Information and Resources from the U-M Comprehensive Cancer Center

Research Roundup

U-M Launces First Human Studies of Gene Therapy for Chronic Cancer Pain

University of Michigan researchers recently began the first study to determine the safety of using gene therapy to treat chronic cancer pain.

A gene transfer vector is an agent used to carry genes into cells. In this groundbreaking clinical trial, investigators will use a vector created from the herpes simplex virus -- the virus that causes cold sores -- to deliver the gene for enkephalin, one of the body's own natural pain relievers.

"In pre-clinical studies, we have found that this method can reduce chronic pain," said David Fink, M.D., Robert Brear Professor and chair of neurology at the U-M Medical School. Twelve patients with intractable pain from cancer will be recruited to examine whether the vector can be used safely.

Enkephalin is one member of the family of opioid peptides that are naturally produced in the body. Opioid peptides exert their pain-relieving effects by acting at the same receptor through which morphine and related opiate drugs achieve their pain-relieving effects. In this trial, the enkephalin peptide, produced as a result of the gene transfer, will be released selectively in the spinal cord at a site involved in transmitting pain from the affected body part to the brain.

"We hope that this selective targeting will result in pain-relieving effects that cannot be achieved by systemic administration of opiate drugs," Fink said. "The trial is the first step in bringing the therapy into clinical use. A treatment is at least several years off."

U-M Study Links Breast Assymetry After Lympectomy to Depression, Fear

Most women with breast cancer assume that surgery to preserve their breast will be less disfiguring than a mastectomy that removes the entire breast. But nearly one-third of women reported pronounced asymmetry between their breasts -- and that perceived disfigurement greatly affects a woman's quality of life after treatment, according to researchers at the University of Michigan Comprehensive Cancer Center.

The researchers found that compared to women with little to no breast asymmetry, women whose affected breast looked significantly different were twice as likely to fear their cancer recurring and to have symptoms of depression. These women also were more likely to perceive themselves as less healthy and to feel stigmatized by their breast cancer treatment.

"We found that one of the most important factors of post-operative quality of life and satisfaction was post-operative asymmetry or the aesthetic outcome that women experienced after their surgery," said lead study author Jennifer Waljee, M.D., M.P.H., a resident in general surgery at the U-M Medical School.

Results of the study were published in the Journal of Clinical Oncology.

Many women who are diagnosed with cancer have a choice between breastconserving surgery, in which just the tumor and a margin of surrounding tissue are removed, and mastectomy, which removes the entire breast. Reconstructive surgery is an option after mastectomy but can also help correct asymmetry from breast conserving surgery.

"It's important for women to think about all of those issues at the time that they're making their surgical decision and realize that although breast-conserving surgery may or may not be less disfiguring than mastectomy, they're likely to experience some asymmetry afterwards that may impact their quality of life," Waljee said.

However, lumpectomy is still the best option for breast conservation. Women who are considering this option are encouraged to ask their doctors about what to expect after surgery.

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