Sun and skin cancer

summer-sun

Summer is coming (finally!) and you notice that because more people are outside enjoying the day. Being active outdoors is an important part of a healthy lifestyle and the sunlight also provides positive effects on us such as the stimulation of vitamin D synthesis, heat and the release of the hormone of happiness – the serotonin. However, it is important to know that the Sun has bad consequences on our skin and we should protect ourselves from it. Underestimating the risk of the sun and its potential to cause skin cancer is risky.
Skin cancer is the most common cancer in Caucasians, with around 240.000 people diagnosed every year and its incidence is rising rapidly: is the 5th most common form of cancer in the United Kingdom and malignant melanoma is the 19th most common cancer worldwide.

Incidence of skin cancer worldwide

Incidence rate of skin cancer worldwide

According to this picture, the highest incidence rate of skin cancer worldwide is in Australia and New Zealand, where it is the 3rd most common cancer in males and females. In addition, Nordic countries are exposed to the sun during holidays at lower latitudes and they have experienced an increase in the number of skin cancer cases.

Incidence rate of skin cancer in European countries

Incidence rate of skin cancer in European countries

European countries such as Denmark, Sweden and The Netherlands are the three countries with the highest incidence rate of skin cancer, whilst Greece, Romania and Cyprus are the lowest ones.

The skin cancer is one of the most frequent tumours in humans and it can have different features.  Nevertheless, not all the skin changes are cancer. Therefore, a regular visit to the dermatologist is a good practice when the person sees any change or has many freckles on the skin.

The early diagnosis and the correct treatment increase the probabilities to cure it.

The ozone layer protects the Earth from the UV-light, which rays are dangerous. According to some recent studies, the ozone layer is becoming thinner and thus, a good sun protection is extremely important in order to decrease the health risk of suffering skin cancer.

Melanoma | Live Sciences

Melanoma | Live Sciences

The most common types of skin cancer are:

  • Malignant melanoma.
  • Non-melanoma skin cancer: basal cell carcinoma and squamous cell carcinoma.
  • Rare types of non-melanoma skin cancer: Kaposi’s sarcoma, Merkel cell carcinoma and T cell lymphoma of the skin.


Effects on the skin
There are two types of UV-light radiation: UV-B radiation and UV-A radiation. The first one has shorter wavelengths than the latter one.
The UV-B radiation normally induces a sunburn and is the most effective in inducing an erythema (redness, sunburn) on the skin, whilst the UV-A radiation is less potent in inducing an erythema, and usually tans our skin. Nevertheless, UV-A radiation penetrates deeper in the skin and causes wrinkles, premature skin aging and pigment alterations.

Both types of radiation are one of the risk factors for the development of skin cancer. The UV-B radiation induces genetic changes in the DNA and UV-A radiation does it by photooxidation mechanisms and contributing to the formation of oxygen free radicals that significantly form cutaneous tumours.

How to detect a melanoma | American Academy of Dermatology

How to detect a melanoma | American Academy of Dermatology


Skin cancer risk factors

  • Age and sex
  • UV- radiation (from sun exposure and sunbeds)
  • Skin type, hair and eye colour: higher risk in people with blue/green eyes, red/blonde hair and with freckles.
  • Moles
  • Family history and genetic conditions
  • Previous cancer
  • Medical conditions and treatments: increased skin cancer risk in some medical conditions may be linked with use of the immunosuppressants azathioprine and cyclosporine, and the eczema treatment. It is also related to several diseases: Chron’s disease, atopy and allergy, Parkinson’s disease and rheumatoid artritis.
  • Infections: having HIV (human immunodeficiency virus) and HPV (human papillomavirus) arise the risk of skin cancer.
  • Height: the risk is higher in women than in men and it increases with height.
  • Overweight and obesity: there is an increased risk of skin cancer in overweight and obese men; nonetheless, this association is inverted in women
  • Ionising radiation: X radiation, gamma radiation, radiotherapy and CT (computed tomography) are classified as skin cancer causes.
  • Occupational exposures


Diagnosis and treatment
A screening programme of the skin (breast and cervical regions) is the procedure followed in order to detect cancer cells in the skin. This screening is carried out by a specialist (dermatologist). The vast majority of women and men diagnosed with skin cancer present a stage I.

In order to treat malignant melanoma, the gold treatment when the tumour is localised is surgery. However, radiotherapy (sometimes alongside with chemotherapy) is also used to cure or palliate the tumour growth.
In the case of non-melanoma skin cancer the key treatments are surgical removal, photodynamic therapy (PDT), which uses light therapy combined with a photosensitive cream that destroys cancer cells, and radiotherapy (X-rays machines).

You can also find information related to skin cancer clinical trials performed in the UK; for instance, to treat acral and mucosal melanoma skin cancer that has spread with nilotinib.

Characteristics and changes in the skin | National Cancer Institute

Characteristics and changes in the skin | National Cancer Institute

 

Useful Tips:
A self examination is a good practice in order to detect any change in your skin and can save your life. Once a month, after a bath or shower, stand in front of a full-lenght mirror and check yourself.

  1.     Avoid sun at midday (between 11 am and 3 pm)
  2.     Use sun screen daily and with > 30 SPF
  3.     Apply sun screens 20-30 minutes before sun exposure
  4.     Wear a hat or a cap to protect your head
  5.     Wear sunglasses to protect your eyes!
  6.     Drink enough water (make sure you are hydrated)
  7.     Avoid artificial sun light (sun beds/tanning salons)!
  8.     Arrange regular dermatologic skin exams with your specialist/GP!


Enjoy the Summer and the Sun with the correct protection!

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Pancreatic Cancer: there is still a lot to do

Last week I was attending a lecture at the University when the word “pancreatic cancer” came out. Since then, I realized that I do not have too much knowledge about pancreatic cancer but I would like to know more about it and understand all the mechanisms behind this disease.

In this post I will try to explain you more about this lethal type of cancer, its treatments and its incidence amongst the public.

Pancreatic cancer is the fifth most lethal cancer in the UK with a survival rate of 4% after five years of being diagnosed. It is not a common type of cancer and its detection tends to be late, meaning that it is often too late for treatment.

Pancreas

Pancreas | Macmillan

Pancreas | Macmillan

The pancreas forms part of the digestive system. It is a gland located in the upper half of the abdomen.

It lies behind the stomach and just in front of the backbone and it is surrounded by the small bowel, the liver, the spleen and the gall bladder.

 

The pancreas has two main roles:

  • Exocrine function: produces enzymes that help to digest food.
pancreas and gall bladder ducts

Pancreas and gall bladder ducts | St. Francis Care

When we eat food, exocrine glands secrete enzymes (pancreatic juices), which travel through small tubes (ducts) along the pancreatic duct.

The latter joins to the bile duct – which carries bile from the gall bladder and the liver – and released the content into the duodenum (small intestine). Once inside the duodenum, these enzymes help to digest proteins, carbohydrates and fats.

  • Endocrine function: involved in hormones production.

The two main pancreatic hormones are: insulin and glucagon. Both are produced in the Langerhans cells and secreted into the bloodstream.

Insulin helps to decrease the level of glucose in the blood, whereas glucagon increases it. In addition, insulin enables the body to use sugars and store fats.

Both hormones work together to keep the level of glucose in the blood constant and stable.

 

Pancreatic Cancer

Risk factors and causes of pancreatic cancer
About 8,000 people are diagnosed with pancreatic cancer in the UK each year.
We don’t know what causes it to develop, but research into this is ongoing.

The common risk factors of pancreatic cancer are:

Risk factors of pancreatic cancer | National Cancer Institute (US)

Risk factors of pancreatic cancer | National Cancer Institute (US)

  • Age.
  • Smoking and tobacco.
  • Diet.
  • Alcohol.
  • Body weight and physical activity.
  • Chronic pancreatitis and diabetes.
  • Family history.

 

Symptoms of pancreatic cancer
The most common symptoms are:

  • Pain in the upper abdomen.
  • Weight loss.
  • Jaundice.

However, pancreatic cancer may not cause any symptom for a long time or just one.

 

Types of pancreatic cancer
Any region of the pancreas can be affected by cancer, but 80% of pancreatic cancers start in the head of the pancreas.
Although there are various different types of pancreatic cancer, the most common type (95%) is ductal adenocarcinoma.

Other – less common – types of pancreatic cancer include:

  • Cystic tumours: some fluid-filled sacs in the pancreas are cancerous.
  • Acinar cell carcinomas: the cells that make pancreatic juice become cancerous.
  • Neuroendocrine tumours: the endocrine cells become to be cancer cells.
  • Lymphoma: it is a cancer of the lymphatic tissue in the pancreas.

 

How pancreatic cancer is diagnosed
Pancreatic cancer is difficult to diagnose because the symptoms can be similar to other common diseases.
The first thing to do when feeling bad is seeing your GP (general practitioner). There are some steps (tests) that are followed after that:

  • Ultrasound scan: painless test that uses high frequency sound waves to create images of organs and structures inside the body.
  • CT scan (computerised tomography): imaging method that uses x-rays to create pictures of cross-sections of the body.
  • Endoscopic ultrasound (EUS): medical procedure in which endoscopy is combined with ultrasound in order to obtain images and information about the digestive tract and the surrounding tissue and organs.
  • MRI scan (magnetic resonance imaging): radiology technique that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body.
  • Biopsy: medical procedure that involves taking a small sample of tissue to be examined.
  • Blood tests
  • Laparoscopy: surgery that uses a thin, lighted tube put through a cut (incision) in the belly to look at the abdominal organs or the female pelvic organs.
  • Laparotomy: invasive surgical procedure performed on the abdomen.

 

Treatments for pancreatic cancer

Surgery for pancreatic cancer
Not every patient with this disease can undergo surgery to have the pancreatic tumour removed. Only those who are in an early-stage of the cancer are suitable candidates. And, occasionally, the whole cancer can be removed amongst these patients.

However, depending on where the cancer is and how much of the pancreas is affected, the surgery is different:

  • Whipple procedure (pancreatoduodenectomy).
  • Total pancreatectomy.
  • Distal pancreatectomy.

The surgery can be used to relieve symptoms when the bile duct or the small intestine is blocked.

It is important to bear in mind that all the treatments have their own risks and benefits, which should be discussed with the surgeon before taking any decision.


Radiotherapy
This treatment is based on high-energy X-rays that destroy cancer cells, and tends to do little harm to normal cells.
It is used less often than the surgery or the chemotherapy. When used, it targets the cancer that has not spread out but which cannot be removed by surgery.

Types of radiotherapy

  • External beam radiation therapy: the radiation is originated from a machine outside the body.
  • Brachytherapy: radio active pellets.
  • Chemoradiation: when chemotherapy is given together with radiotherapy.
  • Palliative radiotherapy: it is often used to treat pain and is given at lower doses in a shorter course of treatment.

Radiotherapy is given in the hospital and the treatment varies depending on the patient’s particular needs.

Side effects

  • Feeling sick (nausea).
  • Vomiting.
  • Diarrhoea.
  • Tiredness.

Nevertheless, these side effects depends on how much treatment you are having.


Chemotherapy

This is another treatment to destroy cancer cells using anti-cancer drugs.
It is one of the most commonly used treatments for pancreatic cancer.

In addition, chemotherapy may be given after surgery to reduce the cancer as well as the possibility of recurrence.

Types of administration

  • Tablets.
  • Systemic chemotherapy. 
  • Regional chemotherapy.
  • Small portable pump: the amount of drug given into the bloodstream is controlled over a controlled period of time.

The treatment given is so that the patient has to spend the shortest time possible at the hospital. 
The problem is that chemotherapy destroys either cancer cells or normal cells in the body because its administration is through the bloodstream.

Side effects

  • Risk of infection
  • Sore mouth
  • Diarrhoea, nausea and vomiting
  • Hair loss
  • Skin changes: rash or dry skin, which might be itchy.
  • Sore hands and feet
  • Numbness or tingling in hands or feet

 

Interesting video to watch as a summary of all the information explained above.

 

Drug treatments and Clinical trials

Drug treatments

  • Gemcitabine is the most common drug treatment (intravenous infusion) used in chemotherapy. Another drug used after surgery is fluorouracil (5FU), called capecitabine when is given as a tablet.
  • FOLFIRINOX is a three-drug combination chemotherapy treatment (5FU, irinotecan and oxaliplatin) in combination with folinic acid (leucovorin) to be used for advanced pancreatic cancer. Its effects last for a longer time when compared to standard treatment with Gemcitabine. Nevertheless, it causes much more severe side effects than Gemcitabine.


Clinical trials
The drug treatments are not good enough for pancreatic cancer and people still die from it. Because by the time the diagnosis is made, the cancer has already spread.

Further investigation in finding potentia treatments and biomarkers to detect this disease earlier is needed.

Many research trials into pancreatic cancer are:

  • Improvement of the screening test for high-risk people.
  • Treatment improvement: for example,  by combining chemotherapy with other treatments such as radiotherapy, vaccines or targeted therapies.

According to pre-clinical results at the Sidney Kimmel Comprehensive Cancer Center, a new therapy option for patients with pancreatic cancer might be the combination of two drugs that simultaneously block two major signalling pathways downstream the KRAS protein.

Mice experiments | Nature

Mice experiments | Nature

Recently, British scientists at the Cancer Research UK Cambridge Institute have discovered that cancer cells form a protective barrier around the tumours. This new drug (AMD3100) could help to break down this barrier and allow the immune system to attack cancer cells. The development of the drug is still in its early phase – experiments on mice have been performed – and has to be tested on humans. But if the clinical trials are successful, the anti-cancer treatment for patients with pancreatic cancer could be available within a decade.

 

This just reminds me that a lot of work has to be done and researchers have a long way journey until they find (almost) the perfect treatment. But being positive, lots of advances have been made until now. We have just to keep going on!

 

Finally, this video down here shows Jack Andraka, a young boy from Maryland who wants to find a faster, better and cheaper test for pancreatic cancer. A very close friend of him died because of this disease and he decided to investigate “why are we so bad at detecting pancreatic cancer.” The answer was that the current method was old, extremely expensive and inaccurate.

In preliminary tests, Andraka’s method shown 100 % accuracy, being able to find pancreatic cancer in early stages only for a cost of 0.03$. His discovery was a breakthrough in pancreatic cancer screening tests and his speech caused furor amongst the audience!
His enthusiasm towards the topic motivates, without a doubt, those who watch the video. This is the kind of people that science needs: people who want to change the world.

 

A protein secreted by healthy cells would explain tumour resistance

At some point, you may ask why chemotherapy is not as effective as it should be.

Chemotherapy | Wired

Chemotherapy | Wired

 

Why 90% of some cancers – e.g. breast, prostate, lung or colon cancer – develop resistance to chemotherapy above others, instead of stopping its development or making it slower?

 

 

Experiments in the laboratory seem to “cure” most of the cancers by administrating high doses of toxic therapies.
However, when these treatments are translated into patients, high doses of drugs not only kill the cancer cells but also normal cells.

Moreover, you might have heard that, “cancer has reversed the treatment.“

The truth is that, even the tumour has responded well initially, after a period of time it becomes resistant to chemotherapy. And this is because chemotherapy treatments are given in cycles or intervals and in small doses in order to allow normal cells – and also the patient – to recover from the toxicity of the anti-cancer therapy. But in that way not all the tumour cells die. Those tumour cells that survive become resistant to further rounds of anti-cancer treatment.

 

A team of scientists at the Fred Hutchinson Cancer Research Centre in Seattle were seeking ways to explain why cancer cells are so resilient inside the human body when they are easy to kill in the lab. As a result of their study, the key factor that triggers drug resistance has been found.

This shocking study states that chemotherapy, long considered one of the most effective cancer-fighting treatments, can make cancer worse. Therefore, this new finding provides valuable information to improve the effectiveness of therapy and save time for patients with cancer in a late stage. Developing cancer resistance to chemotherapy is a lethal consequence that needs to be avoided.

It is thought that chemotherapy inhibits the reproduction of fast-dividing cells such as those found in tumours. However, it can affect other cells: particularly those healthy cells in and around the tumours.

 

One year ago, researchers in the United States published in the journal Nature Medicine a study about the effects of chemotherapy on tissue from men with prostate cancer. They discovered that healthy cells showed evidence of DNA damage after treatment.

Fibroblast | Withfriendship

Fibroblast | Withfriendship

This damage can be explained by looking at the fibroblast cells, which are the main component of connective tissue (e.g. tendons) and their function is to maintain cells’ integrity and structure. But when fibroblasts are exposed to chemotherapy, their DNA is damaged promoting the production of growth factors that stimulate cancer growth.

Especially, when healthy cells are damaged by chemotherapy, a protein from the WNT family – WNT16B – is overexpressed.

When WNT16B is secreted, it would interact with nearby tumour cells enabling cancer cells to grow, invade surrounding tissue and leading to resist the subsequent therapy.

Peter Nelson, the co-author of the article, says that “the tumour microenvironment can also influence the success or failure of these more precise therapies.”.

In summary, when cancer cells are exposed to different microenvironments, they might respond differently to the treatment. Due to healthy cells surrounding the tumour can also help the tumour to become resistant to the treatment.

These findings were also tested in breast and ovarian cancer tumours with the same results.

A cancer treatment overview should follow these key points:

  • Identify WNT16B role in cancer.
  • WNT16B antibody given with chemotherapy to improve responses.
  • Administrate small doses (less toxic) of treatment.
  • Find a way to block microenvironment response from the cells around the tumour.

 

Last but not least, not everything is related to “conventional medicine”.
Natural alternatives existed and still exist – for instance, eating some food products: broccoli, ginger, food rich in vitamin D, etc. – but they do not receive any special mention or funding like pharmaceutical drug companies or other organisations because there is no space for benefits. It is important to think about it for a while…

Finally, this video will help you understand better my post.

Cholesterol and Breast Cancer

Two months ago I read an article about cholesterol and breast cancer. Its main conclusion was that a by-product of cholesterol – which functions as the hormone estrogen – fuels the deadly growth and spread of breast cancer.

First of all, before introducing you to the article’s topic, I would like to put you in context about cholesterol and breast cancer.

 

Cholesterol
Cholesterol is a lipid (fat) produced by the liver and transported into the blood plasma. It is a waxy steroid vital for normal body function and, moreover, every cell in our body has cholesterol in its outer layer.

However, an excess of cholesterol leads to its combination with other substances and the posterior attachment to the walls of the arteries.

Types of cholesterol
Cholesterol is carried in the blood by molecules called lipoproteins, which are complexes or compounds containing both lipids (fats) and proteins. There are three main lipoproteins:

  • LDL (low density lipoprotein): carries cholesterol from the liver to the cells, but an excess of it can be harmful. It is also called bad cholesterol.
HDL and LDL cholesterol. Best Health Nutritionals.

HDL and LDL cholesterol | Best Health Nutritionals.

  • HDL (high density lipoprotein): does the opposite of LDL. Takes the cholesterol away from the cells and back to the liver, where it is broken down or expelled from the body (waste). It is also called good cholesterol.
  • Triglycerides.

High levels of cholesterol in the blood can increase your risk of cardiovascular disease because of this plaque formation (atherosclerosis). Cholesterol levels tend to rise as you get older, but it can be controlled and detected with a blood test.

Below is a list of cholesterol levels, LDL levels and HDL levels in mg/dl (milligrams/deciliter):

Cholesterol levels:

  • Desirable: less than 200 mg/dL.
  • Midly high cholesterol levels: 200 to 239 mg/dL.
  • Very High: 240 mg/dL and above.

LDL levels

  • Desirable: less than 100 mg/dL.
  • Midly high LDL levels: 130 – 159 mg/dL.
  • High: 160 – 189 mg/dL.
  • Very high: 190 mg/dL and above.

HDL levels

  • Desirable men HDL levels: above 40 mg/dL.
  • Desirable women HDL levels: above 50 mg/dL.

HDL levels 60 mg/dL or above help to protect against cardiovascular diseases.


Causes and Treatments

Causes

  • Lifestyle: nutrition, sedentary life, body weight, smoking, etc.
  • Diabetes
  • High blood pressure

Treatments

  • Lifestyle: exercise, equilibrate diet, avoid saturated fat food and alcohol and sleep well (8 hours).
  • Cholesterol-controlling medications: statins, aspirin, anti-hypertensive drugs.

This will decrease the LDL/HDL ratio and will reduce the risk of cardiovascular diseases.

Video

 

Breast Cancer

Breasts

Breast view. Macmillan

Breast view | Macmillan

The breasts are two organs formed of mammary glands, which contain lobes.

The lobes (milk glands) are where breast milk is made. They are connected to the nipple by a network of fine tubes called milk ducts. Mammary glands also have nerves and blood vessels.

These glands are made up of fat, supportive (connective) and glandular tissue and connected to the lymph system.
The skin recovers and protects all the mammary structure.

Breast cancer is an abnormal and uncontrolled growth of the cells in that tissue.

Breast cancer tumours in women are mainly benign (non-carcinogenic) due to fibrocystic breast disease. It is like a fluid-filled cystic lump.
Fibrocystic breast disease does not increase the risks of developing a tumour and it does not need special treatment. However, it can be painful and the liquid can be removed using a needle.

Types of breast cancer
Breast cancer is classified in the following groups:

  • Ductal carcinoma in situ (DCIS)
  • Lobular carcinoma in situ (LCIS)
  • Invasive breast cancer
  • HER2 positive breast cancer
  • Inflammatory breast cancer
  • Rarer types of breast cancer

Many breast cancers are sensitive to estrogen hormones, meaning that this hormone triggers breast cancer development. These cancers have estrogen receptors on the cell surface and are called ER positive breast cancer.

Breast cancer in men
Breast cancer also affects men, but in a lower percentage (1%) compared to the female population. The symptoms are similar to those in women and the diagnosis and treatment is exactly the same.

Men breast cancer detection takes place in a later stage due to its infrequent appearance.


Risk factors

  • Age and sex: people aged over 45 are at risk.
  • Heredity: you have a higher risk to develop breast cancer if someone in your family had it.
  • Genes (mutations): BRCA1 and BRCA2 are the most common mutated genes in breast cancer.
  • Exposure to carcinogens.
  • Obesity.
  • Others

Early detection and screening
Diagnosis and treatment are different depending on risk factors and women phase of development. The earlier a breast cancer is diagnosed and treated, the better the chance of successful treatment.
You can improve your chances of finding breast cancer at an early, curable stage just by checking your breasts regularly for lumps and other changes.

If you’re in your mid-twenties onwards, you should become familiar with how your breasts look and feel at different times. Familiarize yourself with your breasts and look for any changes that might indicate an anomaly.

You can read about what to look out for in the section on symptoms at Macmillan website.

NHS Breast Screening Programme
Women in the UK at higher risk of developing breast cancer because of their age or family history are eligible for regular breast screening as part of a national screening programme.
Also, women aged between 50–70 are offered mammograms (breast x-rays) every three years as part of the NHS Breast Screening Programme.

In England, the age range is gradually being extended to include women aged between 47–73.

Video


To know more about breast cancer, there are a few pages that you would like to see:

http://www.macmillan.org.uk/Home.aspx

http://www.breastcanceruk.org.uk/

http://www.breastcancercare.org.uk/

http://www.breastcancer.org/

 

After explaining you some things about cholesterol and breast cancer, and hoping that you have understood (almost) everything, I will let you know what some researchers at the Duke Cancer Institute have reported two months ago in the Science magazine.

They have found that a by-product of cholesterol (27HC) mimics the estrogen hormone fuelling the growth and spread of one of the common types of breast cancers. 

For the first time, these findings explain the link between high cholesterol and breast cancer, especially in post-menopausal women that are over-weight. This is due to the fact that women suffering obesity generate high amount of estrogens, a hormone related with 75% of breast cancers.
The results of the study rely on mice and cancer tissue and, although these results are made at an early stage, the researchers suggest that diminishing cholesterol levels in the body by dietary changes and/or by statins might reduce breast cancer risk.
McDonnell and colleagues have demonstrated that the molecule 27HC (27-hydroxy-cholesterol) is directly involved in breast tumour growth, as well as in the aggressiveness of the cancer to spread to other organs.

Macrophages of the immune system and breast tumours create a metabolic symbiosis. This symbiosis leds tumours be able of producing an enzyme that converts cholesterol to 27HC, which triggers the growth and spread of cancer. This means that the tumours have developed a mechanism to feed their own growth. A post-doctoral associate at Duke said that, “the worst the tumours, the more they have of the enzyme.”

High levels of 27HC have been observed in breast tissue from women affected by this cancer.

Cholesterol is broken down into 27HC molecule, which can mimic estrogen and produce the same effect as this hormone in some tissues.

Mice experiments demonstrated that a high fat diet increased levels of 27HC in the blood. Human breast cancer tissue also grew more rapidly in the laboratory when it was fed with 27HC. However, inhibition of the cholesterol metabolite activity occurred when the animals were treated with anti-estrogens or when supplementation of 27HC was stopped.

It is unlikely that post-menopause women suffer this type of breast cancer, sensitive to estrogen hormones because estrogen production is reduced after menopause. Nevertheless, 27HC molecule appears to mimic estrogen-like protein producing the same effect and provoking cancer development.

They also have found that anti-cholesterol drugs such as statins seem to decrease the effect of the estrogen-like molecule. 

It is a significant finding because it states a simple and accessible way to reduce breast cancer risk in women by reducing cholesterol levels, especially relevant to post-menopausal women with obesity.

A reduction in the cholesterol levels or the inhibition of 27HC oxidation should be considered as alternative strategies to prevent and/or treat breast cancer.
Although statins are taken to reduce the risk of heart disease, there are studies suggesting that statins can also decrease the risk of breast cancer.
However, do not forget that far from pharmacological strategies, following a Mediterranean diet might have a positive impact on cholesterol bloodstream levels.

Additionally, taking statins might delay or prevent resistance to endocrine therapies such as tamoxifen or aromatase inhibitors for those women who have breast cancer and high cholesterol.

Moreover, it is important to:

  • Clarify the exclusive pro-tumor role of the 27HC molecule in breast cancers that are not ER positive in post-menopausal women.
  • Know how adding statins to the current therapies for breast cancer patients might affect the outcome of the treatment.

Thus, further clinical studies to determine whether 27HC plays a role in other cancers should be performed.

Papillomavirus & Cervical Cancer

Last month, I read in the Daily News this headline: ‘One dose of HPV vaccine may prevent cervical cancer: study

The official recommendation about papillomavirus vaccine indicates that you should receive three injections within one year. However, an American study has shown that women could be protected against the virus just with the first dose.

The data from the study was taken from a previous test to evaluate the efficiency of Cervarix® (one of the two authorized vaccines against the HPV) in women from Costa Rica.

One dose may be enough to prevent cervical cancer

Cervical cancer: one dose may be enough | Lewis Whyld (EFE Press Agency)

This study, published in the Cancer Prevention Research journal and elaborated by researchers at the NCI (National Cancer Institute) in the USA, shows that four years after the first dose, the antibody levels against the HPV (human papillomavirus) were high and stable. It is true that they were lower than those in women who received two and three doses, but enough to protect them.

Thus, the researchers suggest that a simplified vaccination schedule could be cheaper, simpler and easier to implement around the world. Above all, this implementation would be useful in countries with fewer economic resources where cervix cancer represents a big public health problem (85%).
Nevertheless, more studies are needed to confirm these results before changing the official vaccination schedule.

It is important to mention that this study was carried out only with Cervarix®, one of the two vaccines used against HPV type 16 and 18. The other vaccine, Gardasil®, used widely in the USA and other countries, prevents against four strains of this virus.

Basics about Papillomavirus

Papillomavirus (HPV) is a group of 150 types of viruses, from which more than 40 types can be transmitted sexually. Some of them can cause genital warts (low risk HPV); whereas others – called high risk HPV or oncogenic – can cause cancer.

There is not a reliable way to predict who is going to have HPV and who is not. In the majority of cases, HPV disappears without causing any type of health problem and infected people with HPV even notice that because it does not present any symptoms.
Sometimes, HPV infections can last several years. Persistent HPV infections (high risk) can cause cell anomalies and are the principal cause of cervical cancer.

The FDA (Food and Drugs Administration) from the USA has approved two vaccines, Gardasil® and Cervarix®, which are really effective to prevent the infection from two types of HPV that cause the majority of cervical cancer.

Gardasil, however, also prevents the infection from two types of HPV that cause the majority of genital warts.

 

Some questions that you might ask . . .

Who is at risk?
Everybody who has (or had) sexual relations can get the virus (HPV). This virus is so common that almost everybody (woman and man) sexually active can get it at some point of their lives.


Which is the relation between the HPV infection and cancer?
The persistent HPV infections are considered the main cause of every type of cervical cancer and the majority of anal cancer cases.
It has been calculated that the HPV infection represents the 5% (approximately) of all the world cancers.


Are there any specific types of HPV related to cancer?
Both the high risk and the low-risk HPV can cause an abnormal growth of cervix cells, but only the high-risk types of HPV result in cancer.

It is important to mention that high-risk HPV infections disappear and do not cause cancer.

Molecular structure of papillomavirus

Molecular structure of papillomavirus | The Healthy Back Blog (modified)

 

It has been identified 15 types of high-risk HPV. Types 16 and type 18 together cause around 70% of all cervical cancers. In addition, the high-risk HPV infection by type 16 causes 85% of anal cancers.

It is possible that, according to the geographic region, there are a variable proportion of cancers caused by HPV.


Which are the risk factors of HPV infection and cervical cancer?

  • Having a lot of sexual partners/couples.
  • Smoking.
  • Having a lot of kids.

These two latter are factors that increase risk of cervical cancer in women who are persistently infected by high risk HPV.

 

How to avoid the HPV infection?

  • Avoid sexual and genital contact with another person.
  • Correct and constant use of condoms (however, do not provide an entire protection).
  • Vaccines:
  1. Gardasil® and Cervarix®: Both are effective to prevent infection of HPV type 16 and HPV type 18. These types cause the 70% of cervical and anal cancers.
  2. Gardasil also prevents against the infection of HPV type 6 and type 11. These types cause the 90% of genital warts.

 

How are these infections detected?

  • Papanicolaou test or Pap test: is a screening test that checks for changes in the cervix.
  • DNA test: looking for the viral DNA of the virus. Extractions of cervix cells to examine and identify different types of high risk HPV that might be present.

When the results show anomalies in the Pap test women are monitored in order to evaluate the progression of the infection.

Nowadays, there are no approved tests to detect the infection of HPV in men.

Diagnosis and Treatments

The diagnosis of cancer always requires a biopsy of the tumor to do a histologic study to verify the stage of differentiation as well as to determine biological and genetic markers.

In order to measure the cancer development, clinicians also use:

  • Physical exploration.
  • Radiography.
  • NMR (nuclear magnetic resonance).
  • CT (computational tomography).
  • Other techniques.
Nuclear Magnetic Resonance (NMR)

Nuclear Magnetic Resonance (NMR) | MagLab

 

There is a technique called TNM (tumour, nodules, metastasis), which classifies the progression of cancer using the size and extension of the primary tumour, the lymphatic affectation and the presence of metastasis.

 

 

According to the treatments, these can be used alone or together according to the type of cancer. The aim of all treatments is to eliminate the tumour and cure the patient in early stages.

There are mainly three kinds of treatments:

  • Surgery: removes the tumour in part on in its entirety.
  • Radiotherapy: exposes the tumour to radioactivity to prevent the cancer cells to multiply.
  • Chemotherapy: administration of (chemical) substances to destroy cancer cells or prevent them from spreading.

Chemotherapy and radiotherapy act on cancer cells as well as on normal cells (healthy cells), which explains the side effects.

However, the scientific community is improving new therapies and new mechanisms to defeat all types of cancer such as biological therapies, hormonal therapies, stem cells and bone marrow transplants and also supportive therapies.

To go into more detail, I am going to further explain these treatments deeply.

Surgery
Surgery is used when tumours are small and located in a specific site. Part of the tissue that is around the tumour is removed to make sure that all cancer cells have been eradicated.
If cancer has reached other areas, through the blood or the lymphatic system, other treatments should be applied.


Radiotherapy
Radiotherapy uses high-energy particles that interact with the cells in our body.
Human cells are sensitive to this radiation and at high doses can kill any cell. Therefore, the energy is directed towards the cancer cells, but it may also affect the immediate surroundings. Each session lasts 20 minutes and zones where the radiotherapy is going to be applied are marked whereas the other areas are protected.

Radiotherapy

Radiotherapy | Liquidarea

 

This treatment can be a unique treatment in cases where tumours are especially sensitive to radiation and have not reached other areas. Also, radiotherapy can be used before surgery to decrease the size of the tumour and make the extirpation easier.

 

 

Chemotherapy
Chemotherapy uses medicines which function is to eliminate, harm or delay the growth of cancer cells. The problem is that these medicines act, above all, against cancer cells but also have an effect in normal/healthy cells.

The action takes place in cells which division is fast, thus interrupting their growth. Other chemotherapeutics change the environment conditions (i.e. negative for these cancer cells).

Last years, a combination of chemotherapeutics has been used because it has been shown that a combined/joint action is more efficient in destroying the tumour. These combinations try to be more efficient in terms of cancer cells and less harmful to normal cells.

There are different ways of having chemotherapy:

  • Oral tablet.
  • Intravenous or intramuscular injection.
  • Bone marrow puncture.

Because of its high side effects, chemotherapy is administrated in cycles with a rest period in between. In this period, there is an hematologic recover given that during chemotherapy the bone marrow – where blood cells are produced – is affected.

Side effects

  • Vomits.
  • Nausea.
  • Diarrhea.
  • Ulcers in the mouth.
  • Temporary loss of hair
  • Anemia and fatigue.

However, side effects depend on the type of medicine is administrated, its duration and the general state of the patient.

combined radiotherapy and chemotherapy treatment is also possible: sometimes chemotherapy is used before radiotherapy to make the cancer cells sensitive to the radiation. However, other times radiotherapy is applied to make sure that all cancer cells are eliminated.


Bone marrow transplant
It takes place when there is a damage/harm in the bone marrow that blocks normal functions such as the generation of blood which is important and fundamental for the human life.

Chemotherapy is administrated to destroy cancer cells but sometimes can damage the bone marrow and other organs.

Generally, doctors and clinicians do not use high doses of chemotherapy. However, when cancer does not disappear with a moderate dose it requires the administration of a higher dose (sometimes in combination with radiotherapy). This higher dose will destroy the bone marrow and that is why  a bone marrow transplant is needed.

Bone marrow stem cells transplant

Bone marrow stem | Medindia

One method is using stem cells to produce blood cells. The patient has to be anesthetized because a litter of bone marrow has to be extracted – to get a sufficient number of stem cells – from the body by multiple punctures.

Another method consists in using cytokines, which allow peripheral blood stem cells to be collected (leukopheresis).

 

Once these stem cells are extracted they are placed into a transfusion bag in order to be administrated via intravenous to the patient.

Sometimes, this is the only possibility to cure patients with leukaemia and other illness such as malignant lymphoma, bone marrow aplasia, etc.

There are two types of stem cell transplant:

  • Allogeneic stem cell transplant: the transplant cells (bone marrow or peripheral blood) come from a donor (relative or not) whose tissue is almost identical to the patient’s tissue.
Allogenic stem cell transplant

Allogenic stem cell transplant | Bone Marrow MX

  • Autologous stem cell transplant: obtain bone marrow from the own patient and keep it frozen (-200oC) to carry out the transplant after the administration of a higher dose of chemotherapy.
Autologous stem cell transplant

Autologous stem cell transplant | Bone Marrow MX

 

This latter is carried out just when it does not exist a possible donor or the risk is too high to do an allogeneic transplant (rejection).
If the patient has not a twin, the probabilities to find a compatible donor are not higher than 35%.

Once the transplant is done, it takes 3-4 weeks for the bone marrow to recover completely.

 

Due to the higher risk of infections and hemorrhages, the patient stays in the hospital in order to receive transfusions, antibiotics and treatments to stimulate the growth of granulocytes (immune system cells).

Influences and Risk Factors about Cancer

Cancer is a complex and diverse disease. There are different influences and risk factors, which can promote the starting process or accelerate it. However, others can reduce its progress.

I would like to summarize some of the influences and risk factors you should take into account when talking about cancer.

The rate of cancer incidence mainly depends on:

  1. The environment.
  2. The lifestyle.
  3. The diet.

These are the three common factors that influence the development of cancer.

For example, it is reported a high incidence of stomach cancer in Japan. This is due to the high consumption of uncooked food, especially fish (i.e. sushi). However, in Kuwait it is the other way around.
I should also mention that Japan has a low incidence in skin cancer. Nevertheless, Australia has the highest.

In our daily lives we are exposed to the environment, specific from where we live, in which there are positive as well as negative factors. The following ones are risk factors that we should take into account:

  • Hereditary genetic anomalies.
  • Exposure to some viruses: VIH, Hepatitis B and C, Papilomavirus, Epstein-Barr virus.
  • Exposure to toxic agents, radiation and sun.
  • Diet too rich in fat and low in fruit and vegetables.
  • Tobacco and alcohol consumption.
  • Stress.

Generally, the cancer is manifested in advanced stages. It is a mutational process that accumulates in time, although there are always exceptions.

Over 25 million people are affected by cancer and 7 million die each year from it. The cancer disease has the leading cause of mortality for those under 25 years old.

 

Case Study: Lung Cancer and Pollution

Concerning exposure to toxic agents such as pollution, I read a few weeks ago that the youngest lung cancer patient was an eight-year-old Chinese girl. This girl lives near a busy road in the province of Jiangsu. She was exposed to a high level of particles and dust throughout her entire life.

Among these particles, the smallest and most dangerous type of airborne particles are the so-called PM2.5, which go directly to the bloodstream. During two weeks, some zones of Harbin (a city in China) had reached the level of 1,000 micrograms per cubic meter in the atmosphere (40 times WHO’s recommendation), becoming a “smoke city” where the visibility was reduced and even some roads and airports were closed.

There is a link between high levels of PM2.5 and health problems, including lung cancer and heart disease.

The average age of lung cancer diagnosis is about 70 (according to the American Cancer Society). Thus, lung cancer cases among children are extremely rare.

The fast process of industrialization and urbanization it is behind the huge growth in China. Not only has put off 400 millions of Chinese people from poverty, but also has been the factor which has destroyed their environment.

Lung cancer deaths in China have multiplied over the past 30 years (it was reported an increase of 56% between 2001 and 2010), being lung cancer the reason of the highest mortality in men. Indeed, cancer is the main cause of death in Eastern Asia.

Read more: http://www.nydailynews.com/life-style/health/china-youngest-lung-cancer-patient-8-years-old-article-1.1507272

Types of Cancer

Cancers are classified according to:

  • Site: part of the body where cancer first develops (primary site).
  • Cell type: which type of cell the cancer started from.

A. Cancer by site

  • Skin.
  • Lungs.
  • Breasts.
  • Prostate.
  • Colon and rectum.

B. Cancer by cell type

  • Epithelial: cells that cover the outside part of the body (skin) and make tissues covering the organs.
  • Mesenchymal: connective tissue cells which functions are to support and connect tissues such as muscles, bones and fatty tissue.
  • Mesenchymal and hematopoietic: cells from the blood and lymphatic system.
  • Neuroectodermal: cells from the peripheral and central nervous system.
Cancer cell types

Cancer cell types classified according to their origin | Biology of Cancer (University of Barcelona)

 

Depending on where cancers start in each of these cell types, a different name is given:

1. Carcinomas
This type of cancer starts in epithelial cells. The majority of tumours come from epithelial cells (85%). However, there are different types of epithelial cells:

  • Squamous cells
  • Adeno cells.
  • Urothelial cells (transitional).
  • Basal cells.

2. Leukaemias and lymphomas
Leukaemias are developed in the blood and bone marrow (site where white blood cells are formed to fight infection in the body). In contrast, lymphomas are formed in the lymphatic system (part of the body which helps to fight infection).
These types of cancers only represent the 7%.

3. Sarcomas
In this case, the cancer starts in connective tissue cells. Sarcomas are quite rare (1% of cancers) and are divided in two types:

  • Bone sarcomas: found in the bones.
  • Soft tissue sarcomas: developed in other body supportive tissues.

4. Others
Other cancers can develop in other types of cells such as brain cancers.

 

For more information about cancer types, see this website: http://www.macmillan.org.uk/Cancerinformation/Aboutcancer/Typesofcancer.aspx

 

Primary tumors and their metastatic tropisms

Primary tumors and their metastatic | The Biology of Cancer (Weinberg)

In this picture, I would like to show you the association between different types of tumours. You can observe that primary tumours also have their metastatic tropisms.

The most common affectation in prostate cancer and breast cancer is the bone marrow.
In colon cancer and pancreas cancer it is common to find tumours in the liver.

 

Thanks to different techniques, it can be known whether a tumour is a metastasis of another. For example, we can associate that a brain cancer is a metastasis from a breast cancer.

The most wide spread types of cancer are:

  1. Lung cancer.
  2. Breast cancer.
  3. Colorectal cancer.
  4. Stomach cancer.
  5. Prostate cancer.

Basics about Cancer

Normal cells and Cancer Cells

The human body is formed by 60,000 billions cells. The cell is the simplest element with life that forms the tissues and the organs.

The cellular membrane of the cell protects and separates it from the environment. Inside the cell there are different components: one of them is the nucleus where the DNA is kept.

The cell division is controlled and organised in normal cells. The cells split into two and replace those cells that are defective or dead. Their aim is to preserve the shape of the tissues and respect their functions. Every cell has a cellular life program to grow and die.

division

Cellular division | Inteldig

The lifetime of the cell depends on the DNA. Some cells have shorter lifetimes such as the cells from the intestine, which existence last about two weeks; in contrast, red blood cells live for three months.

The nucleus has chromosomes that contain genes made of DNA. Sometimes these genes undergo a change (mutation). Then, the cells multiply uncontrolledly: each new cell produced contains the same mutation. Those cells progress chaotically and form a tumour.

Cancer cells have different features: distinct shape, bigger or smaller nucleus, etc. These cells are unable to do their normal functions. Generally, their cell division is faster than the normal cells because of the loss of growth control.
However, sometimes these cancer cells just simply die or are destroyed by the lymph nodules (immune system). But often these cells are alive and start to divide, multiply and grow.

What is Cancer?

Cancer is a disease where normal cells from our body lose both proliferation and growth control. Cancer comes from normal cells, which have been transformed (changed) into tumour cells.

primary-secondary tumor

Metastasis spreading | Nature Reviews

Cancer cells have different features, being invasive one of them. They are able to go to other tissues, migrate to the bloodstream and produce metastasis.

A metastasis is a malignant tumour which cells, derived from itself, are located in a different site.

How and why a normal cell becomes a cancer cell

When a tumour grows, if there is not angiogenesis, the distal cells will die because of no irrigation.

cancer angiogensis

Angiogenesis process | Buzzle

The tumour cell forms new blood vessels (angiogenesis) to survive. These blood vessels will supply the tumor with oxygen and nutrients. Some of them are also able to escape.
The tumour becomes dangerous when the cancer cells invade adjacent areas through the vessels and spread into surrounding organs.

Cancer cells, mainly, segregate two types of proteins which permit their entrance into the bloodstream:

Proteases: break the basal lumen and enable the cells to migrate to other tissues.

Integrins: promote adhesion between cells – cells and tissues.

metastasis process

Metastasis process | Nature Reviews

The metastasis is the term used for the spreading process that follows the next steps:

  • Local invasion.
  • Intravasion.
  • Survival in the bloodstream.
  • Extravasion.
  • Colonization.

 

 

Take a look at this video from YouTube. It is very useful to understand the progress from a healthy cell to a tumour cell.

The Big van Theory

Surely most of you thought that the title of this article was “badly” written. The curiosity of discovering what is wrong draws your attention to the following story.

Some of you have probably heard, listened or overheard someone talking about the American TV show The Big Bang Theory. If it is not the case, I will put you in context. The TV show is about the life of two physicists (Sheldon and Leonard) and how their lives change since Penny (waitress and actress) becomes their new flatmate and, at the same time, part of their social life.

Captura de pantalla 2013-10-24 a las 13.22.10

The Big van | Thebigvantheory

Without going into further detail, a group of Spanish researchers – which was created as a result of the scientific competition  Famelab – had the idea to start (in March 2013) a tour around different Spanish cities performing the play “Monologues about science” inside the title The Big Van Theory. For those who do not know this contest, the Famelab is a science competition created in 2005 inside the Cheltenham Festival Science in the UK. It is supposed to be the basis of inspiration and motivation for those young scientists and engineers who want to bring the science closer to the public.

The Cheltenham Festival Science, as well as the Famelab, has become a global event around the world in which all countries want to take part. There is also the Spanish version of Famelab, which started in 2012. There, a group of Spanish researchers participate and bring the public the opportunity to be involved in the show.

The members of this group belong to different scientific areas (Physics, Biology, Maths, Engineering, etc.). Communicating and showing their daily experiments to the audience has created a special bonding between them.

With humour, they explain interesting things about science in an amusing and attractive way. This way, they have managed to get to a diverse audience who learn science in a very simplistic but realistic manner.

It is a good way to learn new things about science, to re-discover it, to see it from a different point of view, to erase stereotypes and, above all, to approach it to the audience. Because thanks to the involvement of these science communicators, science is able to go across social and international borders and be part of our lives.