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News Archive - Progress Newsletter Spring 2002 Online

Research Roundup

NewTreatment for Pancreatic Cancer Shows Promise

Study finds melanoma web sites give incomplete or wrong information

New Treatment for Pancreatic Cancer Shows Promise

When someone is diagnosed with pancreatic cancer, surgery to remove the tumor offers the greatest potential for survival. But in the vast majority of cases, surgery is not an option, forcing patients and their doctors to look to other, less-effective treatments – often involving radiation together with chemotherapy, or chemotherapy alone.

Even with these therapies, nearly all pancreatic cancer patients show evidence that the cancer has spread throughout the body within months of diagnosis, making it one of the most deadly and difficult cancers to treat. In 1996, the Food and Drug Administration approved a more effective chemotherapy drug called gemcitabine for use, and several leading medical centers have investigated techniques to combine this drug with radiation. But many of these studies have found the combination causes unacceptable side effects.

U-M study of combined therapy
Now, a new University of Michigan Cancer Center study has shown that the drug can be delivered safely in combination with accurately targeted radiation. In fact, the combination could actually be more beneficial than currently available therapy, without an increased risk of severe side effects.

In a paper published in the Journal of Clinical Oncology (please note this link will open in a second browser window), a team of U-M pancreatic cancer specialists reports that gemcitabine can be delivered at the recommended standard dose together with carefully aimed radiation without substantial side effects. This clinical study results from years of laboratory research at the U-M to understand the mechanism of interaction between gemcitabine and radiation, and technical advances in the delivery of radiation.

Side effects of combination therapy
Previous research on this combination has focused on broadly targeted radiation therapy techniques with the addition of relatively low doses of gemcitabine. Although promising, the combination proved to result in unacceptable nausea, vomiting and excessive weight loss.

The U-M technique, co-developed by Cornelius McGinn, M.D., assistant professor of radiation oncology, and Mark Zalupski, M.D., clinical associate professor in medical oncology, produced relatively modest side effects and allowed the chemotherapy to be kept at a standard dose, rather than a reduced dose.

Conformal radiation with standard-dose chemotherapy

“Since pancreatic cancer spreads very easily, it is important to attack it throughout the body with effective chemotherapy. But treatment must also target the tumor in the pancreas itself, and that’s where focused radiation comes in,” says Dr. McGinn. “By investigating the appropriate radiation dose using a conformal radiation technique that spares non-cancerous tissue, we have effectively targeted the primary cancer while still delivering systemic therapy for potential spread, something no other study has attempted.”

Encouraged by the initial results, the team of researchers is opening a new trial to further test the approach at the U-M and other medical centers throughout the country. The development of a specific clinic for patients with pancreatic cancer within the U-M Comprehensive Cancer Center is under way as well, as a means to provide coordinated multidisciplinary care for this special patient population and develop further research efforts.

For the complete news release, visit our newsstand.

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Study finds melanoma web sites give incomplete or wrong information


Popular Internet sites devoted to melanoma may seem trustworthy, but the information they provide is often only skin-deep, a new Univer-sity of Michigan Cancer Center study finds. In fact, the majority of sites studied had incomplete facts about the increasingly common and potentially deadly form of skin cancer, and about one in eight had an inaccuracy.

The results from the first study of its kind, published in the Journal of Clinical Oncology (please note this link will open in a second browser window), suggest that Web users should beware when searching for information on melanoma, and that their physicians should guide them toward sites that give full and correct details on the disease.

With more people turning to the web for health information, especially after diagnosis, the researchers warn that incomplete sites could raise anxiety for those diagnosed with melanoma, mislead those at risk, and even undermine the relationship between doctors and patients.

“No one expects every web site on a given topic to include every bit of information available, but the lack of even basic preventive, diagnostic, treatment and risk factor data on so many sites amazed us,” says lead author Christopher Bichakjian, M.D., a lecturer in dermatology at the U-M Health System. “The fact that melanoma so often strikes young adults, who might be most likely to turn to the Internet for medical information, gives web-site quality even more importance.”

Search engine results for “melanoma”
The study’s authors – most of them dermatologists in the Cancer Center’s melanoma clinic – often encounter skin cancer patients who come to appointments with printouts from web sites, some of them misleading or inaccurate. So, the researchers conducted their study by putting themselves in their patients’ shoes. They typed the word “melanoma” into six of the most popular commercial search engine services, as well as two well-known medical search engines.

After discarding more than 160 dead links, duplicates and pages with many links but no facts, they found 74 web sites that could be assessed against a “gold standard” checklist of 35 factors, from basic definitions and incidence rates to specific risk factors and treatment options.

Dangerous inaccuracies
Only eight of the factors were included on at least half the sites, and no one piece of information appeared on more than 62 percent of the sites. Fourteen percent of sites had erroneous information. Most inaccuracies were relatively minor, but some were considerably more dangerous. “Some sites recommended unnecessary tests and more invasive, unnecessary surgery,” says co-author Timothy M. Johnson, M.D., director of the U-M Comprehensive Cancer Center’s melanoma clinic and the William B. Taylor professor of Dermatology.

Scarce information
According to researchers:

• Only 62 percent of sites defined melanoma, while 59 percent correctly stated that the prognosis for someone diagnosed with it can range from death to disease-free survival, depending on what stage it’s in when treated.
• Just 47 percent of sites included statistics on melanoma incidence.
• Less than a third included images of melanomas, which could be powerful tools for those wondering if a spot on their skin might be dangerous.
• Just over half the sites listed signs and symptoms of melanoma.
• Only 38 percent mentioned the importance of screening by oneself or a physician.
• Prevention techniques such as sunscreen, hats or clothing, and avoidance of the midday sun were only mentioned on a third of sites.
• The increased risks of melanoma that come with a history of sunburn, fair skin or hair, moles on the skin, or a personal or family history of the disease, were raised on less than half of the sites.
• About half of the sites mentioned surgery as the treatment to remove lesions, but less than a quarter mentioned diagnostic workups or sentinel lymph node biopsies, which can tell whether the cancer has begun to spread beyond the skin.

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This article is part of the Cancer Center's News Archive, and is listed here for historical purposes.

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