BCR/ABL1 Testing: Introduction, indications, methods and interpretation

Fig. BCR-ABL1 fusion gene (Philadelphia chromosome)

BCR-ABL1 refers to a gene sequence found in an abnormal chromosome 22 of some people with certain forms of leukemia. Unlike most cancers, the cause of chronic myelogenous leukemia (CML) and some other leukemias can be traced to a single, specific genetic abnormality in one chromosome. The presence of the gene sequence known as BCR-ABL1 confirms the diagnosis of CML and a form of acute lymphoblastic lymphoma (ALL). Chronic myelogenous leukemia (CML) is part of a group of diseases called the myeloproliferative disorders, with an estimated 4600 newly diagnosed cases and 850 deaths in 2005. More than 95% of patients with CML have the distinctive Philadelphia chromosome (Ph1) that results from a reciprocal translocation between the long arms of

Chemotherapy and it's side effects

Chemotherapy side effects

Chemotherapy drugs kill cancer cells, but they can also damage healthy cells. This damage to healthy cells causes side effects. Different cells and tissues in the body tolerate chemotherapy differently. Chemotherapy drugs have the greatest effect on rapidly dividing cells, such as blood cells in the bone marrow, cells lining the mouth and gastrointestinal (GI) tract and hair follicle cells.

What causes side effects?

Cancer cells tend to grow fast, and chemo drugs kill fast-growing cells. But because these

Breast Cancer: Introduction, pathophysiology and diagnosis

Breast Cancer: Where It Starts

The earlier a breast cancer lump is found, identified, and treated, the better the outlook. That’s why breast cancer testing plays such a key role in so many facets of the disease.

Unfortunately, signs of breast cancer are rarely visible from the surface of the skin. Breast self-exams should be done regularly to detect physically substantial lumps under the skin. But even self-exams may miss some cases. By moving the slide from left to right, you will see where (in most cases) breast cancer develops: deep down in the inner structures of the breast, within the ducts.

Cellular Abnormalities & Cancer

Cancer begins deep down in the body, at the cellular level. Cells are the basic building

Birth Control and Cervical Cancer

People who are not ready to raise a family or don’t want to have anymore kids should practice birth control. For those who use birth control pills, you should be alarmed by a new study that shows that women who have taken it for a long time are at risk for developing cervical cancer.

Cervical cancer happens to about 15,000 Americans. Of that that number, a little over a third will die from this disease while the rest can be treated thanks to its early detection using Pap tests.

Women get cervical cancer from an infection known as the human papilloma virus or HPV through sexual intercourse. Most of the time, the body is able to fight it but researchers have discovered that more than half of the test group that has used oral contraceptives for more than 5 years are at risk of this disease.

You won’t see any symptoms during the early stages of cervical cancer. This will only be seen later on as you experience continuous vaginal discharge that may be bloody, brown, pale, pink and foul smelling. It is also possible that there is abnormal vaginal bleeding when you have a period, after intercourse or during post menopause. Another possibility could be heavier and longer lasting periods.

The researchers who conducted the study did not really explain why or how pills increase the risk of this form of cancer. It merely said it did and when other people read the findings, the only conclusion they could think of was the fact the since the women in the study were on the pill, this made them more sexually active.

There is nothing wrong with being sexually active but if you have multiple partners, there is a chance that one of them could be a carrier of this kind of sexually transmitted disease.

But there are those who disagree with the findings. Other studies have shown that the practice of birth control especially the use of pills decreases the chances of women from ever being diagnosed with ovarian cancer.

To be safe, women are advised to undergo regular screenings like the Pap test. Women under the age of 30 should go to the clinic annually while those who are older should have this done every two to three years.

Birth control methods also have other risks aside from cervical cancer. These include high blood pressure, liver tumors, breast cancer.

The more common side effects that you will encounter are nausea, breakthrough bleeding or spotting, breast tenderness, mood chances, decreased sex drive, weight gain, vaginal discharge, cervical changes and gallbladder disease.

But not all birth control methods available do have side effects. Abstaining and outercourse which is the opposite of intercourse are still considered to be the most effective as the sperm never meets the egg.

For those who can’t control their urges and want to get physical, they can rely on the condom since the only possible problems could be skin irritation and if your sexual partner is allergic to the latex version.

Until private companies are able to develop a better birth control pill or device that does not have side effects or increase the risk of cancer or any other disease, these are things that both men and women have to live with when they want to get some action.

PROSTATE CANCER

Introduction:-

Prostate is a glandular organ present only in males. It surrounds the neck of bladder & the first part of urethra and condributes a secretion to the semen. The gland is conical in shape and measures 3 cm in vertical diameter and 4 cm in transverse diameter.It has got five lobes anterior,posterior,two lateral and a median lobe.Since the first part of the urethra pass through it any lesion in the prostate will produce difficulty in passing urine.

Diseases of the prostate gland:-

1) Prostatitis:-
This is the inflamation of the prostate gland due to bacterial infection.

2) Benign enlargement of the prostate:-
This is a non cancerous tumour of the prostate seen after the age of 50. 3,Cancer of the prostate:-This is the 4th most common cause of death from malignant diseases in males.

Cancer of the prostate.
Cancer of the prostate is directly linked with the male sex hormones(androgens).If the levels of sex hormone increases the growth rate of cancer also increases.It is found that after the removel of testes there is marked reduction in the size of tumour.

Site of tumour:-
Prostate cancer is seen mainly in the posterior lobe.Non cancerous enlargement is seen in other lobes.

Changes in the gland in cancer:-
The gland becomes hard with irregular surface with loss of normal lobulation .Histologically prostate cancer is an adeno carcinoma(cancer of the epithelial cells in the gland)

Growth :-
Growth rate is very fast in prostate cancer .The tumour compresses the urethra and produce difficulty in urination.

Spread of tumour:-
Metastasis in cancer of prostate is very early.

1) Local spread:-
From the posterior lobe the cancer cells go to the lateral lobes and seminal vesicles.Tumour cells also move to the neck and base of the urinary bladder.

2) Lymphatic spread:-
Through the lymph vessels cancer cells reach the internal and external illiac group of lymph nodes.From there cells move to retroperitonial(Behind the peritonium) and mediastinal lymph nodes(in the chest)

3) Spread through the blood:-
Spread of cancer cells takeplace through the periprostatic venous plexus and reaches the vertebral veins while coughing and sneezing and finally enders the vertebral bodies of the lumbar vertebrae.

Signs and symptoms of prostate cancer:--
Signs and symptoms depend upon the stage of the cancer. The following symptoms may be seen.

1) No symptoms:-
Tumour is small and only in the posterior lobe. This is diagnosed accidentely.

2) Slight difficulty in urination:-
Here the tumour is enlarged and urethra is slightly compressed.Shortly there will be frequent urge for urination with difficult urination.

3) When the tumour spread to all nearby areas including neck of bladder and urethra there will be painful urination with bleeding.Urine comes drop by drop.

4) Retention of urine:-
When the urethra is completely compressed there will be retention of urine.This can lead to hydronephrosis, renal failure ect.In this condition patient may get convulsions due to renal failure and finally coma.

5) Signs of metastasis:-
Some patients come with the signs and symptoms of metastasis.

a) Lumbo sacral pain due to spread of cancer cells to lumbar and sacral vertebrae.
b) Fracture of spine due to cancerous growth in the spine.
c) Swelling, pain and fluid collection in the abdomen due to lesion in the abdomen.
d) Respiratory complaints due to cancer of mediastinal lymphnodes and lungs.
e) General weakness due to spread of cancer to different parts of the body.
f) Anaemia due to involment of bone marrow and increased destruction of RBCs.

Clinical examination :-
Includes per rectal examination to feel the prostate gland,palpation of abdomen to feel the swelling in kidneys and any tumours.Patient is examined from head to foot to find out any lesions.

Investigations:-
1) Complete blood investigations;-
RBC,WBC,Platlets,ESR,bleeding time ,clotting time ect.

2) Urine analysis:-
Microscopic examination to detect pus cells,occult blood,casts,Crystals ect.

3) Renal function tests:-
Blood urea level,serum creatinine level,electrolyte level ect.

4) Serum acid phosphatase:-
Increased in cancer of prostate.

5) x-ray of the spine:-
To detect any tumour or fracture.

6) Ultra sonography;-
Gives idea about prostate,bladder,kidney ect.

7) C T scan:-

More detailed information about organs and tumour.

8) MRI of the spine:-
Gives detailed information about spine ,disc and nearby soft tissues.

9) Lymphangiography:-
Gives idea about lymphatic spread of cancer.

10) Biopsy to confirm cancer:-
Biopsy is taken from the tumour and is send for histopathological examination under the microscope.This will detect the presence of cancer cells.

Treatment:-
1) If there is retention of urine catheterisation is needed.
2) Dialysis if kidney failure.
3) If there is coma monitoring of all vital functions along with parentral nutrition and electolyte supply.
4) Specific treatment is prostatectomy(removal of prostate)

Partial prostatectomy :-
Here only the affected lobe is removed.

Radical prostatectomy :-
Total removal of prostate along with nearby lymphnodes.

5, Hormone therapy :-
Stilbestrol is given to reduce tumour growth.Since this treatement increases the chance for cardiovascular disease phosphorylated diethyle stilbesterol is used nowadays.

6) Chemotherapy:-Drugs like cyclophosphamide, cisoplatim ect are given.

7) Radiotherapy is also done for some cases.

8) Homoeopathy:-
Homoeopathic drugs like carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulphur ect can be given according to symptoms.Constitutional homoeopathic medicine will give great relief and can increase the life span.

9) Yoga and meditation is also helpful.

Cancer Information

A diagnosis of cancer can be very frightening, and the best way is conquer fear is through greater knowledge of the topic. To find reputable health related resources online including cancer information like early detection, prevention, treatment, new research advances and more visit the American Cancer Society at www.cancer.org, dedicated to “eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering.” This site is educational and easy to navigate; there is plenty of comprehensive information on specific cancer topics discussing common types of cancer including bladder cancer, breast cancer, colon and rectal cancer, endometrial cancer, kidney cancer, leukemia, lung cancer, melanoma, Non-Hodgkin’s lymphoma, pancreatic cancer, prostate cancer, skin cancer (non-melanoma), and thyroid cancer, in addition to causes, treatments, coping, drug information, and clinical trials.

The National Cancer Institute of the United States National Institutes of Health located online at www.cancer.gov features accurate, up-to-date, comprehensive cancer information from the United State government’s principal agency for cancer research. Find common types of cancer listed by types in A-Z format, by body location and system, childhood cancers, women's cancers, clinical trial results, educational materials, and other cancer topics including treatment, prevention, genetics, causes, screening and testing, coping with cancer, smoking and cancer, cancer health disparities, fact sheets, and more. This site discusses types of cancer treatment, and cancer drugs including specific drugs approved to treat cancer or conditions related to cancer, and updates on new drug development and approval. Complementary and alternative medicine, like healing philosophies, approaches, and therapies are popular options, and can be used in addition to or instead of conventional cancer treatment as well.

Learn about cancer treatment trials that are of potential benefit to you or a loved one and use this information to help decide whether or not to participate. Also find good suggestions for choosing a physician and cancer treatment facility, national Cancer Institute supported cancer centers, after care treatment like follow-up medical care, physical and emotional changes, changes in social relationships, and workplace issues. You can also access breast cancer information, lung cancer information, and more general information on cancer online at www.cancer-info.com, an extensive cancer website offering unbiased support and information regarding all types of cancer and chemotherapy options, cancer research advances, continuing medical education and more. Take this new found knowledge and use it to beat cancer; get a new perspective and a new outlook on life.

Can You Prevent Cervical Cancer?

You may have heard about a new vaccine that can help prevent cervical cancer. This is something that is marketed towards teenage girls in the hopes that they will not develop some types of this cancer. You may not think you are at risk, but even older women can have problems with this. At times, it can be deadly, or at the very least, it can cost a woman the opportunity to have a baby of her own. The vaccine is helpful, but it is not the only way that a woman can try to prevent getting cervical cancer. The answer is to do a few important things and to start young. If you have daughters, help them make the right choices.

The vaccine on the market can help prevent cervical cancer, but you should know that it does not cover all types of cancer of the cervix. Unfortunately, there are a few different ones and the vaccine is known to work with only one or two of these types. That means it is not always 100 percent helpful, but it can be for some girls. As a parent, it is a good idea to research this vaccine and talk with the doctor about it. In some cases, and ounce of prevention is the key, but not always. It certainly can not hurt to have the vaccination if it has been proven safe.

Some parents do not want to allow their daughters to get this vaccine that can prevent cervical cancer in some girls. They feel that if their daughters have this shot, they will feel protected and will not get the right type of medical attention. There is some truth to this, that is why it is important to discuss the power and the limitations of such a shot. While it can help, routine pap smears are still essential to good health. As stated, this shot only works with one or two types of cervical cancer, which means pap smears are important to check for the other types. If girls understand this and parents take them to appointments when needed, this problem can be eliminated.

If the shot is not something that parents choose for their daughters, routine pap smears become even more important in an effort to prevent cervical cancer. These appointments should be kept each year and follow up is important. Many times a result of 'irregular cells' may come up – which can indicate cervical cancer. However, that is not always the case. When this happens, a medication is prescribed and a follow up is necessary. For most girls, the follow up with come up clean and there will be no more problems. If cancer is a possibility, it is important to know it and get quick treatment to better the chances of survival.

There is no way to totally prevent cervical cancer, but you can do all that you can to lower your chances. This means routine medical care, the vaccination if appropriate, and taking any abnormalities very seriously. Some women still get cancer and have to go through treatment and there may never be anything that can be done about that. However, taking your health seriously can mean something is caught early and treated effectively. Cervical cancer is different from other types, so learning about it can go a long way towards preventing cervical cancer for some girls and women.

Facts about Breast Cancer

Cancer is so ubiquitous in modern society that it seems we are supposed to know all about it - but no one bothers to take the time to explain it. For example, I didn't know anything about breast cancer until it invaded my family. If I had known just a few things about breast cancer, we might have been ready. Cancer is scary, but the greatest weapon against fear is knowledge. Here are some basic facts about breast cancer, about breast cancer risks and prevention, and finally, about breast cancer treatment.

Cancer takes place at a cellular level. Normal cells divide and grow at a normal pace, but cancer is a out-of-control growth of cells in such a way that they form tumors and take over the organ that they are found in. Breast cancer is especially dangerous. Breast cancer can easily spread to other organs nearby, such as the lungs or the heart.

There are several risks to breast cancer, and sadly, for some of them, nothing can be done. Still knowing about breast cancer risks that cannot be reduced, such as age and family history is still useful. Knowing about these risks will help you understand if additional preventative and detection methods are needed. Other risks you can control are diet, weight and alcohol usage. Aiming to maintain a healthy diet is crucial to breast cancer risk reduction.

The key to finding about breast cancer in yourself is with a breast self-exam. The key about breast cancer self-exams is not necessarily to find lumps or tumors, but to familiarize yourself with your breasts. In this way, a regular breast self-exam is extremely useful in finding any unusual changes in your breasts, which may or may not be lumps. Finally, mammograms should be regularly attended on a yearly basis after the age of 40. Both of these things will help with early detection. Early detection is key to successful treatment.

Treatments for breast cancer include surgery - wherein the tumor or growth or surgically removed. The extreme form of surgery is a complete removal of one or both of the breasts. Other treatment options about breast cancer include radiation therapy as well as chemotherapy, where chemicals that have defeated cancer cells are introduced in your blood system. All of these treatment options carry their own benefits and risks a serious conversation with your physician about breast cancer treatment options is of the utmost importance.

Knowing about breast cancer and reducing your risks is crucial in this world to maintain a healthy lifestyle. Knowing about breast cancer treatments will help you make the right choice in consultation with your physician.

Five Common Breast Cancer Treatments

Breast cancer treatment is evolving with each passing day. Every new invention in this field usually represents a ray of hope for the millions of women and some men who have to undergo the pain of loosing a breast or both to the disease. Sometimes, this amounts to loss of lives. Today, there are five standard breast cancer treatments adopted by medics. They include surgery, radio therapy, chemotherapy, hormone therapy and targeted therapy. Still, there are other types of treatments in clinical trial stages. Such include sentinel lymph-node biopsy and stem-cell transplant, which has to be preceded by high doses of chemotherapy treatment.

Surgery is the most prevalent breast cancer treatment. Surgeons conduct a lumpectomy to remove the lump or tumor and adjacent tissue or partial mastectomy whereby, part of the infected breast and normal tissue surrounding it is removed. Lymph nodes are also taken from the underarm for purposes of checking if they have cancer cells. Total mastectomy involves the removal of the entire breast, while modified radical mastectomy involves the removal of the breast, lymph nodes and some chest-wall muscles where the cancer may have spread. Radical mastectomy is more like modified radical mastectomy except that all lymph nodes and more chest -wall muscles are removed. Usually, surgery is followed with radiotherapy, hormone therapy of chemotherapy in order to kill any cancer cells left in the body.

Radiation therapy is another common cancer treatment that kills cancer cells or reduces their growth rate using high energy x-rays. Radiation therapy is either administered externally using a machine that sends radiations towards the cancer, or internally through radioactive substances passed through catheters, seeds, wires or needles. Such are placed near or directly into the cancer. The choice of treatment that a doctor chooses depends on the severity and development stage of each cancer.

Breast cancer treatment through chemotherapy refers to the use of drugs to stop the cancer from developing either by killing the cancerous cells or through inhibiting them from dividing. In systemic chemotherapy, the drugs can either be injected into the blood stream or taken orally. In regional chemotherapy however, the drugs are placed directly on the body cavity, spinal column or the affected organ. Just like in radiotherapy, the treatment approaches in chemotherapy mainly depend on severity of the cancer, the type and development stage of the disease.

Hormone therapy-based breast cancer treatment removes specific hormones from the body or blocks their action for purposes of stopping the cancer cells from growing. Ovarian ablation is one such treatment that stops ovaries from producing estrogen. Other hormone therapy treatments have tamoxifen and aromatose inhibitors.

Targeted therapy treats cancer using drugs that identify and attack cancer cells without causing harm to normal cells. Tyrosine-Kinase inhibitors and monoclonal antibodies are the two common types of targeted therapy breast cancer treatments. No matter the type of breast cancer treatment that is used on a person, regular medical checkups will be required in future in order to gauge if the treatment managed to arrest the spread of the disease completely.

Facts about lung cancer

When looking for facts about lung cancer, one jumps off the page faster and more vividly than any other facts about lung cancer: Smoking is the cause 95% of the time. In no other cancer is the cause so obviously and clearly outlined. Yes, there are ties between red meat and colorectal cancer. Yes, certain hormone treatments have been linked to breast cancer. And everone knows asbestos's history.

But when it comes to facts about lung cancer, it's unassailable that smoking is very, very likely to be the casue of any given case. Ignore this at your own peril.

Some other facts about lung cancer:

Just under 200,000 people in the United States will be diagnosed with lung cancer in 2010. This is a decrease in percentage of the population that coincides perfectly with the decrease in percentage of smokers over the decades.

Unfortunately, while instances of lung cancer have become less common among men, it's become far more common among women. This is attributable to the increase in smoking among women in the caucasian community in the 1970s as well as the increase in minority communities in the 1980s and 1990s. There are also some recent stories that suggest women may generally be more predisposed to getting lung cancer than men, but many in the health industry view these reports skeptically.

And understand this: Even if you've been a lifetime smoker, quitting smoking at any time will help your chances of avoiding lung cancer! It's never too late to quit smoking and improve your health. Yet another of the facts about lung cancer that can't be missed.

Symptoms should be aware of are largely what you'd expect them to be. There's shortness of breath and wheezing, a persistent cough, chest pain, and spitting up blood. If you're experienceing any or all of the above, make sure to monitor your condition closely and get to a doctor. It's not worth taking chances with your life when it comes to the most common cancer in the western world.

While lung cancer is survivable if caught early, as of the year 2004 it still caused nearly one point five million annual worldwide deaths. The countries where the percentage of deaths from lung cancer are the highest tend to be in Eastern and Central Europe, though both the United States and Canada also have high rates of death from lung cancer.

Targeted Radiation Might Help Fight Advanced Breast Cancer

A minimally invasive treatment that delivers radiation directly to tumors may slow progression of breast cancer that has spread to the liver, a new study suggests.

The treatment is called yttrium 90 (Y-90) radioembolization. Doctors insert a catheter through a tiny cut in the groin and guide it into the artery that supplies the liver. Radiation-emitting micro beads are then sent through the catheter and float out to kill small blood vessels that feed the tumor.

Researchers led by Dr. Robert Lewandowski, an associate professor of radiology at Northwestern University Feinberg School of Medicine in Chicago, looked at the outcomes of 75 patients. The women ranged in age from 26 to 82, and had chemotherapy-resistant breast cancer that had spread to the liver ("metastatic" disease). Their liver tumors were too large or too numerous to be treated with other methods, the authors noted.

Y-90 radioembolization therapy stabilized 98.5 percent of the treated liver tumors, according to the study, which was to be presented Monday in San Diego at the annual meeting of the Society of Interventional Radiology.

In addition, 24 of the women experienced a more than 30 percent shrinkage in tumor size after treatment, which caused few side effects.

"Although this is not a cure, Y-90 radioembolization can shrink liver tumors, relieve painful symptoms, improve the quality of life and potentially extend survival," Lewandowski said in a society news release.

"While patient selection is important, the therapy is not limited by tumor size, shape, location or number, and it can ease the severity of disease in patients who cannot be treated effectively with other approaches," he added.

Two breast cancer experts were cautiously optimistic about the findings.

According to Dr. Neelima Denduluri, "while these results appear promising, this is a very small retrospective study," meaning that it fell short of the "gold standard" type of prospective trial that tracks patients going forward over time. "Randomized controlled prospective studies addressing this issue are necessary before radioembolization can be incorporated routinely," she believes.

For now, "in women that cannot receive systemic therapy due to toxicities [side effects], are not eligible for clinical trials that utilize new agents, or have exhausted conventional chemotherapy options, radioembolization may be a choice," said Denduluri, a medical oncologist with Virginia Cancer Specialists in Arlington, Va., a US Oncology Network affiliate.

Dr. Stephanie Bernik is chief of surgical oncology at Lenox Hill Hospital in New York City. She said that while this type of therapy has been used to fight liver tumors, "the ability to use this therapy in treatment of metastatic breast cancer to the liver offers some hope to patients with the disease."

Bernik stressed that, right now, the treatment can only extend survival for women with advanced breast cancer, it is not a cure. However, "as the technique is modified and perfected, it is hoped the [treatment] can help achieve remission in women with advanced disease."

Each year in the United States, about 117,000 patients are diagnosed with breast cancer that has spread to the liver. Chemotherapy is the standard treatment in such cases, but is not effective in, or suitable for, all patients.

Experts note that studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

SOURCES: Neelima Denduluri, M.D., medical oncologist, Virginia Cancer Specialists, Arlington, Va., a US Oncology Network affiliate; Stephanie Bernik, M.D., chief of surgical oncology, Lenox Hill Hospital, New York City; Society of Interventional Radiology, news release, March 24, 2014

Breast Cancer in Young Women

Cancer is a disease in which cells in the body grow out of control. When cancer starts in the breast, it is called breast cancer. Except for skin cancer, breast cancer is the most common cancer in American women.

Most breast cancers are found in women who are 50 years old or older, but breast cancer also affects younger women. About 11% of all new cases of breast cancer in the United States are found in women younger than 45 years of age. While breast cancer diagnosis and treatment are difficult for women of any age, young survivors may find it overwhelming.

CDC's Division of Cancer Prevention and Control is working to increase awareness of breast cancer and improve the health and quality of life of young breast cancer survivors and young women who are at higher risk of getting breast cancer.

Link between Coffee to Lower Liver Cancer Risk

Daily drinkers had reduced risk of the most common form of liver malignancy, but researchers can't say why

By Brenda Goodman

Researchers say they've discovered yet another reason to love coffee: A new study suggests that people who drink at least a cup a day have a lower risk of liver cancer compared to those who only indulge occasionally.

The study was to be presented Wednesday at the annual meeting of the American Association of Cancer Researchers in San Diego. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

When the study started in the 1990s, researchers asked nearly 180, 000 adults of different racial and ethnic backgrounds about their coffee drinking and other lifestyle habits.

Study participants have now been tracked for as long as 18 years, and researchers have kept tabs on how many have developed hepatocellular carcinoma, the most common kind of liver cancer. So far, 498 study participants have been diagnosed.

People who said they drank one to three cups of coffee a day had a 29 percent reduced risk of liver cancer compared to those who drank six cups or less each week. And more was apparently better: People who regularly had more than four cups of coffee a day had a 42 percent reduced risk, according to the study.

To put that in perspective, one in 81 men and one in 196 women will get liver cancer over the course of their lives, according to the American Cancer Society. A 29 percent risk reduction lowers the odds of that diagnosis to one in 104 for men and one in 253 for women.

What is more, those reductions held even after researchers accounted for other things known to increase a persons risk for liver cancer such as age, obesity, smoking, drinking, sex and diabetes.

However, the study was only designed to show association, not to prove a cause-and-effect relationship. There may be something else common to coffee drinkers that also reduces cancer risk.

Still, it's not the first study to uncover such a link.

A review published last year in the journal Clinical Gastroenterology and Hepatology, which combined the results of 16 different studies involving more than 3, 200 patients, concluded that drinking more than three cups of coffee a day might cut the risk of liver cancer by as much as 50 percent.

One expert praised the most recent research.

"This is a really well-done study," said Susan Gapstur, vice president of epidemiology for the American Cancer Society. "It adds to the growing body of evidence that coffee might be associated with a lower risk for a number of cancers."

Beyond liver cancer, studies have suggested that coffee may be tied to reduced risk for head and neck cancers, colorectal cancers, prostate cancer, and bladder, endometrial, esophageal and pancreatic cancers.

What researchers don't yet understand is how coffee may ward off cancer.

"That's what everybody wants to know," said study author V. Wendy Setiawan, an assistant professor in the department of preventive medicine at the USC Norris Comprehensive Cancer Center in Los Angeles.

Isetan says coffee has close to 100 active compounds including antioxidants, polyphenols and caffeine. It's also known to affect liver enzymes.

"At this time, I don't think anybody has any idea what compound is protective," she said.

Chemo Might Give Certain Lung Cancer Patients an Edge

By Randy Dotinga

Cancer specialists have been unsure about how best to treat certain patients with an advanced form of lung cancer.

Now, a new analysis of existing research finds that traditional chemotherapy outperforms newer, targeted treatments in delaying the time until the cancer worsens for these patients. However, chemo doesn't extend their survival, the review found.

Patients with non-small cell lung cancer make up 85 percent to 90 percent of lung cancer patients. Some of them have a mutation in a gene that makes their tumors more responsive to medications known as epidermal growth factor receptor tyrosine kinase inhibitors. But most patients with non-small cell lung cancer do not have this mutation, and doctors have been unsure whether this larger group of patients should get chemo or the targeted medication.

"In our opinion, conventional chemotherapy is a better treatment option for patients if patients are in suitable condition for chemotherapy because it is associated with delayed tumor progression and higher rate of tumor shrinkage," said review co-author Dr. Dong-Wan Kim, of the department of internal medicine at Seoul National University Hospital in South Korea.

About 10 percent of patients in the West and half of Asian patients have the mutation, according to the study, published in the April 9 issue of the Journal of the American Medical Association.

People with advanced non-small cell lung cancer typically survive for only 10 to 12 months, said Dr. Suresh Ramalingam, a professor of medical oncology at Emory University's Winship Cancer Institute in Atlanta.

The authors of the new analysis looked at 11 prior studies that included over 1,600 patients who didn't have the mutation.

Overall, half of those on traditional chemotherapy lasted 6.4 months or more before their cancer worsened, the study found. But that midpoint, or median, of progression-free survival was just 4.5 months for those who took medications that help lung cancer patients with the mutation -- erlotinib (Tarceva) and gefitinib (Iressa).

However, the length of time patients lived after the treatment wasn't appreciably different between the two groups.

Still, in this group of patients, even in the late stages of the disease, "chemotherapy appears to have a modest advantage," Ramalingam said.

Do the treatments matter if they don't extend lifespan? Yes, said Ramalingam.

"Improvements in outcome for lung cancer have mostly come in incremental steps," said Ramalingam. "An improvement in survival by a few months is still valuable for what was considered an untreatable disease not too long ago."

Because patients weren't randomized to one treatment or the other, the study cannot be considered conclusive.

Also, the analysis doesn't examine side effects. However, Ramalingam said the side effects of the treatments are known "and can be managed with appropriate supportive care measures in both settings."

Traditional chemotherapy has a wide variety of side effects, including nausea, hair loss and other problems. The targeted drugs cause side effects like skin rashes (which can become infections), diarrhea and fatigue.

As for expense, both treatments -- traditional chemotherapy and the alternate "targeted" form of therapy used for the comparison -- cost about the same, Ramalingam said.

Scientists need to continue developing different treatments for non-small cell lung cancer patients based on their genetic makeup, especially those who don't have the "treatable target mutation," Ramalingam said.

Testing for the mutation is becoming more common because treatment can be individualized for patients who have it. Last year, the College of American Pathologists, the International Association for the Study of Lung Cancer and the Association for Molecular Pathology recommended that doctors use a test for the mutation to guide treatment for patients with advanced lung cancer.

SOURCES: Dong-Wan Kim, M.D., Ph.D., associate professor, department of internal medicine, Seoul National University Hospital, South Korea; Suresh Ramalingam, M.D., professor, hematology and medical oncology, and director, division of medical oncology, Winship Cancer Institute, Emory University, Atlanta; April 9, 2014, Journal of the American Medical Association

Diabetes Tied to Higher Risk of Pancreatic Cancer in Study

By Serena Gordon

People with DM have double the risk of pancreatic cancer compared to people who don't have diabetes, according to a new analysis of 88 previous studies.