Tag Archives: Skin Cancer

INNOVATIONS IN CANCER TREATMENT

Understanding Cancer: Targeted Treatments

Cancers develop from multiple causes including genetic factors, infection, environmental toxin exposure and lifestyle factors such as tobacco use. Some are very slow growing while others grow and spread rapidly. No cure-all for cancer is likely in the near future. A strong immune system efficiently suppresses cellular and precancerous changes. With age and reduced immunity and sometimes for unknown reasons, abnormal cells grow and spread by direct extension to surrounding tissues, and metastasize throughout the body via blood and lymph. Each year treatments improve and many more of them are targeted at mutations and cell surface markers.

Two heritable disorders are mutations in the human genes that belong to a class of genes that are tumor suppressors, the BRCA1 and BRCA2 genes. The normal genes help stabilize DNA and prevent uncontrolled cell growth. Mutations block the stabilization and lead to early breast and ovarian cancer.

BRCA= BReast CAncer Susceptibility gene 1 and 2, affect both men and women. Men who carry this gene are also at risk for breast, and possibly pancreatic, testicular and early prostate cancer.

Other harmful mutations in the BRCA 2 gene increase risk of many other cancers including melanoma skin cancer.

Knowing you carry the BRCA gene can allow you to make decisions before the cancer develops. In women without the abnormal gene, the lifetime risk of developing breast cancer is 12% or 120/1000. In women with the harmful BRCA1 or BRCA2 mutation, they have a 60% chance or 600/1000, of developing the cancers. Many affected women make the decision to have both breasts and ovaries removed before cancer develops. This may sound drastic, but it is life saving.

An example of targeted treatment based on cell surface receptors is the Human Epidermal Growth Factor Receptor 2 (HER2) an abnormal protein found on breast cancer cells. The abnormal cancerous cell growth is triggered by an excess of HER2 due to a gene mutation and is found in other cancers, not just breast. This form of breast cancer tends to be more aggressive than other types. It is also less responsive to hormonal treatment.

Luckily there are two very specific drugs that target HER2, killing the abnormal cells but not the normal ones. These are Herceptin (Trastuzumab) and Tykerb (Lapatinib). Both may be used in combination with other chemo therapy drugs. They are not without side effects as both can cause heart toxicity and allergic reactions.

Other examples of innovations in the treatment of cancer patients are a vaccine that targets a particularly aggressive brain tumor (glioblastoma). This new treatment significantly prolongs life.  Another is melanoma skin cancer.  40-60% of them contain a mutation that encodes BRAF gene. The BRAF mutation is associated with features of high risk aggressive melanoma. This gene makes a protein (B-Raf) which is involved with directing cell growth. Inhibitors have been developed to target the abnormality; one year ago Vemurafenib was released to treat late-stage melanoma.

Betty Kuffel, MD

Summer Sun – Benefits, Dangers & Preventions

Image1.  Sun Benefits: Smiles and Vitamin D

Invigorating sunshine can scatter the winter blues and put a smile on your face. When ultraviolet sun rays strike and warm your skin they trigger Vitamin D synthesis. Residents in northern climate are often Vitamin D deficient. We miss the beneficial sun effect because much of the year we are bundled in clothing. To maximize your absorption of Vitamin D from the sun, you may want to soak up a few rays before applying your daily sunscreen. Vitamin D is necessary for the body to absorb dietary calcium, essential for strong bones, teeth and more. Very few foods are rich in Vitamin D, so dietary supplements may be necessary to maintain a healthy Vitamin D level. All Vitamin D forms, including those from the sun, food and supplements are inactive. The liver and kidneys convert the inactive forms into active calcitriol molecules capable of being absorbed by the body.

Inadequate Vitamin D impacts many complex cellular processes including:

  • Bone structure and weakness due to calcium deficiency
  • Cell growth, immune and neuromuscular function, and reduced inflammatory response

A simple blood test can determine an individuals’ level of Vitamin D and supplements can be prescribed to offset a deficiency.

2.  Sun Dangers: Skin & Eye Damage and Skin Cancer

The two ultraviolet radiation spectrums of concern are UVA (320-400nm) and UVB (290-320). UVA is known to penetrate deeper into the skin and is the primary cause of skin wrinkling, non-melanoma skin cancers and possibly melanoma. It is not blocked by automobile or window glass and does not result in sunburn – 95% of sunlight reaching the earth is UVA. UVB is known to be the major factor in tanning and sunburn.

In addition to skin damage, the sun rays can damage both the lens and cornea of the eyes. Clouding in the lens indicates a cataract formation and reduces vision. A feared disease of the retina, the macula, is responsible for sharp visual focus. When the macula deteriorates, acute vision required for reading, is impaired. Macular degeneration often runs in families but UV radiation has also been linked to this disorder. Vitamin supplements may be helpful in prevention. There are some treatments available, but they are not always successful in preventing vision loss.

3.  Sun Risk Preventions:

  • Protect yourself and your children against UVB by wearing sunscreen. SPF stands for Sun Protection Factor. An SPF 15, for example will provide about an hour of protection before it is necessary to reapply sunscreen. This varies from person to person, however, so be watchful and read product directions carefully.
  • Protect your skin against UVA burning, by wearing a protective hat, and clothing.
  • Always avoid prolonged sun exposure to decrease risk for collagen destruction resulting in early skin aging and dramatic increased risk for melanoma.
  • Protect your eyes by always wearing sunglasses. Children also need to wear them. Dogs, too, develop UV eye damage. Doggie goggles are available at www.goggles.com

Enjoy the sun, but in moderation.

Betty Kuffel, MD