cervical cancer Archives

May

2020

New Multi Cancer Blood Screening Test

By Ray Schilling | breast cancer, Cancer, cervical cancer, leukemia, lung cancer, prostate cancer

A recent publication describes how a new multi cancer blood screening test can diagnose various cancers early. Many years back the same research group at the Johns Hopkins Medical School did lung cancer screening studies. The researchers then were analyzing saliva samples between 1974 and 1982. They identified 15 patients who later developed adenocarcinoma of the lung. The researchers were able to diagnose the lung cancer 1 year prior to what ordinary screening tests could do. This ensured an early diagnosis and early treatment with a better long-term prognosis.

Liquid biopsy promises early cancer detection

The new publication from the Johns Hopkins University in Baltimore, Maryland, is based on the following fact: Cancer cells consist of mutated cells. They shed DNA with mutations typical for this cancer into the bloodstream. By taking blood samples and analyzing the circulating mutated DNA researchers can first establish that the DNA belongs to a certain cancer mutation. But at the same time, they can locate the cancer, if they find mutated DNA. The pathologist can say that the patient has a cancer in a breast, the colon, lungs or ovaries, wherever it is located.

Oncoblot test was a precursor to the multi cancer blood screening test

Around 2014 a cancer screening test came out of the human genome project. It was called the Oncoblot test. It screened for 25 of the most common cancers. And it was screening for ENOX2 proteins from cancer cells. Apparently, this is a fetal protein normally expressed only during fetal life, bit in adults only expressed when a cell turns cancerous. It was a 1000 USD test in the US that health plans did not cover. But it screened for more than 25 different common cancers 6 to 8 years before they become clinically manifest: Suddenly around 2017 the Oncoblot test was no longer available. I could not find out the reason for this. Was the test producing too many false positives or false negatives? This would have made this cancer screening test unreliable. Apparently researchers of the Oncoblot test company are attempting to refine the test further.

My own case of prostate cancer

Strangely enough in 2016 I had an Oncoblot test done and it accurately diagnosed that I had prostate cancer. My cancer specialist from Ft. Lauderdale used Doppler ultrasound to visualize it and performed a 3-dimensional prostate biopsy to verify the histology. Subsequently he removed it with ablation cryotherapy, because a study of his involving 70 prostate cancer patients and spanning over 10 years had shown the best survival data. My 3-monthly PSA values since have been negative for recurrent prostate cancer.

New multi cancer blood screening test from Johns Hopkins Medical School

A review in Science magazine explains the details of the new multi cancer blood screening test. It is called CancerSEEK and is based on 16 common genetic markers that show changes in cancer cells. In addition, the researchers also test for cancer-related proteins, which change when cancer cells are present. The test also indicates the location of the early cancer. CancerSEEK can detect about 60% of liver cancers and 100% of ovarian cancer. The researchers tested 812 healthy controls. Only 7 (1%) tested positive for cancer. CancerSEEK also tested 1005 patients who had early cancer.

More details of the CancerSEEK test

The test detected between 33% and 98% of cases, which depended on the tumor type. The sensitivity was 69% or higher for stomach, pancreatic, and esophageal cancers; ovarian and liver cancer had a sensitivity of 98%. In 80% of the cases physicians could narrow the positive cancer test to two possible sites. The researchers think that the cost of one CancerSEEK test will be less than 500.00 USD. There is another study described where 9,911 participants were enrolled. 25 cancers were found. The diagnosis involved 2 lymphomas, 2 colorectal cancers, one appendix cancer, 2 uterine cancers, one thyroid cancer, one kidney cancer, 9 lung cancers, one breast cancer and 6 ovarian cancers. This study will continue to go on for another 5 years.

Possible problems with the new multi cancer blood screening test

Researchers dubbed the cancer screening test as “liquid biopsies” with the purpose to detect hidden cancers. The smaller the cancer is, the less the cancer cells excrete DNA and cancer proteins into the bloodstream. This means that in some of the early cancer cases the sensitivity of the test could be very small. Because many cancers will be detected much earlier there could be definite cures, if the cancer is in an early stage. On the other hand, Dr. Nickolas Papadopoulos from the Johns Hopkins University in Baltimore, Maryland, said: “The issue is not overdiagnosis, but overtreatment.” Some of the small tumors may never turn into larger tumors and it is justified to observe for a period of time.

A large 5-year clinical study involving up to 50,000 women is the next project to test the CancerSEEK test further. A private philanthropic group, The Marcus Foundation, is funding this project.

New Multi Cancer Blood Screening Test

Conclusion

A new multi cancer blood screening test, the CancerSEEK test, is in development. It is based on a combination of various cancer markers. Researchers measure cancer DNA mutations and also cancer proteins. They also determine the tissue location of the cancer. Researchers did much work already in terms of sensitivity and specificity of the test. Physicians integrate the test further with conventional medical tests to confirm the location of the cancer. With breast cancer mammograms are the additional tests, with colorectal cancer colonoscopies. A large 5-year clinical study involving up to 50,000 women is the next project to test the CancerSEEK test further. In future the CancerSEEK test will become a routine screening test for cancer. The cost for one CancerSEEK test will be less than 500.00 USD. The hope is that cancer cures will improve due to earlier detection.

Apr

2020

Side Effects of the Birth Control Pill

By Ray Schilling | autoimmune disease, birth control pill, breast cancer, Cancer, Cardiovascular disease, cervical cancer, depression, headache, heart attack, Hormones, Menopause, Osteoporosis, Stroke

Dr. Jolene Brighten gave a lecture about side effects of the birth control pill. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. Her exact title was “Your Body on Birth Control- What Prescribers Should Know About the Effects of Birth Control on the Female Body”.

Most commonly the oral contraceptive pill is prescribed to prevent pregnancy. But the long-acting reversible contraceptives like the IUD and progestin implants are also popular. Depot Provera, the ring and the patch are the least popular ones.

Why women use the birth control pill

Women age 15 to 49 are often on some form of birth control method. 58% of women who use the birth control pill use it for reasons other than to prevent pregnancy. They use it to control symptoms of various conditions.

31% use it for menstrual cramps
28% want to regulate their periods
14% hope to improve their acne
4% use the pill for menstrual pains associated with endometriosis
11% for other reasons

What the birth control pill does

The birth control pill exerts a negative influence on the hypothalamus and the pituitary gland. This is called “functional hypothalamic amenorrhea”. The birth control pill is not suitable to treat polycystic ovarian syndrome. Symptoms of bleeding may improve for 3 months, but after that the original symptoms return. Thyroid disease that may be present needs separate investigations.

The hormones that are part of the birth control pill are synthetic hormones. They do not quite fit the body’s hormone receptors. For instance, the progestins, artificial analogues of progesterone behave like estrogens, not progesterone. This causes clotting problems cancers of the uterus, breasts and cervix. It can also cause heart attacks and strokes.

List of side effects of the birth control pill

From depression to liver health

The list of side effects of the birth control pill (BCP) is long. The BCP can worsen symptoms of depression and anxiety. The deeper the depression is, the higher is the risk for suicide. There is increased risk of hair loss. The BCP depletes nutrients in the body that the thyroid gland needs to produce thyroid hormones. This can result in hypothyroidism.

It also increases thyroid binding globulin, a protein in the blood that binds thyroid hormones. As a result, there are fewer thyroid hormones available to the body cells. Breasts may become tender and enlarged after the start of the BCP. In some women with fibrocystic disease of the breasts the BCP may improve her cyclical breast changes. The BCP changes the liver both structurally and genetically. As a result, there is a higher risk of developing benign liver tumors and liver cancer.

From gallstones to blood clots

Women with a history of gallstones may experience faster gallstone formation on the BCP. The pill also can elevate your blood pressure. You should have blood pressure checks from time to time to prevent a stroke. Weight gain is common on the BCP. However, some women experience weight loss. Usually the BCP is 99% effective for the prevention of pregnancy. Pain from heavy periods or menstrual cramps are often relieved by the BCP. There is an increased risk to develop diabetes, because insulin resistance is gets worse in patients on the BCP. In postmenopausal women on HRT there is an even higher risk of developing diabetes. Blot clots are a common side effect of the BCP. Being a smoker, having a heart or liver condition, a history of genetic risk of blood clots, having migraines with an aura or being overweight are all additional risk factors for developing blood clots.

From effects on the brain to cancer risks

The BCP can change brain function and structure. This may lead to a different mate selection and production of neurotoxins. Some women get relief from hormonal headaches; but others experience exacerbations of migraines and headaches. In some women acne improves on the BCP; in others acne gets worse. When it comes to stress, some women experience an altered hypothalamic-pituitary-adrenal gland response from the BCP. The BCP reduces some cancer risks, like the risk of ovarian, uterine and colorectal cancer. But the risk for breast cancer, brain cancer and liver cancer are higher. The BCP increases gut permeability, leads to leaky gut syndrome and the disruption of the microbiome. There is often overgrowth of yeast in the gut. In addition, people with a genetic predisposition for autoimmune disease of the gut can develop immune diseases. Multiple studies have shown malabsorption of vitamins, minerals and antioxidants when on the BCP.

From vaginal yeast infections to osteoporosis and autoimmune diseases

Many women develop vaginal yeast infections. Women on the BCP often complain about low or a lack of libido. There can be vaginal dryness and pain with sex.

Teenage women on the BCP often develop decreased bone density. Synthetic hormones lack the specificity to the natural hormone receptors, which leads to decreased bone density. On the other hand, bioidentical estrogen and bioidentical progesterone will indeed build up bone mass. In the past it was thought that hormones would be good for the bones and this is still true with the use of bioidentical hormones.

A number of autoimmune diseases have been identified to be directly related to the use of the BCP. These are Crohn’s disease, multiple sclerosis, lupus, interstitial cystitis and ulcerative colitis.

Synthetic hormones will always have side effects

The body is a complex organism with various hormone receptors built into its cells. In order to be able to cash in on patented modified hormones Big Pharma introduced progestins to replace natural progesterone and various synthetic estrogen products to replace natural estradiol. However, the Women’s Health Initiative has shown in 2002 that these artificial hormones produced heart attacks, strokes, blood clots, colorectal and endometrial cancer and hip fractures. There was an increase of mortality of 15% over 5.2 years compared to controls who did not take artificial hormones within the same timeframe.

Bioidentical hormones have a perfect fit to the natural hormone receptors

In contrast, when bioidentical hormones are given in menopause, there is a 10 to 15 year extension of life expectancy and researchers did not see any of the above mentioned side effects that were noted with synthetic hormones. Many people in Europe have elected to stick to bioidentical hormones for decades; they did not use the synthetic hormones. As a result, there are good data going back to the 1960’s about the safety of bioidentical hormones. In this study several thousand postmenopausal women were followed for 9 years or more and showed no increase in the rate of heart attacks or any cancer. Their postmenopausal symptoms were optimally controlled. I conclude from this that bioidentical hormone replacement in menopause will protect the women from missing hormones safely. There are no side effects and for this reason the bioidentical hormone replacement should become the standard of care.

Side Effects of the Birth Control Pill

Conclusion

Synthetic hormones have a long list of devastating side effects. Yet, Big Pharma managed to influence general practitioners and gynecologist to prescribe them to postmenopausal women. The Women’s Health Initiative has changed everything. The promise was that synthetic hormones would show heart-protective effects, cancer protective effects and healing effects for osteoporosis. These have been empty promises! None of this occurred with synthetic hormones- to the contrary! Many physicians are now prescribing bioidentical hormone replacement for women in menopause.

No good alternative for teenage girls

However, for teenage girls there is no good alternative for the traditional birth control pill, even though the catalogue of side effects is of serious concern. One compromise is to limit prescribing the birth control pill for up to 5 years only and then switch to several years of a copper T or other intrauterine device (IUD). Suicide in teenage girls on the BCP is of real concern. Despite the list of side effects many doctors continue to prescribe synthetic hormones for decades to the same patients, who trust that it will benefit them. In time patients will know about the side effects, and unfortunately many will experience them. As a result, it is only a matter of time, till this will be exposed as malpractice!

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Dec

2019

The Use Of Oncolytic Viruses For Cancer Treatment

By Ray Schilling | Cancer, cervical cancer, immune system, prostate cancer, vaccinations

In the first place, preliminary experiments indicate that the use of oncolytic viruses for cancer treatment may become a reality. There are several lines of research that point to the fact that oncolytic viruses can make a difference in treating incurable cancer patients.

Notably, Canadian researchers had reported in 2011 that oncolytic viruses created by genetically modifying smallpox vaccine viruses would enter tumor cells of patients, but not damage normal cells. Specifically, a high percentage of the end stage patients responded with tumor regression.

Shortly after Mayo Clinic physicians were desperate when two patients with end stage multiple myeloma, a vicious bone tumor, did not respond to chemotherapy. Significantly, they tried something unconventional: high doses of the measles vaccine in an attempt to stimulate the immune system. Here is an overview from 2014 that shows that many different cancers respond to various immunological approaches.

Study from Holland regarding end stage melanoma patients

Here is a small human study involving end-stage melanoma patients treated with the oncolytic virus T-VEC combined with pembrolizumab (Keytruda). It is important to realize that Keytruda helps to reactivate a T-cell response to the cancer cells. In this case the cancer cells absorb the oncolytic virus (T-VEC), but it leaves normal cells alone. Inside the cancer cells the oncolytic virus multiplies and destroys the cancer cells. In this 2017 study 21 patients with terminal, nonresectable melanoma received treatment with T-VEC and Keytruda. Specifically, 62% of the patients showed an objective response to the treatment. Moreover, 33% fulfilled the criteria of an immune-related response. In the past terminal patients like these had a 0% response to radiotherapy or chemotherapy.

History of research about oncolytic viruses

To begin with, in 1912 rabies virus treatment against cervical carcinoma was a first attempt to treat cancer. Researchers conducted many experiments between 1950 and 1970 with wild type or naturally attenuated viruses. This included, for example, hepatitis A and B viruses. In 1991 cancer researchers developed the concept of genetically engineered oncolytic viruses. Today cancer researchers know that the protection mechanisms in most cancer cells have deficiencies. This involves the interferon‐beta signal pathway. Having said this, there is an opportunity to let oncolytic viruses destroy cancer cells, while normal cells stay unaffected. An oncolytic virus that cancer experts use in human cancers is the genetically engineered herpes simplex virus type I (HSV‐1). Others that cancer researchers developed have strange names like T‐Vec, G47∆, JX594, CG0070 and Reolysin.

Various cancers that researchers treated with oncolytic viruses

Here are a few examples of cancers where researchers used oncolytic viruses to exert a significant therapeutic effect.

Glioblastoma

Glioblastoma is a deadly form of a brain tumor, which has a high rate of mortality. Researchers have investigated new avenues to treat this cancer. Researchers tested the genetically engineered dendritic vaccine. Initial clinical trials showed significant effectiveness compared to non-treated controls. In a large phase 3 clinical trial 331 patients with newly diagnosed glioblastoma received treatment at the time of neurosurgery with dendritic cell vaccine. 30.2% of the patients were still alive and doing well after 3 1/3 years. Without the added vaccination procedure all of these patients would have died in the past because of the aggressiveness of the glioblastoma.

Multiple myeloma

Researchers could cure multiple myeloma and other cancers by using the measles vaccine. Here is a report by the popular press about two women who had multiple myeloma. One woman got cured by high doses of a measles vaccine. The other women experienced some relief, but did not survive.

This publication explains that oncolytic viral therapy of cancer is a lot more complicated than originally thought.

Prostate cancer

Researchers found that vaccines against prostate cancer were effective with the combination of oncolytic virus therapy with regular anti-cancer treatments. But oncolytic virus therapy alone has a poorer prognosis than a combination of chemotherapy or radiotherapy with oncolytic virus therapy.

Cervical cancer

The high-risk HPV16 strain most often causes cervical cancer. The HPV (human papilloma virus) vaccine targets patients with previous exposure to HPV16. However, researchers have noticed that in some cases a phenomenon called the “HPV immune escape” has allowed in some vaccinated women to still develop cervical cancer. Now a group of researchers are investigating how the vaccine could be improved by finding out how the immune system is being tricked in these cases by the HPV virus to bypass the antibodies of the vaccine.

Pancreatic cancer

This cancer is very difficult to detect in the early stages, and as a result the outlook for chemotherapy or radiotherapy is extremely poor. Researchers have used several approaches as an alternative to conventional therapy. Immunotherapy is an option. Mayo clinic researchers have already announced that the measles vaccine approach will likely be applicable to pancreatic cancer treatment as well in the near future. However, other clinical trials are on the way to use alternative vaccination procedures.

Neuroblastoma, glioma and melanoma

This link shows that the FDA has accepted engineered oncolytic herpes virus (engineered to secrete GM-CSF) as a treatment against melanoma. Other approaches with engineered bacteria can affect neuroblastoma and glioma.

Survival data using oncolytic viruses for cancer treatment

Cancer researchers have completed a number of smaller clinical trials at this point. One of them describes end stage melanoma (stage III and IV) where the only treatment was with the oncolytic virus T‐Vec. The overall response rate compared to the control, which was only 5.7%, the experimental group with T-Vec was 26.4%. This is considered a good response rate given that we are dealing with end stage melanoma patients.

Mechanism of how oncolytic viruses stimulate the immune system to overcome various cancers

As mentioned above oncolytic viruses multiply in the cancer, once they have been incorporated. This leads to cancer cell death. It exposes the dead cancer tissue to the immune system. What helps in the process is that inhibitory proteins from the cancer cells that used to inhibit the immune system are no longer provided by the dead cancer cells. The end result is that the immune system mounts a formidable response against the cancer cells through killer T cells. This immune response also affects remote metastases of the same histological cancer type. This review article summarizes how oncolytic viruses work for cancer cell destruction and how this method can be combined with other treatment modalities.

The Use Of Oncolytic Viruses For Cancer Treatment

Conclusion

Currently various cancer centers are involved with clinical trials in humans to test the power of oncolytic viruses. What cancer researchers have learnt is that oncolytic viruses are a useful tool to kill cancer cells. But the immune system of cancer patients is in a suppressed state. Pembrolizumab (Keytruda) is a medication that will stimulate the immune system by stimulating killer T cells to destroy cancer cells. The combined effect of killing cancer cells with oncolytic viruses and stimulating the immune system is the big news. This has been the breakthrough that cancer researchers have been waiting for. Now several clinical trials are on the way where survival rates for cancer patients given the new combination therapy are assessed.

Oncolytic virus therapy here to stay

It is a treatment which is no longer a thought model with animal experiments. Well known medical centers are using it in patients, and as the results become more obvious, it will very likely become a new treatment modality for cancer.

Apr

2019

Some Reasons For Variations In Cancer Rates

By Ray Schilling | alcohol, breast cancer, Cancer, cervical cancer, exercise, Fitness, heart attack, leukemia, lung cancer, mitochondria, Nutrition, Obesity, prostate cancer, Smoking, sugar, telomeres

It can be confusing to see that various countries have big differences in cancer rates, but here I am giving some reasons for variations in cancer rates.

The following countries have high cancer rates: Denmark, France, Belgium, United States, Hungary, Ireland, New Zealand, Australia.

These countries have low cancer rates: Niger, Yemen, Oman, Nepal, Mauritania, Gambia, Cape VerSe, Bhutan. These are only samples; it is not a complete list.

Short life expectancy in many low cancer rate countries

People in many low cancer rate countries do not live long lives because of parasitic infestations, bacterial infections and AIDS. Life expectancy in Gambia, for instance is only 61.15 years. People in Yemen suffer from malnutrition and the life expectancy is only 64.95 years. One can make an argument therefore that people do not live long enough to get a lot of cancer. Cancer is a disease of the older population, as DNA mutations, shorter telomeres, and loss of mitochondria in older cells cause many cancers.

These three countries have various cancer rates

Low cancer rates in India

India is one of the countries with lower cancer rates when compared to the US. Scientists have pointed out that 40% of Indians are consuming vegetarian diets without meat; (red meat consumed in high amounts like in the US is carcinogenic). India has some of the highest spice consumption in the world. We know that curcumin, for instance, has cancer-preventing qualities. You could say that Indians inadvertently treat themselves with herbal, non-toxic chemotherapy (curcumin and others spices) before a cancer even occurs. On the other hand India is a nation with high consumption of refined sugar, which is a factor that can cause cancer over a long period of time. The life expectancy in India is only 68.56 years, which skews the statistics towards lower cancer rates when one compares India to countries with a life expectancy of 80.0 years.

Why is Denmark a high cancer rate country?

The biggest factors are a reliable cancer reporting system, but also a high smoking rate among Danish women and high alcohol consumption in the Danish population. See below what these factors do.

Why is Oman a low cancer rate country?

A study done in Oman showed that a lot of people do not know that certain risk factors could be changed to lower the present cancer incidence. Cigarette smoking, passive smoking, excessive alcohol consumption, reduced intake of fruit and vegetables, increased consumption of red meat and processed meats, infection with HPV, being overweight, less physical activity and an age above 70 are all risk factors for cancer. At the present time Oman still compares favorably with the US, as there is less obesity in Oman. But the average person still eats fairly healthy with an emphasis on fruit and vegetables.

Increasing cancer rates in Oman

The cigarette consumption per year per person in Oman is 271.1 versus 1016.6 in the US. The life expectancy has increased from 50.47 in 1970 to 77.03 in 2016. Oman is expecting the cancer rate to double by the year 2030 due to the increasing life expectancy and lifestyle factors (more drinking, smoking and gaining weight from junk food). A lot of the differences in the cancer rates between the US and Oman are simply due to lifestyle differences.

Cancer risk factors analyzed

What do the various cancer risks mean in terms of cancer development?

Cigarette smoking

About 480,000 premature deaths are caused by cigarette smoking in the US. This is due to a combination of cancer, heart attacks and strokes. Smoking causes cancers of the lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon, rectum, but also acute myeloid leukemia.

Passive smoking

Passive smoking is as bad, if not worse than smoking. This reference explains that a passive smoker has double exposure to cigarette smoke, namely to the smoke from the smoker, but also to the direct smoke from the burning cigarette. This means that a passive smoker may have exposure to a higher concentration of carcinogens than the smoker!

Excessive alcohol consumption

Heavy alcohol consumption introduces a cell poison into your body. If you drink more than 8 drinks per week as a woman or more than 15 drinks per week as a man, you are a heavy drinker. It leads to cancer of the mouth, esophagus, throat, colon, liver, breast and prostate. The data on prostate cancer is somewhat weaker.

Reduced intake of fruit and vegetables

Consumption of fruits and vegetables, but also foods high in fibre are known to reduce the risk of cancer. So, when you lower the intake of fruits and vegetables, you have less of a cancer protective effect, which leads to more cancer.

Increased consumption of red meat and processed meats

Another big factor about cancer causation is when you eat foods that contain known carcinogens. Such cancer causing substances are contained in red meat, processed meat like sausages, and salt-preserved foods.

Infection with HPV

Type 16 and 18 HPV virus is the cause of cervical cancer, penile cancer, oropharyngeal cancer, anal cancer, vulvar and vaginal cancer. It can be of concern for all sexually active people.

Being overweight

When a person gets overweight or obese, there is more estrogen production from the fat cells that circulate in your blood. There is also more insulin production and IGF-1 production, which is a growth factor for cancer cells. Estrogen dominance due to estrogen production from fat cells with a relative lack of cancer-controlling progesterone tips the balance towards cancer development. These are the cancers that are common in obesity: breast (in women past menopause), colon and rectum, endometrium (lining of the uterus), esophagus, kidneys and pancreas.

Less physical activity

Breast cancer and colon cancer are reduced when people exercise regularly. This seems to be because of a reduction in circulating estrogen in women and because of reduced insulin and insulin-like growth factors. Even prostate cancer can be kept at bay with a regular brisk walk.

An age above 70

The medium age for cancer diagnosis is 66 years. This means that half of the cases are below this age, the other half above it. 25% of new cancer cases are diagnosed in the age group of 65 to 74. Age is an independent, but important risk factor for the development of cancer.

Sugar and starchy food consumption

Refined sugar and starchy foods lead to an accumulation of fat. At the same time there is a metabolic change with more insulin production and growth factors appear in the blood. It is these growth factors and an increase in estrogen (via aromatase) from the fat cells that lead to conditions that favor cancer development. Switch to a low-glycemic diet like a Mediterranean diet, and you can reverse this process.

Some Reasons For Variations In Cancer Rates

Conclusion

It is never too late to reduce your cancer risk. No matter how old we are, it is never too late to live healthier, which translates into a stronger immune system. We can stop smoking, or cut out drinking too much. If we keep a healthy weight and eat a healthy diet we will stop chronic inflammation in our bodies and strengthen our immune system. We need to stay away from ultraviolet light (direct sun exposure). We also need to stay active, no matter whether it is choosing to take the stairs and take daily walks, or whether we exercise regularly in a gym.

Aug

2018

HPV Testing For Cervical Cancer

By Ray Schilling | Cancer, cervical cancer, Prevention, Women’s Diseases

HPV testing for cervical cancer is more sensitive than the traditional Pap test. For years physicians recommended the traditional Pap test once a year to prevent cancer of the cervix. But a few years ago a new cervical cancer screening test, namely the HPV test made the news. It stems from the observation that cancer of the cervix develops in 99.7% of women who test positive for the HPV virus. There are many types of HPV, here we are interested in the few subtypes that produce cancer (carcinogenic HPV virus).

Transmission of the HPV virus between men and women

The human papilloma virus transmits from males to females through bisexual contact. The problem starts when he develops HPV lesions on his penis. Without him wearing a condom, the contact with her cervix during sex can transmit HPV to her cervix. Both partners are not aware of the transmission of that virus, as it does not cause any symptoms. HPV invades the superficial skin layer of the cervix in the woman. In the man HPV will invade the skin of the glans of the penis. After certain incubation time it causes transformation into cervical cancer in the woman. Strangely enough it does not cause cancer in the male. However, in both sexes HPV virus is in the mucous membranes and can contaminate the other sex’s genital.

A recent study comes from UBC Vancouver, British Columbia, which compared the Pap test with HPV testing.

Details of the Vancouver study on HPV testing for cervical cancer

On July 3, 2018 this study appeared in the medical journal JAMA.

19,009 women were part of this randomized clinical trial. With HPV testing only 2.3 cases per 1000 women of early cervical cancers were present four years later. Using the traditional Pap test this figure was 5.5 cases per 1000 women after 4 years. 224 clinicians participated in this study. Women were recruited for this study from January 2008 to May 2012. Follow-up took place till Dec. 2016. The participating women in this study were 25 to 65 years of age.

In 2017 in the US there were still 12,820 women in the United States who got cancer of the cervix. Approximately 4210 are dying from this disease every year. Many women do not like to take the Pap test or the HPV testing. There are compliance problems with either one of these tests.

Significance of this trial regarding HPV testing for cervical cancer

The newer HPV testing was superior to the regular Pap test. The HPV test was more sensitive and resulted in much lower cancer rates after 4 years of follow-up. Every woman would have an HPV test every 4 years. In this case we likely would see cervical cancer go to the bottom of cancers that kill women. The reason for that is that HPV testing and colposcopy pick up cancers much earlier. This leads to a more effective treatment of cervical cancer. After 4 years much less cancer of the cervix was found when the researchers tested again using HPV testing.

Implications of HPV testing for cervical cancer

In third world countries

Many 3^rd world countries do only the HPV testing. At the time when this decision was made, it was unknown that they had actually chosen the better method to test for cancer of the cervix. Now this trial reassures all the health care providers in 3^rd world countries that they should continue with the program, and they only have to do the test every 4 years, not every 2 years, which makes it even more cost effective.

Implications for the US

In the US so far the recommendation was to do both the regular Pap test and the HPV test simultaneously. This trial, however, says that this is not necessary. It would be better to use the more sensitive HPV test and abandon the more expensive and less sensitive PAP test. In 2012 a taskforce recommended to do the Pap smear in women age 21 to 65 every 3 years. The taskforce further recommended to women age 30 to 65 that they screen with a combo of cytology and HPV testing every 5 years. The lead investigator, Dr. Ogilvie said: “Offering women HPV [testing] for cervical cancer screening detects more precancerous lesions earlier, and also a negative HPV test offers more assurance that women will not develop precancerous conditions in the next four years,” she said. “This can mean that women may need less frequent screening but have more accurate results.”

What other doctors are saying about HPV testing for cervical cancer

Comments by Dr. Kathleen Schmeler

Dr. Kathleen Schmeler said that the study was “well-designed” and provided a much-needed comparison of Pap versus HPV testing. She is a gynecologic oncologist and at The University of Texas MD Anderson Cancer Center. She was part of the new research. Dr. Schmeler added: “The bottom line is that this could really potentially simplify how we screen women and have it be more effective and not quite as complicated and burdensome — and opens the door for doing just HPV testing, which is actually what’s currently recommended by the World Health Organization for countries that don’t have Pap testing capabilities,”

Comments by Dr. Stewart Massad

Dr. L. Stewart Massad Jr. is a professor of obstetrics and gynecology in the division of gynecologic oncology at Washington University School of Medicine. He wrote an editorial to the study in the JAMA. He wrote: “What will replace the Pap test? In 2012, the American Cancer Society endorsed co-testing with cervical cytology testing and HPV testing at 5-year intervals as the preferred strategy for screening women 30 to 65 years of age because this approach combines the sensitivity of HPV testing with the familiarity of traditional Pap testing,” He then went on to say: “However, the addition of cervical cytology testing adds little to the accuracy of HPV testing while increasing cost and false-positive results. In 2018, organizations that develop cancer screening guidelines are wrestling with whether to recommend replacing co-testing with primary HPV testing as the optimal screening strategy.”

Future dilemma

In view of all those comments the regulatory agents will have to come up with solutions for what is in the best interest of women for testing for cervical cancer.

HPV Testing For Cervical Cancer

Conclusion

A large randomized clinical trial in Vancouver, BC, Canada has compared screening methods for cancer of the cervix in women. Half of the subjects underwent screening by the newer HPV tests that checks for the presence of HPV virus. The other half received conventional screening by the Pap test (a cytological screening test.) The result was that the HPV test was more sensitive and resulted in less early cancer tests 4 years down the road. With the conventional Pap test there were more than double the amount of abnormal cells present 4 years down the road, which makes the Pap test less safe compared to the HPV test.

It appears from this trial that the Pap test is no longer a choice, except for colposcopy procedures that take care of early cervical cancers. But for screening in general HPV testing every 4 years is all what every women needs for her protection.

Frequent Flying Can Increase Cancer Rates

By Ray Schilling | breast cancer, Cancer, cervical cancer, Circadian rhythm, immune system, lung cancer, prostate cancer

A review article from June 25, 2018 discusses that frequent flying can increase cancer rates. A study showed that cancer of the breast, cervix, skin, thyroid and uterus are about twice as common in female stewardesses than in women at large. Also, gastrointestinal system cancers including cancer of the colon, stomach, esophagus, liver and pancreatic cancers are more common. This observation was true in both male and female flying personnel who engage in frequent flying. This publication comes from a scientific paper published on June 26, 2018.

Study of flight attendants

Patients from the National Health and Nutrition Examination Survey (NHANES) served as a control for flight attendants. This control group consisted of 2729 patients; they were of a similar socioeconomic status as the flight attendants. In contrast there were 5366 flight attendants with much higher cancer rates than normally expected. Specifically breast cancer had a 1.51-fold higher frequency than the control group. Melanoma had a frequency of 2.27-fold in comparison to controls, and non-melanoma cancers had a cancer rate of 4.09-fold when compared to controls. Non-melanoma cancer cases include basal cell and squamous cell carcinomas.

Cancer rates in pilots

In a meta-analysis of various studies it became obvious that pilots had 20% more prostate cancer than a non-pilot control group. However their mortality was not higher than controls.

In an interesting study spanning over 60 years Icelandic airline pilots underwent an analysis for cancer development.

83 cancers were registered. The general population (non-pilots) served as controls. There was an increase of 2.42-fold for all cancers compared to controls. Prostate cancer was higher in these pilots by 2.57-fold. Malignant melanoma had a 9.88-fold increase in pilots in comparison to controls. The basal cell carcinomas in these pilots were 3.61-fold more common than the rates in the controls. With regard to basal cell carcinomas of the trunk there were 6.65-fold more of them in comparison to controls.

The difference between the pilots and the general population was likely due to the higher exposure to cosmic radiation. This is what the authors concluded.

How does cancer develop?

There are several ways cancer can develop. One of the known cancer causations is ionizing radiation. We know a lot about this from the atom bombs of WWII in Japan. There were many more thyroid cancers in children than were normal following the dropping of the atom bombs.

But diagnostic CT scans and X-rays are not without risk of cancer development either. There is a lag period of 10 to 20 years and even longer. But after this time the higher cancer rate becomes measurable. A person who had a CT scan done as a diagnostic test in childhood will still have a 25% higher cancer rate 15 years later. This is how powerful radiation of the DNA of our cells is despite inherent repair mechanisms that fight back to keep things normal.

Single cancers versus multiple cancers

It is interesting that female stewardesses and male pilots came down with a mix of various cancers. There were skin cancers, breast cancers, cancers of the prostate and many gastrointestinal cancers. The numbers were not big enough to show statistical significance for leukemia also being a likely cause of cancer from cosmic radiation.

If cosmic radiation was going through the body randomly hitting various DNA strands in all cell types, which could explain why a random number of cancers develop in those cells that got the highest exposure. The ones who got above average cancer were stewardesses and pilots who were longest on their jobs. A variety of cancers would develop from various tissues. This is exactly what the studies have shown. Radiation exposure following the Fukushima disaster led to thousands of thyroid cancers.

There are frequent flyers like business travelers and vacation seeking retirees who will also be at a higher risk of developing cancer. The more they fly, the higher the risk.

Other causes of cancer

Cosmic radiation is only one cause of cancer. There are many other causes of cancer. If you smoke heavily or abuse alcohol this can cause genetic mutations of cells that can develop into cancer. There is a pathway to cancer, which consists of initiation, promotion and progression. After those initial hurdles the cancer cell will multiply and start metastasizing into other areas of the body.

Carcinogens can damage the DNA of cells. In the case of pollution carcinogens enter the body through the air. But consuming processed meat and red meat has a proven link to cancer development as well, namely colon cancer.

Diverse factors all can cause cancer

Chronic inflammation from chronic infections is also carcinogenic. Chronic gastritis is caused by H. pylori. After years of infection with this pathogen stomach cancer can develop. Hepatitis viruses that are chronically present in liver cells can be the cause of liver cancer. Human papilloma virus (HPV) is the cause for the development of cancer of the cervix. The majority of cancer is caused from the environment or by poor life styles. Only 5 to 10% of cancers are inherited.

Tumor suppressor genes are important in terms of resisting the development of cancer. The TP53 gene produces a protein that interferes with the multiplication of cancer cells. Cancer cells in turn can produce a protein that interferes with TP53 function. The end result is that it will interfere with the body’s immune system to produce killer T cells. This way the cancer has the upper hand. There are some herbs that have shown anti-cancer effects, such as curcumin. https://www.askdrray.com/curcumin-and-cancer/. As I explain in this blog, there are absorption problems with curcumin presently. It is not yet primetime for curcumin, but it could be once the absorption problems are overcome. Nevertheless the research surrounding curcumin is interesting.

Frequent Flying Can Increase Cancer Rates

Conclusion

Several interesting studies have shown that stewardesses, pilots and frequent airplane travellers have a higher risk of developing cancer. Research groups have been careful to control these studies for lifestyle factors and other causes of cancer. Exposure to cosmic radiation is the common culprit that is behind this cancer causation. There was a multitude of cancers rather than one single type of cancer in pilots and stewardesses. This makes it more plausible that it is indeed cosmic radiation that caused the cancer increase. But cancer development is complex, and I have summarized this briefly here. It is important to be aware of all the possible causes of cancer. This allows you to minimize your exposure to carcinogens. We all get exposure to carcinogens from pollution. In addition we get exposure to cosmic radiation according to how much time we spend flying to holiday destinations or on business trips. Be safe and be informed!

Dec

2016

Cancer Rates Increased In Women

By Ray Schilling | breast cancer, Cancer, cervical cancer, lifestyle, lung cancer, Prevention

A recent review of cancer rates worldwide shows that cancer rates increased in women. This by itself is alarming, but based on that data the rates likely will go up by 60% in the year 2030. The main reason is the smoking discrepancy among women and men. Men as a group have been smoking more than women. But women as a group are more and more embracing smoking. All of the negative health consequences of the last 3 decades for men are just starting to show now for women as well.

The World Health Organization explains it this way: in high-income countries like Australia, Canada, the US and Western Europe women smoke at nearly the same rate as men.

But in low and middle income countries women do not smoke as much as men do. For instance in China 61% of men are smokers, but only 4.2% of women are smoking. In Argentina 34% of men are currently smokers, which compares to 23% of women who smoke in this country.

When this gap will close, likely by the year 2030 women will have a whole host of diverse cancers, heart attacks and strokes caused by the smoking habit.

Some statistics and facts

High-income countries like Australia, Brazil, Canada, Israel and many northern and western European countries have a 5-year survival rate for breast cancer of 85%. In contrast the 5-year survival rates are 60% or less in low- and middle-income countries like South Africa, Mongolia, Algeria and India.

Cancer prevention measures can make a big difference later in life. Examples are hepatitis B vaccination, which will prevent liver cancer; vaccinating boys and girls against HPV, which will prevent cervical cancer in women; also having regular mammograms will detect breast cancer earlier and improve breast cancer survival rates.

Dr. Nestor Esnaola, surgical oncologist at Fox Chase Cancer Center at Temple University Hospital, Philadelphia, PA said that the cancer prevention methods just mentioned might not be available in developing countries. Instead of mammographies repeat breast self-examinations are more important there. Campaigns against smoking can be utilized in order to prevent cancer of the lungs, the throat and neck. And if colonoscopies are not available, stool samples can be tested for blood and hemoglobin to check for colon cancer.

Different cancer rates increased in women in different countries

There are different cancer types that make the top chart for different countries. For instance in 2012 breast cancer was on top of most countries worldwide as the number 2 killer behind heart attacks and strokes. But other cancers ranked fairly high as well as causes of death: colorectal, lung and cervical cancers.

Despite this trend there were other countries like China and North Korea that had a higher incidence of lung cancer rather than breast cancer. The cancer researchers stated that the reason for this is that the smoking rates are higher in these countries. As already pointed out in China more than ½ of the men smoke, but only a small minority of the women smoke. But women in China are exposed to high amounts of secondhand smoke in addition to environmental pollution, which still causes a lot of lung cancer in women who live in this environment.

In many African countries cervical cancer is very common. Women, who are HIV positive, have a 5-times higher rate of cervical cancer. Southern and eastern Africa where there are higher rates of HIV, have higher rates of cervical cancer.

More data about women’s cancer rates

An overview article entitled “Global Cancer Incidence and Mortality Rates and Trends—An Update” points out some interesting statistics. The greatest numbers of cancer cases and deaths occur among women in Eastern Asia. The estimate for 2012 worldwide was for 1.7 million cancer cases and 1 million deaths in women. China dominated its region with 75% of all female cancer cases and deaths in the region. In North America cancer cases and deaths within the US comprise 90% of the region. The cancer cases and deaths in India make up about 65% of the region of South-Central Asia.

The top mortality rates are found in low to medium income countries, namely in Zimbabwe, Malawi, Kenya, Mongolia and Papua New Guinea.

The most frequently diagnosed cancers in women are breast, lung, and colorectal cancers in economically more developed countries. However, the statistics are different for less developed countries where the top three most diagnosed cancers are breast, cervix, and lung. Similarly the leading causes of cancer deaths for women in developed countries are lung, breast, and colorectal cancers. In developing countries the leading causes of cancer deaths for women is cancer of the breast, lung, and cervix.

Cancer frequencies for women in different countries

The American Cancer Society reports that breast cancer is the most common diagnosed cancer among women in 140 countries. Cervical cancer is most common in 39 countries, all of which are low to medium income countries. There are some countries where other cancer types are more common. For instance in China and North Korea lung cancer is more common among women, in Mongolia and Laos liver cancer, and in South Korea it is thyroid cancer.

The most common cause of death from cancer in women is breast cancer in 103 countries, cancer of the cervix in 43 countries and lung cancer in 27 countries. Other most common cancer deaths in women are in the following countries:

Stomach cancer: in Bhutan, Peru, El Salvador, Guatemala, and Tajikistan
Liver cancer: in Laos, Mongolia and The Gambia
Colorectal cancer: in Japan and Slovakia
Esophagus cancer: in Turkmenistan.

Prevention and early detection

Changing the risk factors could modify 20% of breast cancer mortality worldwide. Avoiding excess body weight, physical inactivity and reducing alcohol consumption could all significantly reduce breast cancer mortality. For instance, women with a body mass index of greater than 35.0 have a 1.6-fold higher risk of breast cancer and a 2.1-fold higher mortality rate from breast cancer than women with a body mass index of less than 25.0.

Regular breast cancer screening with mammography is another tool that will reduce breast cancer mortality as the cancer is diagnosed earlier and treated at an early stage where it can often be cured. The WHO recommends for those countries where mammography programs are established that screening should be done only every two years and only between the ages of 50-69 to avoid X-ray over exposure.

Early detection, like for any cancer is the key for successfully treating breast cancer. When there is an early diagnosis of breast cancer, surgical removal in healthy tissue (lumpectomy) often cures breast cancer. Unfortunately in low to medium income countries the cancer is often found too late, requires more invasive mastectomies and radiotherapy and has a lower survival rate than in developed countries.

Cervical cancer

Cervical cancer accounts for the 4^th most frequently diagnosed cancer in the world. In 2012 there were 527,600 cases of cervical cancer worldwide and 265,700 deaths from cervical cancer occurred in the same year. 90% of cervical cancers occur in developing countries with India accounting for 25% of the total cases. The key in detecting cervical cancer is a regular screening program. In developed countries where this has been in place cervical cancer incidence has decreased by 80% in 4 decades. At the other end of the spectrum are countries like Uganda, Zimbabwe, and some countries of Central and Eastern Europe where cervical cancer rates have been climbing.

Human papilloma virus

The reason for the spread is that the human papillomavirus (HPV) is now more common and screening methods for cervical cancer are not in place. HPV 16 and 18 are the most common carcinogenic subtypes of the human papilloma viruses; they are responsible for 70% of cervical cancers worldwide. Vaccinating teenagers before they engage in sex is a powerful tool to interrupt the infectious spread of an important risk factor for cervical cancer.

Cervical swab for HPV-DNA test

Instead of the traditional Pap test from the past the new test that is in use now is an HPV-DNA test, a cervical swab that will detect DNA from HPV directly. It is more sensitive than the traditional Pap test. If the HPV-DNA test is positive, the patient sees a gynecologist who performs a colposcopy test. This is a microscopic exam of the cervix. The gynecologist can use several effective treatment methods like a loop electrosurgical excision procedure, laser ablation therapy, cryotherapy or conization for deeper cervical cancer lesions.

As with any cancer early detection and treatment is paramount with cervical cancer. In developed countries the 5-year survival rate is 60 to 70%. In India the 5-year survival rate is 46%.

Cancer of the lung

In 2012 there were 583,100 cases of lung cancer in women worldwide and 491,200 died from it. Lung cancer is the second leading cause of cancer death in women and the third most common cancer. The statistics of lung cancer reflect the tobacco epidemic. It takes about 20 to 30 years after widespread smoking begins in a country before the deadly statistics set in. The peak of the cancer epidemic and the heart attack rates occurs about 30 to 40 years following the peak of smoking in that population.

Lung cancer rates globally

Lung cancer rates in women have lagged behind men, because women as a group have started smoking later. In places like Hong Kong, the United Kingdom, Australia, and the United States women started smoking earlier, and they are in the process of declining their smoking habit or quitting. The new lung cancer cases and also the lung cancer mortality rates are reflecting this. Sadly, in many countries of Europe and Latin America women started smoking much later and they are still increasing their lung cancer statistics and mortality rates. Lung cancer killed 1.1 million men and 0.5 million women worldwide in 2012. Cancer epidemiologists estimate that in addition there are 21,400 lung cancer deaths annually from second-hand smoke in non-smokers worldwide.

Other causes of lung cancer

Beside smoking there are other risks causing lung cancer. The estimated risk for women to die in millions is: exposure to household air pollution, 1.6; outdoor air pollution, 1.4; second-hand smoke, 0.35; occupational risk factors, 0.10; and residential radon, 0.03.

Cancer Rates Increased In Women

Conclusion

Women are still in the midst of a global increase of cigarette smoking, which starts often with female teenagers. As long as the smoking rate goes up there will be more breast cancer, lung cancer and cervical cancer. The American Cancer Society provided a detailed review of various cancers and how they are still increasing worldwide, because nobody pays attention to preventative measures. A simple step to prevent cancer is to quit smoking. Another step is to engage in regular physical activity. Finally keeping your body mass index under 25.0 is a third step that can be done by adopting a Mediterranean diet.

There are several pockets within the developed countries where cancer rates are coming down, which is encouraging. I illustrated this complex topic by giving an initial overview and then three examples of breast cancer, cervical cancer and lung cancer.