Pancreatic Cancer Treatment: Could

Tuesday, November 20, 2012

Telomere Length In Blood Cells Could Lead To Test For Pancreatic Cancer

Main Category: Pancreatic Cancer
Also Included In: Genetics; Blood / Hematology
Article Date: 25 Oct 2012 - 0:00 PDT Current ratings for:
Telomere Length In Blood Cells Could Lead To Test For Pancreatic Cancer
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A new study shows that a blood marker is linked to pancreatic cancer, according to a study published by scientists at the University of Wisconsin Carbone Cancer Center and Mayo Clinic.

First author Dr. Halcyon Skinner, assistant professor of population health sciences at the University of Wisconsin School of Medicine and Public Health, says the study is the first time pancreatic cancer risk has been linked to differences in telomeres' length in blood cells.

"This suggests a new avenue to identify those with pancreatic cancer or those at risk of developing the cancer in the future,'' he says.

Skinner's colleagues at Mayo Clinic took blood samples from more than 1,500 people - 499 of them with a diagnosis of pancreatic cancer and 963 of them cancer-free control subjects. Specifically, the scientists were interested in the length of the telomeres - the end caps on chromosomes - found in white blood cells. They found a direct relationship with the risk of pancreatic cancer: the shorter the telomeres, the more likely a person was to have pancreatic cancer.

Telomeres maintain the stability of genes, and are known to shorten with age as cells divide. People of the same chronological age can have vastly different telomere lengths. In other words, some people's cells can by viewed as biologically older than cells from other people the same age.

"We know that people with many factors that are classically unhealthy also tend to have shorter telomeres. Those who have had stressful lives, exposed to chronic inflammation, have poor glucose control or smoked cigarettes tend to have shorter telomeres, and that can set the stage for genetic damage,'' Skinner explains.

Shortened telomeres in the blood have already been associated with other types of cancer, including colon cancer.

"We found the same relationship with pancreatic cancer, and for the vast majority of our participants, there was a direct linear relationship," he says, "the shorter the telomere, the higher the likelihood of pancreatic cancer."

But because shorter telomere length is also associated with the development of other cancers and other diseases of aging, measurement of telomere length alone is not a specific marker for pancreatic cancer.

Dr. Lisa A. Boardman, of Mayo Clinic, who led the overall study, says that future studies need to address if telomere length and other markers of pancreatic cancer should be combined to create a test that could be used clinically.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our pancreatic cancer section for the latest news on this subject. Skinner and UW colleagues Ron Gangnon and Kristin Litzelman led the design and data analysis of the study. It is being published in Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.
Skinner's work was supported by the National Institutes of Health (K07 CA109361).
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Tuesday, November 13, 2012

Lives Could Be Saved By Referring Cancer Patients To More Experienced And Successful Hospitals For Surgery

Main Category: Pancreatic Cancer
Also Included In: Public Health; Colorectal Cancer
Article Date: 21 Oct 2012 - 0:00 PDT Current ratings for:
Lives Could Be Saved By Referring Cancer Patients To More Experienced And Successful Hospitals For Surgery
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Researchers at Rice University report that referring cancer patients to hospitals with better track records for surgery could save lives and not raise the cost to patients. The study was reported online in the journal Forum for Health Economics and Policy.

The researchers reviewed data on two cancer operations that are at "opposite ends of the spectrum" - colon and pancreatic resections, said paper author Vivian Ho, Rice University's Baker Institute Chair in Health Economics and a professor of economics. Pancreatic resection is performed much less often than colon resection, but it's a very complicated operation that can take 5 to 8 hours and has a much higher mortality rate. Colon resection is more straightforward, is performed much more often and has a much lower mortality rate.

"If all patients needing surgery for colon cancer were referred to hospitals that have consistently achieved mortality rates in the bottom half of all hospitals performing this operation, then the average mortality rate could fall from a rate of 3.8 percent to 2.4 percent," Ho said. "And if all patients who require surgical resection for pancreatic cancer were referred to hospitals performing 11 or more of these operations per year, mortality rates could fall by half, from a rate of 6 percent to 3 percent."

The analysis was based primarily on hospital records for all patients who received surgery for colon cancer or pancreatic cancer in California, Florida, New Jersey or New York between 2001 and 2005. This data was combined with hospital information from the American Hospital Association, the Medicare program and MarketScan Research Data. The researchers used this data to determine the association between the number of surgical operations performed each year and patient mortality rates for each cancer type. Regression analysis was used to adjust for multiple differences in patient characteristics that are important determinants of patient mortality.

The investigators then used their regression analyses to simulate how mortality rates might change if, for instance, patients at poorly performing hospitals were referred to the closest hospital that had achieved mortality rates (adjusted for differences in patient characteristics) in the lower half of the distribution relative to all other hospitals in their state between 2001 and 2005.

For colon cancer patients, higher-volume hospitals did not achieve lower mortality rates than hospitals that performed fewer colon resections per year. However, many hospitals performed consistently better than others in terms of lower patient mortality during the study period, Ho said.

"We were concerned that the centralization of cancer care that would result from referring patients to a smaller set of higher-volume hospitals could give these hospitals additional market power to raise prices," Ho said. "We also wondered whether higher-volume hospitals might have a different cost structure that would raise or lower costs per patient. We found no statistical evidence that hospitals that performed more of these cancer operations were able to charge higher prices to patients for these services. We found that costs per patient were indeed higher for hospitals performing more pancreatic cancer surgery. However, these higher costs were not passed on to patients as higher prices for patient care."

Ho recommended that mechanisms be constructed to refer cancer patients to those hospitals where they are likely to achieve better outcomes. "Some states already post information on their health department's website on the number of pancreatic cancer surgeries performed by each hospital per year, or inpatient mortality rates adjusted for patient characteristics. Private not-for-profit organizations such as the American Cancer Society and the American College of Surgeons could partner with public national and state organizations to replicate the information in our study and make it available to referring physicians and their patients."

The study, “Can Centralization of Cancer Surgery Improve Social Welfare?”: http://www.degruyter.com/view/j/fhep.2012.15.issue-3/issue-files/fhep.2012.15.issue-3.xml

Rice University

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