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Correlates of soy food consumption in women at increased risk for breast cancer.

OBJECTIVES: The objectives of the present study were to examine sociodemographic correlates of soy food consumption among women at increased risk of breast cancer, describe factors influencing soy food consumption or nonconsumption, and identify women's sources of information about soy foods. DESIGN: A cross-sectional, self-report survey was used to assess frequency of and factors influencing soy food consumption. Soy food intake was reported for the past year. SUBJECTS/SETTING: Participants were 452 women with family histories of breast cancer who were enrolled in a cancer risk assessment program. STATISTICAL ANALYSES PERFORMED: Comparisons between consumers and nonconsumers of soy foods were performed using multivariate logistic regression and chi(2) analyses. RESULTS: Thirty-two percent reported soy food consumption. Commonly consumed soy foods were vegetable burgers, tofu, and soymilk. Consumers of soy foods were more likely to have higher levels of education and report eating five or more daily servings of fruits and vegetables. The primary reason for consumption of soy foods was eating a healthful diet, whereas insufficient knowledge about soy food preparation was the primary reason stated for nonconsumption. Both consumers and nonconsumers reported obtaining information about soy foods from magazines, friends, and newspapers. Consumers also indicated using the Internet to seek information. CONCLUSIONS: These findings contribute to our understanding of the level of soy intake among women at increased risk for breast cancer and highlight potential factors that may influence women's decisions regarding soy food consumption. Women, particularly in this vulnerable population, would benefit from clear messages regarding the health effects of soy.

Adult↗

Renal ontogeny of ifosfamide nephrotoxicity.

Ifosfamide-induced nephrotoxicity adversely affects the health and well-being of children with cancer. We have recently shown age-dependent nephrotoxicity induced by ifosfamide, with younger children (<3 years) substantially more vulnerable. The mechanisms leading to this age-related ifosfamide-induced renal damage have not been identified. Underlying this work is the hypothesis that renal ontogeny is involved in the expression and activity of the cytochrome P450 (CYP) enzymes responsible for IF metabolism to the nephrotoxic chloroacetaldehyde. We evaluated renal CYP3A and 2B22 activity in pigs between the ages of 1 day and adulthood, as well as the metabolism of ifosfamide by renal microsomes to 2- and 3-dechloroethylifosfamide (2-DCEIF and 3-DCEIF, respectively). Kidney CYP3A messenger RNA expression peaked 15 to 60 days (0.7-76 +/- 0.19 CYP3A/actin ratio; P < 0.001). Subsequently, this level decreased to adult values (0.54 - 0.03 CYP3A/actin ratio; P = 0.04). Similarly, we detected an increase in the ifosfamide-metabolism rate between young (18 +/- 2 pmol/mg protein/min) and adult (12.2 +/- 0.17 pmol/mg protein/min) animals (P = 0.002). Ours is the first documentation of ontogeny of renal CYP3A and of renal ifosfamide metabolism. These data suggest that age-dependent ifosfamide nephrotoxicity is, at least in part, due to ontogeny in the production chloroacetaldehyde.

Acetaldehyde↗

Fatal hepatic necrosis after high-dose chemotherapy following haloalkane anesthesia.

We describe two patients who died with rapidly progressive hepatic necrosis following intensive chemotherapy and haloalkane anesthesia. Intensive multiple-drug chemotherapy has been associated with severe systemic toxic effects, but fulminant hepatic necrosis has not been recognized as a frequent complication. Furthermore, overt hepatic injury following the currently used halogenated anesthetic agents alone is rare without prior exposure and generally is considered to be idiosyncratic, ie, dependent upon unusual patient vulnerability. The unanticipated hepatic failure in these patients is reported to alert clinicians to this potential complication of intensive cancer chemotherapy and the possible additive adverse effect of haloalkane anesthesia.

Adolescent↗

The role of race and residence in determining stage at diagnosis of breast cancer.

Breast cancer kills more than 46,000 women each year. Previous research has found that minorities and those who reside in geographically remote settings are particularly vulnerable. However, virtually no research has been done on the potential "double jeopardy" faced by rural minority women. This research examines (1) the extent to which racial and residential differences contribute to differences in stage at diagnosis; (2) the existence of an interaction between race and residence, which may place black rural women at greater risk; and (3) the influence of both individual and structural characteristics on racial and residential differences. The findings indicate that rural black women are diagnosed with breast cancer much later than are black urban women or whites of either residence. A number of individual and structural variables were influential in predicting stage at diagnosis, yet none of these accounted entirely for racial differences.

Adult↗

[Non-tuberculous mycobacterial infection along the staple-suture line after segmentectomy for small peripheral lung cancer; report of a case].

A 60-year-old non-immunocompromised man who had undergone right upper lobectomy and subsequent left superior segmentectomy for small peripheral lung cancers (stage I well-differentiated adenocarcinomas) 2 years earlier, was referred to us for further investigation of an asymptomatic abnormal shadow observed on a chest radiograph. Chest computed radiography showed air-space consolidation along the staple-suture line associated with the left superior segmentectomy, the abnormality was 4 x 5 x 5 cm. Completion lower lobectomy was performed because transbronchial biopsy did not provide for a definite diagnosis. Pathological examination revealed a large granuloma infected by Mycobacterium intercellulare. The lung parenchyma may be exposed along the staple-suture line and somewhat vulnerable to infection in cases of partial pulmonary resection. We should be aware of this possibility after lesser pulmonary resection for small peripheral lung cancer.

Adenocarcinoma↗

How can the uptake of cervical cytology screening be improved?

BACKGROUND: Cervical cancer remains a killer, despite a screening programme designed to detect cases in the early stages of development. A number of factors appear to influence a woman's decision to attend for a smear test. This literature review considers these factors, and whether nurses can play a part in reducing the death rate by dispelling the misapprehensions and misinformation that deter vulnerable women from attending. CONCLUSION: There is a great need for modification and improvement of the present screening programme if all women who are at risk from cervical cancer are to be encouraged to attend for screening. The attitude of those who conduct smear tests is often crucial in gaining women's confidence--an unpleasant experience might deter a patient from attending again. Other barriers to attendance include administrative errors and lack of knowledge. Given the impact of mass advertising and health promotion campaigns in other areas, such as smoking cessation, there is clearly a need for a similar strategy to be applied to cervical screening.

Attitude to Health↗

Vulnerability and presenting symptoms in burning mouth syndrome.

OBJECTIVES: To investigate if burning mouth syndrome (BMS) patients have differing health perceptions, medication, and life experiences compared with controls and to examine the role of vulnerability factors and differentiate them from the presenting symptomology in patients with BMS. STUDY DESIGN: A nonprobability convenience sample of patients presenting with BMS and age- and sex-matched controls were recruited from Queen's University, Belfast, King's College London, and Baylor College of Dentistry, Dallas. Participants completed a questionnaire to assess 9 aspects of their medical and social history, including early and past life experiences. The subjects completed the Hospital Anxiety and Depression Scale to assess current distress. RESULTS: Participants with BMS had significantly higher experiences of adverse early life experiences compared with controls. They had statistically significantly higher mean scores for anxiety and depression compared with controls. A hierarchical multiple logistic regression analysis showed that the characteristics of BMS included cancer phobia, gastro-intestinal problems, and chronic fatigue. CONCLUSION: BMS is a complex disorder. People who experience adverse life experiences may become vulnerable to developing BMS in later life.

Adult↗

[Imaging features of Waldeyer's ring in non-Hodgkin's lymphoma and its clinical significance].

BACKGROUND & OBJECTIVE: Waldeyer's ring is the most vulnerable site outside lymph nodes in non-Hodgkin's lymphoma (NHL). Its imaging features in NHL of early stage were similar with those of squamous epithelial cancer, which often leads to misdiagnosis. This study was to discuss imaging features of Waldeyer's ring in NHL, and its clinical significance. METHODS: CT and MRI performances of 149 patients with pathologically diagnosed Waldeyer's ring-NHL were retrospectively analyzed. RESULTS: Among 149 cases of Waldeyer's ring-NHL, 98 (65.8%) were B-cell origin, and 51 (34.2%) were T-cell or NK/T-cell origin; tonsil was the most vulnerable site followed by nasopharyngeal tonsil and other positions. CT and MRI showed that 81 were focal nodules or masses (commonly in B-cell NHL), 36 were diffuse infiltrating growth (commonly in NK/T-cell NHL), 7 were pure ulcer, and 25 were mixed type. The lesions of focal masses are characterized with even CT density and MRI signals. The lesions usually localized in pharynx-mucosa clearance, but rarely in deep space, such as parapharyngeal space, and in skull-base. Among 78 cases with involved cervical lymph nodes, 64 were B-cell origin, and 14 were NK/T-cell origin (P< 0.05). CONCLUSION: Multiple positions and centers origin, huge masses, diffuse infiltration growth, and less involvement in deep space and skull-base are typical imaging features of Waldeyer's ring-NHL; CT and MRI may be helpful to diagnose, clinical classifying, and treating Waldeyer's ring-NHL.

Adolescent↗

The social distribution of reports of health-related concerns among adolescents in São Paulo, Brazil.

This study investigated the health-related concerns of adolescents living on streets as compared to poor and privileged adolescents living with their families in São Paulo, Brazil. The different groups of respondents were similar in terms of individuals' fear of disease and lack of concern about health in old age. AIDS and cancer were feared by most of the respondents in the different groups, particularly because of their severity and people's vulnerability to these conditions. Health in old age was not a major concern in any of the study groups. It is suggested that health educators take into account the wide range of concerns among adolescents on the streets in order to design interventions that cater for different levels of interest and motivation. It is also argued that there is a need for health education in order to clarify misperceptions about disease transmission, prevention and treatment among adolescents from different socioeconomic backgrounds.

Acquired Immunodeficiency Syndrome↗

Oral cancer and precancer as diseases of the aged.

Some cancers, especially sarcomas, favor younger age groups, whereas others, particularly carcinomas, are most likely to develop in older age groups. The relative frequency, mortality and morbidity rates are defined using lip and tongue cancer as examples. The paper demonstrates how oral cancer rates increase with age. For tongue cancer there is a worsening of the prognosis with advancing age. The synergistic effect of tobacco and alcohol and its relation to age is also dealt with. For leukoplakia there is also a higher rate with increasing age, although there is a shift towards younger ages when compared with oral cancer. Tobacco, age and leukoplakia are also discussed. The increased cancer and precancer rate in older people may be due to age changes in the oral mucosa making it more vulnerable to the action of carcinogens.

Adolescent↗

Evaluation of radioinduced damage and repair capacity in blood lymphocytes of breast cancer patients.

Genetic damage caused by ionizing radiation and repair capacity of blood lymphocytes from 3 breast cancer patients and 3 healthy donors were investigated using the comet assay. The comets were analyzed by two parameters: comet tail length and visual classification. Blood samples from the donors were irradiated in vitro with a 60Co source at a dose rate of 0.722 Gy/min, with a dose range of 0.2 to 4.0 Gy and analyzed immediately after the procedure and 3 and 24 h later. The basal level of damage and the radioinduced damage were higher in lymphocytes from breast cancer patients than in lymphocytes from healthy donors. The radioinduced damage showed that the two groups had a similar response when analyzed immediately after the irradiations. Therefore, while the healthy donors presented a considerable reduction of damage after 3 h, the patients had a higher residual damage even 24 h after exposure. The repair capacity of blood lymphocytes from the patients was slower than that of lymphocytes from healthy donors. The possible influence of age, disease stage and mutations in the BRCA1 and BRCA2 genes are discussed. Both parameters adopted proved to be sensitive and reproducible: the dose-response curves for DNA migration can be used not only for the analysis of cellular response but also for monitoring therapeutic interventions. Lymphocytes from the breast cancer patients presented an initial radiosensitivity similar to that of healthy subjects but a deficient repair mechanism made them more vulnerable to the genotoxic action of ionizing radiation. However, since lymphocytes from only 3 patients and 3 normal subjects were analyzed in the present paper, additional donors will be necessary for a more accurate evaluation.

Adult↗

Higher oxidation and lower antioxidant levels in peripheral blood plasma and bone marrow plasma from advanced cancer patients.

BACKGROUND: Bone marrow (BM) is an important tissue in the generation of immunocompetent and peripheral blood cells. The precursors of hematopoietic cells in BM undergo continuous proliferation and differentiation and are highly vulnerable to acute and chronic oxidative stress. Little is known about the oxidant and antioxidant status in the BM of untreated patients with nonhematologic tumors. In this study, oxidative stress was evaluated in peripheral blood plasma (PBP) and BM plasma (BMP) from lung carcinoma (LC) and breast carcinoma (BC) patients. METHODS: The sample included 13 consecutive untreated LC patients, 15 BC patients, and 11 healthy controls. Luminol-dependent chemiluminescence was used to evaluate oxygen radical generation by peripheral blood neutrophils. Lipid oxidation, assessed by 2-thiobarbituric acid-reactive substances (TBARS), and alpha-tocopherol, beta-carotene, and total ubiquinol-10 levels were determined in PBP and BMP. RESULTS: In LC and BC patients, neutrophil chemiluminescence was higher (128% and 264%, respectively) than in controls (P < 0.05). In cancer patients, TBARS levels were higher in both PBP (51% and 243% for LC and BC patients, respectively) and BMP (66% and 305% for LC and BC patients, respectively) than in plasma from controls (P < 0.01). alpha-Tocopherol and total ubiquinol-10 levels were significantly lower in BMP from BC patients compared with controls. In BC patients, alpha-tocopherol content in PBP was significantly lower than in controls. CONCLUSIONS: Untreated cancer patients presented an imbalance between oxidant generation and lipid-soluble antioxidant levels in favor of the former.

Adult↗

Preferential targeting of apoptosis in tumor versus normal cells.

Elimination of cancer cells by early apoptosis is preferred over other forms of cell growth inhibition. Apoptosis directly leads to tumor regression and reduces risks of selecting more aggressive and/or drug-resistant phenotypes that are often responsible for tumor regrowth and treatment failure. Although DNA damage by anticancer drugs is commonly recognized as an apoptotic stimulus, there is enormous variability in the magnitude and timing of such effects. Especially potent and rapid apoptosis seems to be a hallmark of various alkylating anticancer drugs that are regarded as DNA-reactive agents but are observed to react mainly with cellular proteins. Our studies with such dual-action drugs (irofulven, oxaliplatin) suggest that not only DNA damage, but also protein damage, contributes to apoptosis induction. DNA damage is well known to initiate death-signaling pathways leading to mitochondrial dysfunction. Protein damage, in turn, can distort cell redox homeostasis, which facilitates apoptosis execution. Such dual effects can be particularly lethal to tumor cells, which tend to function under pro-oxidative conditions. In contrast to tumor cells that are highly susceptible, normal cells show marginal apoptotic responses to the dual action drugs. This protection of normal cells might reflect their greater ability to buffer pro-oxidative changes and quickly restore redox homeostasis, despite substantial drug uptake and macromolecular binding. Importantly, by targeting the death process at multiple points, DNA- and protein-damaging drugs can be less vulnerable to various bypass mechanisms possible with single targets. The reviewed studies provide a proof of concept that differential apoptosis targeting in cancer versus normal cells can be a basis for tumor selectivity of anticancer drugs.

Antineoplastic Agents↗

Vulnerability of multidrug-resistant tumor cells to the aromatic fatty acids phenylacetate and phenylbutyrate.

Cytotoxic chemotherapies often give rise to multidrug resistance, which remains a major problem in cancer management. In pursuit of alternative treatments for chemoresistant tumor cells, we tested the response of multidrug-resistant (MDR) tumor cell lines to the aromatic fatty acids phenylacetate (PA) and phenylbutyrate (PB), two differentiation inducers currently in clinical trials. Both compounds induced cytostasis and maturation of multidrug-resistant breast, ovarian, and colon carcinoma cells with no significant effect on cell viability. In contrast to their poor response to doxorubicin, the MDR cells were generally more sensitive to growth arrest by PA and PB than their parental counterparts. The aromatic fatty acids, like the differentiation-inducing aliphatic fatty acid butyrate, up-regulated mdr-1 gene expression. However, while butyrate increased multidrug resistance, PA and PB potentiated the cytotoxic activity of doxorubicin against MDR cells. The latter was associated with time-dependent declines in glutathione levels and in the activity of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, and glutathione S-transferase, the antioxidant enzymes implicated in cell resistance to free radical-based therapies. Taken together, our in vitro data indicate that PA and PB, differentiation inducers of the aromatic fatty acid class, may provide an alternative approach to the treatment of MDR tumors.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Fanconi's anemia, transplantation, and cancer.

Patients with Fanconi's Anemia (FA) have high rates of congenital physical abnormalities, bone marrow failure, leukemia, and solid tumors. Stem cell transplant (SCT) is often effective in curing bone marrow failure, but high-risk patients, particularly those whose donor is not a human leukocyte antigen matched sibling, are vulnerable to early mortality from transplant-related complications. Long-term survivors of SCT have risks of solid tumors (particularly of the oral cavity), which are even higher than the already high 'baseline' risk of neoplasia in untransplanted FA patients. In this group, the major types of cancer are head and neck squamous cell carcinomas, and gynecologic malignancies. Rapid evaluation of new SCT preparative regimens would be useful in improving both short-term and long-term results.

Adolescent↗

The clavicle: a vulnerable bone in pediatric oncology.

The clavicle is frequently incorporated into the radiation field in the treatment of malignant tumors located in the head and neck. From 1954 to 1995, 499 pediatric patients were treated with moderate to high-dose radiation therapy to the head and neck at the University of Texas M.D. Anderson Cancer Center. The medical records of 312 of these patients were available and were reviewed. The period of observation ranged from 5 to 30 years. Five late radiation-induced abnormalities of the clavicle were encountered: osteosarcoma; osteochondroma; malignant fibrous histiocytoma; radionecrosis and impaired healing following trauma and radionecrosis and lysis. The doses of radiation therapy which induced the abnormalities varied from 35 to 60.5 Gy (median 34.75 Gy). The interval from radiation therapy to discovery of the complications varied from 6 to 11 years. Two patients died: one from malignant fibrous histiocytoma and another from a radiation-induced meningioma of the brain (which accompanied radionecrosis of the clavicle). We conclude that the incidence of radiation-induced abnormalities of the clavicle in pediatric long-term survivors is low (1.5%). However, some of the late sequela are potentially fatal. The clavicle should be considered a vulnerable bone to radiation therapy and should be monitored in long-term survivors of childhood cancer. The experience is compared to radiation-induced abnormalities recorded in the literature.

Adolescent↗

Preneoplastic prostate lesions: an opportunity for prostate cancer prevention.

Environmental factors, especially the diet, play a prominent role in the epidemic of prostate cancer (PCA), in the United States. Many candidate dietary components have been proposed to influence human prostatic carcinogenesis, including fat, calories, fruits and vegetables, anti-oxidants, and various micronutrients, but the specific roles dietary agents play in promoting or preventing PCA remain controversial. We have collected evidence to suggest that GSTP1, the gene encoding the pi-class glutathione S-transferase (GST), may serve a "caretaker" function for prostatic cells. Although GSTP1 can be detected in normal prostatic epithelium, in almost all PCA cases, PCA cells fail to express GSTP1 polypeptides, and lack of GSTP1 expression most often appears to be the result of somatic "CpG island" DNA methylation changes. Loss of GSTP1 function also appears to be characteristic of prostatic epithelial neoplasia (PIN) lesions, thought to represent PCA precursors. We have recently learned that a new candidate early PCA precursor lesion, proliferative inflammatory atrophy (PIA), characterized by proliferating prostatic cells juxtaposed to inflammatory cells, contains epithelial cells that express high levels of GSTP1. These findings have formed the basis for a new model of prostatic carcinogenesis, in which prostatic cells in PIA lesions, subjected to a barrage of inflammatory oxidants, induce GSTP1 expression as a defense against oxidative genome damage. When cells with defective GSTP1 genes appear amongst the PIA cells, such cells become vulnerable to oxidants and electrophiles that inflict genome damage that tends to promote neoplastic transformation to PIN and PCA cells. Subsequently, PIN and PCA cells with defective GSTPI genes remain vulnerable to similar stresses tending to promote malignant progression. This new model for prostatic carcinogenesis has implications for the design of new prostate cancer prevention strategies. Rational prevention approaches might include: (i) restoration of GSTPI expression via treatment with inhibitors of CpG methylation, (ii) compensation for inadequate GSTPI activity via treatment with inducers of general GST activity, and (iii) abrogation of genome-damaging stresses via avoidance of exogenous carcinogens and/or reduction of endogenous carcinogenic (particularly oxidant) stresses.

Adenocarcinoma↗

The emergence of molecular gynecology: homeobox and Wnt genes in the female reproductive tract.

Reproductive tissues respond to steroid hormones and thus are particularly vulnerable to the effects of exogenous steroid 'mimic' compounds (endocrine disrupters). One such endocrine disrupter, diethylstilbestrol (DES), is linked to gynecological cancers and changes in uterine structure that reduce or completely abrogate reproductive competence. Until recently, little was known about the identity of target genes and signaling pathways involved in pathologies linked to endocrine disrupters such as DES. We outline genetic, cellular and molecular roles for patterning genes, with emphasis on homeobox and Wnt genes. There is evidence that changes in the expression of Wnt and homeogenes underlie many of the defects induced by DES. Data obtained from murine systems will likely apply to a broad spectrum of gynecological pathologies involving abnormal cell behaviors ranging from fibroids to malignant tumors. Knowledge garnered from modern molecular genetics should lead to progress in the emerging field of molecular gynecology.

Animals↗