alternative medicine and its role in cancer](http://www.plwc.org/plwc/MainConstructor/1,1744,_12-001079,00.asp). Experts answering questions are Patrick Mansky, MD and Barrie Cassileth, PhD. Dr. Mansky is a medical oncologist and researcher at the [National Center for Complementary and Alternative Medicine](http://nccam.nih.gov/). [Dr. Cassileth](http://www.mskcc.org/prg/mrg/bios/525.cfm) is Chief of Integrative Services at [Memorial Sloan Kettering Cancer Center](http://www.mskcc.org/mskcc/html/1979.cfm) in New York.

Each week’s emailed questions are [posted and answered](http://www.plwc.org/plwc/MainConstructor/1,1744,_12-001175-00_14-00Transcripts-00_17-001029-00_18-0043025-00_19-0043026-00_20-001-00_21-008,00.asp)
online.

To ask a question email [PLWC](chats@plwc.org) and put *Question for PLWC Chat: CAM and Cancer* in the subject line.

[*People Living with Cancer*](http://www.plwc.org/plwc/Home/1,1743,_12-001029-00_21-008,00.html) is the patient information website of the American Society of Oncology (ASCO).

Posted by Kate Murphy on November 21st, 2005
Posted in: Research & Treatment News | No Comments »