New research reveals link between molecular mechanisms in prostate cancer, Ewing’s Sarcoma

The results of the study, reported in the journal Cell Reports, suggest that the molecular mechanism that triggers the rare disease Ewing’s sarcoma could act as a potential new direction for the treatment of more than half of patients with prostate cancer.

A form of bone and soft tissue cancer that affects about one in 1 million children and young adults age 10 to 19, Ewing’s sarcoma is terminal in 44 percent of teens age 15 to 19 and 30 percent of children. Over 100,000 men are diagnosed with prostate cancer each year in the U.S, with more than 99 percent of cases occurring after age 50.

“This research shows that the molecular mechanism involved in the development of most prostate cancers is very similar to the molecular mechanism known to cause Ewing’s sarcoma,” said Peter Hollenhorst, an associate professor in the Medical Sciences Program at IU Bloomington, a part of the IU School of Medicine. “It also suggests that this mechanism might be used to explore a common treatment for both diseases, one of which is not often pursued by drug companies due to its rarity.”

Hollenhorst is also a member of the Indiana University Melvin and Bren Simon Cancer Center in Indianapolis.

Other authors on the paper include Vivekananda Kedage, a graduate student in the IU Bloomington College of Arts and Sciences’ Department of Molecular and Cellular Biochemistry, and Travis J. Jerde, an associate professor in the Department of Pharmacology and Toxicology at the IU School of Medicine in Indianapolis. Kedage is the first author on the study.

Referees add more extra time when the big teams are losing

The stoppage time added by the referee following the obligatory 90 minutes of a football match is used to compensate for time lost due to substitutions, injuries, expulsions and other incidents that arise during the game, but it seems as though other factors also play a role according to a new study.

Researchers Carlos Lago, from the University of Vigo (Spain), and Maite Gómez, from the European University of Madrid, have confirmed that referees favour the big teams by reducing the extra time when these teams are ahead on the scoreboard. In contrast, and according to an article published in the journal ‘Perceptual and motor skills’, referees slightly draw out the match when the big teams are losing.

To carry out the study the authors relied on data from the 380 matches played in the Spanish league during the 2014-2015 season. They then took several variables into account -such as the difference in goals on the scoreboard, the playing level of each team, the number of red and yellow cards, player substitutions, the average number of assists and fouls committed- to see if any of them had an influence on the amount of stoppage time.

After applying a statistical method (called linear regression and widely used to identify relationships between variables), it was observed that the greater the difference on the scoreboard, the less stoppage time was given by the referee. In very tight matches, nevertheless, refs tend to add more seconds when the team in the higher division is losing, and fewer seconds when they are winning. The number of red cards and fouls also cause an increase in extra time.

New radiotracer could make diagnosing prostate cancer faster and easier

Prostate cancer is the fifth leading cause of death worldwide and is especially difficult to diagnose. While prostate cancer is relatively easy to treat in its early stages, it is prone to metastasis and can quickly become deadly. In order to plan how aggressively they should treat the cancer, it is important for doctors to know how far the cancer has progressed. Currently, doctors use a variety of imaging techniques and tests to diagnose and monitor prostate cancer including PSA blood tests, magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT), positron emission tomography (PET), and computerized tomography (CT) scans. Each method has strengths and weaknesses, but there is no single method that is able to successfully identify and monitor primary tumors, metastatic lymph nodes, and bone lesions.

Xiaoyuan Chen, Ph.D., Chief of the Laboratory of Molecular Imaging and Nanomedicine at NIBIB, and his team attempted to solve this problem by developing a radiotracer that could identify prostate cancer at all stages. Radiotracers are made up of carrier molecules that are bonded tightly to a radioactive atom. Like a key fitting into a lock, the carrier molecules bind to certain receptors or biomarkers and the radioactive atoms enable PET or SPECT scanners to image areas where the tracers have collected in large numbers. This new tracer targets two biomarkers, gastrin-releasing peptide receptor (GRPR) and integrin αvβ3, that often indicate prostate cancer. Previous tracers have targeted GRPR but this new tracer is one of the first dual-receptor target tracers, or tracers that target more than one biomarker, to be studied in humans.

The tracer was able to successfully identify 3 out of 4 primary tumors, all 14 metastatic lymph nodes and, significantly, was able to identity all 20 of the bone lesions in the patients. The current method of identifying bone lesions is to use the radiotracer MDP with a SPECT scanner. While this method is consistently able to identify bone lesions, it often comes up with false positives and is not able to identify primary tumors. This can cause the patient to undergo unnecessary treatments or painful biopsies.

“We are far from finding one method to diagnose and monitor prostate cancer, but this is a step in that direction,” says Chen. “Targeting multiple biomarkers could potentially allow us to identify prostate cancer at its early stages as well as after metastasis in one scan.”

Chen believes that dual-receptor targeting tracers could one day be the primary method for diagnosing and monitoring prostate cancer reducing the amount of medical scans a patient would be forced to undergo and streamlining the diagnostic and therapeutic process.

Predicting and preventing prostate cancer spread

Published in the journal Cancer Research, the discovery has potential to lead to the development of a blood test that could predict whether cancer will spread from the prostate tumour to other parts of the body. The research also reveals potential new targets for drugs that may inhibit the spread of cancer.

“Prostate cancers only kill men after they have spread or ‘metastasised’ from the prostate,” says project leader Dr Luke Selth, Senior Research Fellow at the University of Adelaide’s Dame Roma Mitchell Cancer Research Laboratories and a member of the Freemasons Foundation Centre for Men’s Health.

“The identification of markers that accurately predict, at an early stage, prostate tumours that are likely to metastasise could guide the urgency and aggressiveness of treatment — and this could save lives.”

The international research team — led by the University of Adelaide and including members from the University of Michigan, Vancouver Prostate Centre, the Mayo Clinic and Johns Hopkins University — showed that a specific microRNA (a type of molecule involved in regulating the level and activity of genes) called miR-194 promotes cancer metastasis by inhibiting a key protein called SOCS2. SOCS2 can suppress the spread of cancer cells.

“In previous work, we had found that a high level of miR-194 in a patient’s blood was associated with rapid relapse of prostate cancer following surgical removal of the tumour,” says Dr Selth. “This new work explains why miR-194 is associated with a poor outcome, and in the process reveals a completely novel pathway regulating prostate cancer metastasis.

“Importantly, measuring miR-194 in a patient’s blood at the time of diagnosis could become a test for the likelihood of metastasis. Patients with high levels of miR-194 in their blood could receive more aggressive treatment to reduce the chance of the cancer spreading to other parts of the body.” Dr Selth’s team is currently testing this idea using larger patient groups to validate their findings.

Dr Selth says miR-194 also represents a potential therapeutic target. “There are currently no drugs that effectively inhibit the spread of prostate cancer,” he says. “We propose that inhibiting miR-194 could reduce rates of metastasis in patients with aggressive disease, but the development of a drug to achieve this goal is still a long way off.”

Switch from observation only to active treatment by prostate cancer patients varies by race/ethnicity

“A primary reason that we examined whether sociodemographic and clinical factors predicted switching to active treatment was that studies have primarily been performed in non-ethnically diverse populations,” explained co-principal investigator Scott P. Kelly, PhD, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC. “We wanted to determine whether observational management like active surveillance is underused in minority populations, particularly within the framework of an equal access health care system. This is one of the few groups studied with sufficient sample sizes to examine whether the associations of clinical triggers for beginning active treatment varied by sociodemographic factors.”

The study included patients who had been diagnosed with low risk prostate cancer between 2004 and 2012 at Kaiser Permanente Northern California. They did not receive any treatment within the first year of diagnosis and had at least two years of followup. “Because Kaiser Permanente Northern California is a large, integrated health system covering a diverse population, it was possible to independently assess ethnic and economic influences on treatment choices,” said Stephen Van Den Eeden, PhD, co-principal investigator for the study and lead researcher at the Kaiser Permanente Division of Research, Oakland, CA. “Over 31% of patients studied were from minority populations.”

Non-Hispanic black men were slightly more likely to begin active treatment than non-Hispanic white men, independent of their status at the beginning of the study and followup clinical measures. Among men who remained on observation, non-Hispanic black men were re-biopsied within 24 months of diagnosis at a slightly lower rate than non-Hispanic white men.

Despite nonclinical factors like race and ethnicity, Gleason score progression (a measure of tumor aggressiveness) and results of prostate specific antigen testing were the primary clinical triggers that prompted active treatment in men on active surveillance. Other reasons may include lack of patient awareness of active surveillance, patient anxiety, physician anxiety about whether deferred treatment could result in poorer long-term outcomes, and the societal inclinations for treating all cancers.

While the results were only marginally significant, they suggest that race may be a factor for switching to active treatment even among men on active surveillance. “These results are important as clinicians may be increasingly hesitant to require men to undergo serial re-biopsies due to complications, yet black men are known to have a greater likelihood of prostate cancer progression, which suggests that clinicians should be particularly vigilant in the surveillance of black men on active surveillance,” noted Dr. Kelly.

Commenting on the study, David F. Penson, MD, MPH, of the Department of Urologic Surgery, Vanderbilt University Medical Center and the Veterans Affairs Tennessee Valley Geriatric Research, Education and Clinical Center, Nashville, TN, noted that the current study “underscores the need to develop patient navigation tools for prostate cancer that are racially and culturally tailored to individual patients. All men who elect to go on active surveillance should have similar close followup regardless of race, ethnicity, or socioeconomic status.”

Sensors used to monitor dangerous hits on football field

With a grant from Banyan Biomarkers and matching funds from the Florida High Tech Corridor Council — together totaling $574,910 — UF researchers have purchased the Head Impact Telemetry System, or HITS, to measure the impact, duration and location of each hit football players take in real-time through sensors placed in their helmets.

Led by Dr. James Clugston, a University Athletic Association team physician at UF and an assistant professor of community health and family medicine, the UF researchers will correlate the data they collect from the sensors with additional data from blood and magnetic resonance imaging tests. This will allow researchers to get a complete picture of concussions when they occur in athletes.

“We are still trying to find objective ways to detect concussions and help us know when someone is recovered so they can return to play,” Clugston said. “We wanted to get a measure of the amount of force that athletes were experiencing. With this system, we will get real-time data to assess the severity of the impact.”

The researchers began using the system at the start of the current football season in August. They are measuring hits in 30 football players on the UF team.

In addition to helping the researchers understand more about the forces at work in concussions, the data collected from the sensors also can help individual players reduce their own risk of injury. For example, the system has already allowed the researchers to see that some players were putting their heads down during tackles, which is dangerous and increases their risk of concussion and cervical spine injury. The coaching staff was alerted and then able to talk to the players so they could correct the behavior.

Obesity on the rise in adults with a history of cancer

Results were based on data from a nationally representative sample of 538,969 non-institutionalized adults aged 18 to 85 years with or without a history of cancer who participated in the annual National Health Interview Survey from 1997 to 2014. Obesity was defined as body mass index of 30 kg/m2 for non-Asians and of 27.5 kg/m2 for Asians.

Among 32,447 cancer survivors, the most common diagnoses were cancers of the breast followed by prostate, and colorectal cancers. Populations with the highest rates of increasing obesity were colorectal cancer survivors followed by breast cancer survivors. African-American survivors of all three cancers were particularly affected.

“Our study identified characteristics of cancer survivors at the highest risk of obesity, which are important patient populations in which oncology care providers should focus their efforts,” said Heather Greenlee, ND, PhD, assistant professor of Epidemiology at the Mailman School, and principal investigator.

From 1997 to 2014, prevalence of obesity increased from 22 percent to 32 percent in cancer survivors and from 21 percent to 29 percent of adults without a history of cancer. During this time, rates of obesity grew more rapidly in women cancer compared to both male cancer survivors and compared to women with no history of cancer.

In female colorectal cancer survivors, those who are young and non-Hispanic black and had been diagnosed within 2 to 9 years had the highest increasing rates of obesity. Similarly, among female breast cancer survivors, those who are young, were diagnosed within the past year, and are non-Hispanic white had the highest increasing obesity rate. Among male colorectal cancer survivors, the highest increases in obesity were among older men, non-Hispanic blacks, and those at or greater than 10 years from diagnosis. In contrast, prostate-cancer survivors with the highest increases in obesity were younger, non-Hispanic whites, and 2 to 9 years from diagnosis.

“While our findings can be partially explained by the growing population of patients with breast and colorectal cancer — the two cancers most closely linked to obesity — we identified additional populations of cancer survivors at risk of obesity not as well understood and which require further study,” observed Dr. Greenlee.

“These results suggest that obesity is a growing public health burden for cancer survivors, which requires targeted interventions including weight management efforts to stave off the increasing obesity trends we are seeing in cancer survivors,” noted Dr. Greenlee.

Revealed: the world’s top hidden gems (just keep it to yourself)

The world’s best-kept travel secrets are out – but they won’t stay secret for long.

Why? Because a leading tour firm have listed their top 20 following a survey when found that, when we find somewhere exclusive and special, we tend to keep it to ourselves.

Little-known destinations such as Jaffna in the North of Sri Lanka, El Nido Pangalusian Island in the Philippines and Mexico’s ancient Mayan city of Yaxchilan are among everything from tiny towns to palm-flecked beaches named in a list of the world’s top 20 hidden gems.

Bukchon Village in Seoul, South Korea

They were revealed in a study which found that eight in 10 British holidaymakers were more interested in escaping the usual tourist traps than the more well-known destinations on their next holiday.

Just one per cent of the UK has heard of Indonesia’s Gili Meno Island, selected by Kuoni due to its pristine beaches and crystal-clear waters. While its neighbouring island Gili Trawangan is now a hotspot for backpackers, the island of Gili Meno remains firmly off the beaten track.

View of the Taj Mahal from Mehtab Bagh, India

Three quarters said they wanted to go somewhere none of their friends have been and a fifth of them thought it would make them appear more worldly.

When asked for examples, a tiny 0.1 per cent had heard, for example, about the tranquil garden complex of Mehtab Bagh, which sits on the banks of the Yamuna River in India behind the Taj Mahal, according to the survey by Kuoni.

No surprise given that many people admitted that, while they enjoy visiting lesser-known places friends have recommended, they were less likely to tell others about them.

Kuoni’s spokesman Rachel O’Reilly said:

While the Grand Canyon, the Great Wall of China and the Taj Mahal attract thousands of visitors per year between them, a generation of travellers are now seeking more secluded beauty spots.

Six in 10 of our respondents said they’d never share a travel secret with anyone else, suggesting that hidden holiday gems are very personal.

Global travel is accelerating, and many well-known sights have a huge volume of visitors, while other equally beautiful places provide seclusion, with jaw-dropping beauty and in some ways create stronger personal experiences.

People’s travelling lifespan has expanded – from a very young age people are used to travelling to new places with their families and continue to explore the world as they seek new experiences well into their seventies and eighties – so people want fresh perspectives and new inspiration which, is what our new list is all about.

And we are happy to pay for privilege. UK holidaymakers said they’d be happy to pay an average of £300 extra for their holidays, if it included an unforgettable secret sight.

The hike between OIA and Imerovigli, Santorini, Greece

The top 20 best kept travel secrets in the WorldViews of the Taj Mahal from Mehtab Bagh, IndiaThe island of Gili Meno, IndonesiaEl Nido Pangulasian Island, PhilippinesJaffna, north Sri LankaCon Dao Island, VietnamThe hike between OIA and Imerovigli, Santorini, GreeceThe island of Bequia, the GrenadinesTirimbina Rainforest Reserve, Costa RicaThe Journey Through Hallowed Ground National Heritage Area, Virginia, USASalar de Uyuni (Uyuni Salt Flats), BoliviaThe town of Matera in the Basilicata region of Italy (find out more: Matera – from shame to chic in 50 years)The koalas of Kennet River on the Great Ocean Road, Victoria, AustraliaFarewell Spit, New ZealandBukchon Village in Seoul, South KoreaLake Atitlan, GuatemalaOmodos Village, CyprusKwaZulu-Natal (KZN), South AfricaYaxchilan, the ancient Mayan city in the state of Chiapas, MexicoMargaret River, Western AustraliaZebra migration in Botswana

Do you have a hidden gem you discovered during your travels? Leave a comment (or will you keep it to yourself?)

24 Hours in San Sebastian, Basque Country, Spain

Port and Mount Urgull, San Sebastián (c) Guillén Pérez

It’s no longer a secret: San Sebastian, European Capital of Culture in 2016, is a gastronomic gem in a land of spectacular food. If you’re planning on spending 24 hours in this city you’ll need to loosen your waistband.

Sure, Spain has a glut of fantastically picturesque cities and some of the best food on the planet, but San Sebastian known as Donostia in the Basque Country, might just be the jewel in the crown.

The city is also very compact so you will be able to walk from one side to the other relatively quickly. If nothing else, bring your swimming gear and comfy walking shoes.

Must Visit

Playa de la Concha (c) Thomas Julin

La Playa de la Concha beach, with its golden crescent sweeping from Parte Vieja (old town – the heart of the city) in the east to Monte Igueldo in the west, is a wonderful feature of this city.

It is probably one of the finest city beaches in Europe, probably the world, you’ll want to spend a while splashing in the sea or people watching. And let’s not forget Playa de Gros (also known as Playa de la Zurriola), a favourite with surfers.

But to get the picture postcard view you’ll need to head to the funicular up to the top of Monte Igueldo. A €3.15 ride takes you to the antiquated but charming funfair on top of the hill which offers views that can accurately be described as ‘breathtaking’.

We also went for a ride on the rickety roller coaster and climbed ‘The Tower’ for even better views. All the attractions are about €3 each for adults.

Must Eat

pintxos (c) José Porras

Food wise, San Sebastian is akin to a culinary sweet shop. The old town (Parte Vieja) is studded with wood-panelled bars sporting unpronounceable Basque names such as txepetxa and etxberria. Passing each one you’ll spy little gastronomic works of art lined up along the bar.

These are pintxos (pinch-os), the local variety of tapas and it is these that give the Basque region their rep for quality food. Each one costs around €2-3 and it can be tempting to get stuck in and spend a fortune.

Our favourite pintxos bars were Bar Zeruko, where everything on the bar looked picture perfect and Bar Azkena, which is down a flight of stairs hidden in a market near the local Lidl.

Top tip! Order from the specials board. We had slow-cooked veal cheek with foie gras and a lobster morsel served in a shot glass with dry ice (don’t drink the dry ice!).

But our advice is treat the pintxos like an appetizer and head to one of the many Michelin starred restaurants in town. There is a splendid selection.

Arzak is the most famous of the three Michelin starred restaurants on offer. But you’d be hard pressed to choose between them, Akelarre or Kokotxa.

We sampled the fare at Narru for their exquisite lunch menu. Bookings are recommended at all the restaurants.

Must Drink

The Basque’s are a proud lot and they’re justifiably proud of their unique booze options. Just ask any barman what he recommends and the answer will be one of these.

Txakoli (cha-ko-lee) is a tangy apple wine which is poured with a flourish – a cascade from a great height into a small glass. Don’t try and do it yourself!

The local cider (cidra) is also a must try. If you’re not a cider drinker then if you only try once, do it in San Sebastian.

Must Stay

A literal stones throw from La Concha beach, Hotel de Londres y de Inglaterra is a grand and palatial looking building in the heart of the city centre. The rooms are cool and light with a chic modern finish, despite the classical exterior. The location is ideal for the 24 hour visitor, with the old town a 10 minute walk, the beach barely 2 minutes and the main shopping area on the doorstep.

The bar in the hotel also overlooks the beach so you can watch the world go by over breakfast.

Search more hotels in San Sebastian:

Getting There

San Sebastian’s airport is small and only flies internally between Madrid and Barcelona. The nearest international airports are Bilbao (around an hour by bus) or Biarritz in France (just under an hour).

Tickets can be bought at both airports directly to the bus station in San Sebastian.

Link between common prostate cancer treatment, dementia detailed in new study

The team compiled data from four different global databases looking at studies on ADT patients and dementia and Alzheimer’s. An analysis of more than 50,000 patients worldwide showed a consistent statistical link between men who underwent ADT for prostate cancer and men who developed dementia. Nead says the numbers show correlation, not causation at this point, but that there is evidence of a direct connection.

“Research shows androgens play a key role in neuron maintenance and growth, so the longer you undergo this therapy to decrease androgens, the more it may impact the brain’s normal functions,” Nead said.

The analysis was less conclusive on the question of Alzheimer’s. While there was still a connection, it was not as clearly defined as the link to dementia. Nead says evidence for a link between ADT and neurocognitive dysfunction is growing and should be part of the conversation between doctors and patients.

“There’s enough evidence of these links that patients should know about them when considering their options,” Nead said.