Monday, April 30, 2012

Gene discovery could help treat deadliest form of cancer

Gene discovery could help treat deadliest form of cancer
Justin Norrie
News Editor, Sydney

The discovery of a tumour suppressing gene could offer hope to patients with the deadliest form of cancer, new research has shown.

An international team of researchers, including scientists from Australia, has been able to identify a faulty gene that is instrumental in the most aggressive forms of pancreatic cancer, which kills more than 600,000 people each year.

The research is reported in the latest online edition of the journal Nature.

The gene, called USP9x, could effectively “go missing” in around one in seven pancreatic cancers, the team found. Research on human cell lines and mice demonstrated that the gene is switched off by chemical tags on the surface of its DNA.

After discovering the gene, dubbed USP9X, in a study of pancreatic cancer in mice, the international research team went on to show that it plays a similar role in humans.

Stephen Wood, Research Member from Griffith’s Eskitis Institute for Cell and Molecular Therapies and one of the lead researchers, said that “based on the mouse model results, we looked in human tumour specimens and found that it was missing in a significant fraction of patients – those who died the fastest.

“Although there are no mutations in the USP9X gene, patients that had a low level of gene expression died very quickly after their operation. In addition, patients who at the end of their life had many metastases – or spreading of the cancer – also had a very low level of this protein. In this study we identify chemicals which can re-activate USP9X gene expression.

“My group has worked on USP9X for several years and shown it is expressed in many of our cells. This collaborative study is the first to show that it goes missing in some tumours, and it has a novel role as a cancer suppressor."

Dr Wood said that several other pancreatic tumour suppressor genes were known to exist, but that USP9X was the one whose absence probably promoted metastasis, “and that is what kills people with pancreatic cancer”.

The finding had two major implications, he said. It allowed scientists to potentially treat people who had lost this gene expression in their pancreatic tumours. And it could help identify novel avenues in preventing pancreatic cancer.

Dr Wood said drugs that re-activated gene expression had already been developed. But scientists had not yet determined where exactly they would be useful.

Pancreatic cancer kills about 96% of its victims within five years of diagnosis, which means it has one of the lowest cancer survival rates.

Early diagnosis is difficult, so the disease is often discovered only after it has already spread.

Lead scientist Professor David Tuveson, from Cancer Research UK’s Cambridge Research Institute, said: “Drugs which strip away these tags are already showing promise in lung cancer and this study suggests they could also be effective in treating up to 15% of pancreatic cancers.”

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Aspirin may reduce cancer risk, it is becoming a wonder drug

Aspirin Really Is Kind of a Wonder Drug, Studies Continue to Show - Alice G. Walton - Health - The Atlantic

In addition to positive heart health effects, it helps cut your risk of cancer, too, new research suggests.

The evidence that over-the-counter (OTC) medications can benefit our long-term health in meaningful ways keeps accruing. Aspirin, ibuprofen, and acetaminophen all have various health benefits, but aspirin is emerging as a key player in the fight against cancer. Three new studies by the same research team have shown that aspirin over the long term can reduce the risk of cancer - and its spread through the body.

The team’s earlier work had shown that daily aspirin could reduce cancer risk over the next 20 years. Now, Peter M. Rothwell and his team have expanded on their original findings. In one large scale review of 51 earlier studies, people who took less than 300 mg of aspirin every day had a 25 percent reduced risk of developing any type of cancer after three years. It reduced the risk of death from cancer by about 15 percent. The longer people took aspirin, the better: after five years, the risk of death was reduced by 37 percent in aspirin-takers.

Another study determined how aspirin affected the spread of cancer once it had developed. People who took at least 75 mg of aspirin a day had a 36 percent reduced risk of metastatic cancer than non-aspirin takers. One type of cancer called metastatic adenocarcinoma, which can affect the prostate, lungs, and colon, was reduced by 46 percent in people who took aspirin.

A third study was a confirmation of aspirin’s effects on metastasis. Looking at both observational studies and randomized trials (where participants are assigned to take the drug or not), metastatic cancers were reduced by 38 percent and 42 percent for observational and randomized trials, respectively. The reductions in risk were found for esophageal, colon, throat, biliary, and breast cancer.

The mechanisms by which aspirin may prevent cancer are still somewhat unclear. With regard to preventing metastasis, the fact that aspirin inhibits platelet cell functioning might contribute, since cancer metastasis is thought to hinge on platelet movement through the body.

Authors of an accompanying editorial point out that there are still some risks associated with aspirin itself, like gastrointestinal bleeding and stroke. One should always discuss with a doctor the decision to begin any medication, even OTCs.

That said, this series of studies may change the way we think about aspirin’s long-term impacts on health. Its role may not be solely in the prevention of heart disease, rather its effects may be much more widespread than previously imagined.

The studies were carried out at the University of Oxford. The first and second studies were published in The Lancet. The third was published in the journal Lancet Oncology.

This article originally appeared on, an Atlantic partner site.

(via Instapaper)

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Friday, April 27, 2012

An Era Ends and NASA's Future Is Subjugated To A Failed Green Policy

Picture from

An Era Ends and NASA's Future Is Subjugated To a Failed Green Policy

If you have been following this Blog you know that it is dedicated to bringing information of new technologies to the tech savvy patient, however today I digress. This morning I watched the Enterprise being shuttled to its final destination at a New York floating museum, and the thought crossed my mind that the technology driver known as NASA was also slowly being relegated to museum status by becoming subjugated to the President's focus on a green initiatives. It seems he is not interested on focusing on the technological, economic, and life altering achievements of NASA but rather on some pie in the sky wind and solar programs.

To give some credence to my belief that NASA may well be more important to our society's well being, bare with me while I note some of the spinoffs that came from their work.

The mouse you used to click your way to this Web page.

The cat scanner

The micro chip that powers your computer, laptop, iPhone or iPad.

Patient monitoring via Telemetry

Dish and Direct TV satellite systems

NASA-inspired communications satellites that connect the world, and are the orbiting eyes in the sky to track hurricanes, weather, wildfires and volcanoes.

Health care workers can monitor many patients at once, thanks to technology first used to watch the health of astronauts.

The cochlear implant, pioneered by NASA engineer Adam Kissiah, selects speech signal information, then sends electrical pulses to the patient's ear.

Patient ventilator technologies that maintain critically Ill patients.

New high pressure systems that suppress fires in seconds

A water filtration system that provides safe, affordable drinking water throughout
the world.

A bacterial spore-detection system.

A low-cost device that creates electrical energy out of mechanical energy.

A tiny light-emitting diode (LED) chips used to grow plants.

Cable-compliant mechanisms which have now been implemented into an adjustable patient harness system used to treat patients recovering from traumatic brain injury, stroke, spinal cord injury, and hip or knee replacement, as well as aid U.S. service personnel with spinal cord or traumatic brain injuries at Walter Reed Army Medical Center in Washington

The development of Liquidmetal, a new type of metal that is twice as strong as titanium but behaves more like a plastic with its flexible, moldable properties.

A geospatial information systems company, NVision Inc., of Stennis Space Center, Mississippi, harnessed NASA’s remote-sensing satellite information to provide innovative geospatial solutions for a variety of applications, including: a crop prescription service for farmers; a disaster management networking tool for local, state, and Federal governments; and an educational service for young farmers.

A tunable diode laser-based gas sensor developed by the Jet Propulsion Laboratory is now employed on flying aircraft as a means to measure water vapor and thus deliver real-time weather forecasting and help pilots avoid dangerous weather conditions. The sensor.

Robots used by the military and police to deal with dangerous situations and IEDs

LADARTracker - Eye-tracking devices must be able to sample the eye’s position at a rate of at least 1,000 times per second to keep up with saccadic movements, which do not stop during LASIK surgery. LADARTracker measures eye movements at a rate of 4,000 times per second, 4 times the established safety margin.

These are but a few of the NASA innovations that have made it to the private market. Now if you want to check out all of these innovations go to .

No lets look at the wonders of the President's pressing green agenda . Spectrawatt, Solyndra, Enerdel, Beacon Power, and Abound Solar are examples this focus. This administration dumped $10,000,000,000 of our money Into these initiatives that money benefited only the Company's owners, officers, and the required bankruptcy lawyers. If that same $10 billion's and been invested into NASA, given its history, it would yielded a positive return on investment in terms of jobs, economic growth, and a better quality of life. To me the decision is a simple one and it was not the President's choice.

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Thursday, April 26, 2012

New medications discovered with Computer's help

How Computers Are Helping Drug Companies Find New Medications -

After decades spent searching for compounds in nature that might have medicinal potential, most major drug companies are now also designing medicines virtually. Aided by powerful computational analyses that help identify a target for a drug, researchers manipulate molecules on their computer screens to create custom-made compounds that attack disease-causing proteins.

This method of tailoring molecules is known as structure-based design. It was used to create Xalkori, a therapy launched by Pfizer Inc. PFE +0.50% last year to treat a rare and intractable form of lung cancer. It also has played a role in an Alzheimer’s disease treatment being developed at Eli Lilly & Co, LLY +1.05% an antibiotic crafted by GlaxoSmithKline GSK +2.00% PLC that is in midstage trials and a Sanofi SA SNY +0.61% blood thinner in the final stages of development.

With computer-aided design, pharmaceutical companies are finding treatments they might never have discovered otherwise, even with considerable investments of time and expense, says Magid Abou-Gharbia, the director of Temple University’s Moulder Center for Drug Discovery Research and the former head of drug discovery at Wyeth.

FINDING A FIT Jean Cui (center), a Pfizer researcher, designed the recently approved lung-cancer drug Xalkori.

“You will actually increase the chance of success for coming up with a clinical [drug] candidate” by using it, he says.

Keys and Locks

Structure-based design is quite different from traditional drug-discovery techniques, says Jean Cui, the scientist credited with discovering Xalkori.

Typically, a drug works by attacking a disease-causing protein that is interacting with other molecules in an unhealthy way. By connecting to the protein, a drug can stop it, thereby restoring healthy interactions or compensating for unhealthy ones.

A drug connects to a protein much as a key fits into a lock. For most of their histories, drug makers looked for the keys while ignoring the locks. Drug companies sifted through natural substances found in soil, as well as collections of dyes and industrial chemicals and failed compounds from previous drug research-and-development programs. They would test those samples for any impact on diseased cells and, if they were lucky, find one that worked. This is how penicillin was discovered.

TIGHT SQUEEZE Xalkori works by locking into and blocking a protein essential to a form of lung cancer.

Over the years, companies speeded up the process. They accumulated vast libraries of potential compounds—the end of the Cold War opened up a trove of new molecules collected by Eastern European laboratories—then used robots to quickly run through hundreds of thousands of samples to see if any showed medicinal potential.

Yet, drug screening remained dependent on a company’s good fortune to chance upon a promising compound. When researchers hit on a new medicine, they often wouldn’t know for years why it worked, only that it did. They didn’t know what the key or lock looked like.

Frustrated, a Merck & Co MRK +0.58% . scientist named Joshua Boger left to start a company that aimed to take much of the luck out of drug discovery. His firm would figure what a lock looked like, so it could fashion a better key to fit into it. The company, Vertex Pharmaceuticals Inc., VRTX -2.21% established in 1989, was among several conceived with this mission.

“I felt every project wasn’t using all the information available to it, and one of the kinds of information left out most often was the structural information, telling you what a drug was supposed to do,” says Dr. Boger, now a board member at Vertex, based in Cambridge, Mass., whose hepatitis C therapy, Incivek, was approved last year.

Determining the shape of a lock isn’t easy, however. Because proteins run from X-rays taking their snapshots, scientists must first crystallize them so they can’t escape and then deduce their shape by looking at the patterns left by the X-rays deflecting around them. This requires thousands of interference patterns and powerful computers to analyze them.

Then, researchers must fashion a custom molecule to fit into that lock. Coming up with the right shape can be difficult. Moreover, the molecule also must connect, or bind, to the target. And to be a successful drug, a molecule must have other properties. It can’t be metabolized by the body too quickly or slowly, and it must be able to be synthesized and manufactured in large quantities.

Because of those challenges, structure-based design is more an instrument for boosting companies’ drug-discovery efforts than for revolutionizing them, researchers say. It provides information that is helpful and sometimes crucial for discovering new drugs, but it can’t generate the ideal candidate without other information and work.

“It doesn’t tell us everything, but it gives us a very good clue,” says Tony Wood, who heads chemistry at Pfizer.

Scientist’s ‘Aha’ Moment

Xalkori wouldn’t have been discovered in the early 2000s if not for structure-based design, according to researchers at Pfizer.

In 2003, Pfizer bought Pharmacia, the owner of the biotech firm Sugen, where much of Dr. Cui’s early work on Xalkori took place. Researchers were trying to block a protein called c-Met that was found to play an important role in the growth of cancer tumors. They hit upon a naturally occurring molecule that connected to c-Met, and synthesized some prototype molecules.

But even with further refinement, these prototype molecules didn’t have the properties—such as avoiding quick metabolism in the body—needed to make it a workable drug, Dr. Cui says.

Scientists turned to structure-based design for help. The researchers crystallized the c-Met protein with one of the prototype molecules hooked up to it, fired X-rays at the arrangement and, using computers, deduced the structure of the protein and how the prototype molecule fit into it like a key in a lock.

They emailed the results to Dr. Cui, who began trying to come up with an entirely new molecule that would bind to c-Met and possess properties suitable for a drug. It was difficult, Dr. Cui recalls. The new molecule would have to connect to a site on the c-Met protein that scientists hadn’t expected, and it required a tight squeeze into a small space. Dr. Cui says she found herself trying to solve the puzzle all of the time.

In May 2002, after five months of thinking about it, the design came to Dr. Cui while she was at home watching her two daughters play. The next morning, she took a rough sketch of the design to her boss, and soon colleagues were making compounds virtually on a computer and in test tubes for further study. Within weeks, Sugen decided it would try to turn this molecule into a drug. By February 2003, testing in animals showed that the molecule could stop tumor growth. After the Pfizer acquisition, researchers there further refined, synthesized and studied the molecule until Xalkori emerged ready for testing in humans.

The work showed that Xalkori, known chemically as crizotinib, bound to and blocked the tumor-causing activity of a protein called ALK, as well as c-Met. Xalkori was approved last year for non-small-cell lung cancer caused by a genetic hitch affecting the ALK protein. Researchers are still probing its use in other cancers involving the c-Met protein

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My goodness, iPads reduce patient checkin time

New medical iPad platform reduces patient check-in time | TUAW - The Unofficial Apple Weblog

NIIT Healthcare Technologies of Orlando, Florida introduced a mobile platform that’ll speed up check-in times, improve communication and help process payments for hospitals, physician offices, clinics and laboratories.

Called MASH for manage, analyze, sustain and harness, the product lets patients and doctors use mobile devices that tie into the facility’s backend infrastructure. Patients can check-in autonomously using a tablet and describe their injury or illness, enter health insurance details or even navigate the halls of the facility. This information is then sent to the appropriate medical department which is alerted to the patient’s arrival and to the business office for payment processing.

This system is already installed in Antelope Valley Hospital in Lancaster California. “MASH’s ability to reduce the waiting time and paperwork in our ER will provide our hospital with life-saving and cost-saving technologies,” said Humberto Quintanar, CIO of Antelope Valley Hospital.

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Monday, April 16, 2012

How Patients Can Become Partners With Doctors

How Patients Can Become Partners With Doctors -
The Wall Street Journal by AMY DOCKSER MARCUS

Doctors around the country have enlisted some new helpers in the fight against chronic disease—their patients.

A few years ago, a far-flung group of pediatric gastroenterologists set up an online network where they could share data and treatment strategies for children and adolescents with inflammatory bowel disease, in hopes of improving outcomes. It worked—up to a point. The remission rate jumped to 75% from 50% at some of the centers, but then hit a ceiling.

Some of the doctors raised a provocative question: Could they get even better results by bringing patients and parents into the effort?

Patients would experiment with new treatments and closely monitor how the regimens affected them day to day, then feed the data into the online network through computers or smartphones for doctors to examine. The patients could also use the network for things like social support, finding other patients who shared similar interests or lived near them.

Fabrizio Costantini for The Wall Street Journal
WORKING TOGETHER Emily Brandt and her doctor, Jeremy Adler, meet every two weeks to assess her health and sometimes adjust her treatment.

“We were very focused on improving outcomes, but we were doing it without the families,” says Richard B. Colletti of the University of Vermont College of Medicine, director of the doctor-founded network. “Until parents and patients are true partners, you can’t get the best outcomes.”

The new project, called the Collaborative Chronic Care Network, currently includes 33 participating centers testing 22 different projects. The registry has enrolled 6,800 patients, and organizers expect the number to reach 10,000 by the end of the year.

It’s still a work in progress. Doctors need to figure out how to take promising pilot studies involving five or 10 patients and introduce them on a larger scale. The researchers wrestle with how to protect patients’ privacy while still making it possible to extract useful information from the registry.

Then there’s the reluctance of certain patients. One doctor reported that when he showed the results of one unsuccessful mini-trial to the patient, the patient refused to accept that something he thought was working really wasn’t. “It may be hard to change some people’s behavior,” says Jeremy Adler, a pediatric gastroenterologist, “even with clear data.”

The effort comes at a time when doctors are trying new ways to treat chronic conditions and when the rates of those illnesses are rising in children for reasons that are not fully understood, says Neal Halfon, director of the UCLA Center for Healthier Children, Families & Communities and a collaborator on the project.

It’s particularly tough to get data on inflammatory bowel disease, a group of debilitating and painful conditions of the colon and intestines of which the main forms are Crohn’s disease and ulcerative colitis. The problem affects around 50,000 children, and that relatively small number makes it difficult to get drug companies interested in running trials. Even the biggest centers may see only 500 patients, “not enough to tell whether any approach is making a difference,” says Peter A. Margolis of Cincinnati Children’s Hospital Medical Center, who is one of the developers of the network project.

The new network may have an advantage, though: These are patients who are especially comfortable with the technology involved in monitoring and reporting on their condition. Susannah Fox, an associate director of the Pew Internet Project, says their research found that smartphone owners are more likely to contribute and track health data online; so are people who have a chronic condition. The very group targeted by the network is part of the “culture that is nurturing” a new approach, Ms. Fox says.

The idea was to go from a system that focused on clinicians and what they were prescribing to one where patients could contribute new ideas on how to treat their disease as readily as a scientist. “We want the doctors and patients to do experiments together,” says Michael Seid of Cincinnati Children’s, a developer of the network.

One of the participants is Emily Brandt, a 20-year-old student at the University of Michigan with ulcerative colitis. As part of one pilot, she gets four text messages every day asking her different questions, including whether she took her medicine and how many times she woke up in the middle of the night. Her doctor, Dr. Adler, gets the results in graph form, which he and Ms. Brandt analyze together every two weeks.

Both say they have learned new things. Dr. Adler says he was thinking about changing her medications but wanted more information before making a decision. Using the graph, he saw that Ms. Brandt’s symptoms appeared to improve for the first 10 days after an intravenous infusion she receives every eight weeks. Neither of them had been aware of the pattern, and they continue to follow the data to see if it holds. “When you have chronic symptoms, every day blurs,” Dr. Adler says. “So many times, we are fooled into thinking something works or doesn’t work.”

Ms. Brandt says she was diagnosed with inflammatory bowel disease at the age of 6. At one point, she underwent surgery to remove her large intestine in an effort to stop her symptoms. “It didn’t fix it,” she says.

Growing up, she didn’t always tell her doctors when she was in pain because she feared they would suggest another surgery. When she got involved in the network, she finally opened up. She says one of the aspects that persuaded her to participate was when they asked her what she wanted to see studied. She shared that she often ate large numbers of granola bars because she believed they helped control her symptoms. One of their first mini-trials was testing whether that was true. (It wasn’t.)

Ms. Brandt appreciates the flexibility of the network, too. She asked for short trials that more easily fit into the hectic life of a college student. No surgery, she added. “They are giving me options that are a lot more realistic for me to try,” Ms. Brandt says.

After the project began, Ms. Brandt got a sinus infection and was prescribed a short course of antibiotics. She told Dr. Adler that she went to the bathroom less often and didn’t wake up as frequently at night. When she stopped taking the antibiotics, her symptoms returned. They both wondered, “was this real or a coincidence?” Dr. Adler says. So he put Ms. Brandt on an antibiotic for two weeks followed by a two-week washout period, and is collecting more results. “The early data look promising, but I am afraid to draw conclusions yet,” he says.

Ms. Dockser Marcus is a Wall Street Journal staff reporter based in Boston. She can be reached at

A version of this article appeared April 16, 2012, on page R2 in some U.S. editions of The Wall Street Journal, with the headline: Patients as Partners.

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Sunday, April 15, 2012

Now your iPad and iPhone takes your temperature

iPhone peripheral ThermoDock measures body temperature without any body contact by Satish Misra, MD

The range of medical peripherals available for the iPhone is growing rapidly. We have IBGStar for blood glucose measurements, AliveCor for heart rhythm checks, and many more. Add to that list ThermoDock.

Many healthcare providers will be familiar with the temporal artery probe used in many hospitals, which use infrared technology to measure body temperature. These devices are especially useful for intubated patients and children; frankly, they are probably more comfortable for most patients than holding a thermometer in their mouths (let alone some of the other places temperature is measured).

ThermoDock, developed by German device maker Medisana, goes one step further (or perhaps one step back) and measures body temperature without even touching the patient. Using a small peripheral for the iPhone or iPad, ThermoDock uses similar infrared technology to the temporal artery probe to calculate body temperature.

It is part of a suite of devices made for the iPhone and iPad including blood glucose monitors, blood pressure monitors, and weight scales that can already be purchased in the United States. But there are some important factors to consider before you rush out to get one or suggest it to your patients.

According to the technical specifications supplied by Medisana, ThermoDock can measure body temperature to an accuracy of +/- 0.2-0.3 degrees celsius in about 4 seconds. They also cite that the “clinical repeatability” as 0.19 degrees celsius. To do all of this, the device is powered by the connected iPhone or iPad.

The app collects and displays data in the free VitalDoc app which can store data, display trends, and transmit information via email.

Medisana also makes several other products for iOS devices including the CardioDock, GlucoDock, and the inexplicably named Targetscale Body Analysis Scale with Target Function. Data from all of these devices is collected and displayed in the VitalDock app.

ThermoDock is available throughFirebox, where it can be purchased for $96 plus tax and shipping. Other Medisana products can be purchased here as well – the Targetscale goes for about $200 plus tax and shipping.

However, its unclear what sort of clinical testing the device has actually undergone. It has not yet received FDA approval. The device does have CE certification (CD 0483) for sale in Europe. The same appears to be true of the other devices marketed by Medisana. Its not entirely clear whether FDA clearance is something that Medisana is pursuing though other infrared thermometers have certainly sought 510(k) clearance in the past.

Nonetheless, this device certainly continues the march towards medical technology that embraces form as much as it does function.

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Location:Georgetown TX,United States

Tuesday, April 3, 2012

Four Chinese Herbs may be a new Treatment for Cancer

A Chinese Medicine as Cancer Treatment -
The Wall Street Journal

There’s growing acceptance that herbal medicines could be effective for medical conditions, but the scientific evidence to vault such a treatment into an approved drug is often lacking. As Shirley Wang explains on Lunch Break, researchers are making progress on a cancer treatment based on a common herbal combination in Chinese medicine.

Scientists studying a four-herb combination discovered some 1,800 years ago by Chinese herbalists have found that the substance enhances the effectiveness of chemotherapy in patients with colon cancer.

Early studies show a traditional four-herb combination has cancer-treatment benefits. The herbs are Chinese peony (pictured), Chinese jujube, Chinese licorice and baikal skullcap.

The mixture, known in China as huang qin tang, has been shown in early trials to be effective at reducing some side effects of chemotherapy, including diarrhea, nausea and vomiting. The herbs also seem to bolster colon-cancer treatment: Tests on animals with tumors have shown that administering the herbs along with chemotherapy drugs restored intestinal cells faster than when chemo was used alone.

The herb combination, dubbed PHY906 by scientists, is a rare example of a plant-based product used in traditional folk medicine that could potentially jump the hurdle into mainstream American therapy. A scientific team led by Yung-Chi Cheng, an oncology researcher at Yale University, and funded in part by the National Cancer Institute, is planning to begin Phase II clinical trials to study PHY906’s effectiveness in people with colon cancer.

Chinese jujube

Many conventional medications are derived from individual chemical agents originally found in plants. In the case of huang qin tang, however, scientists so far have identified 62 active chemicals in the four-herb combination that apparently need to work together to be effective.

“What Dr. Cheng is doing is keeping [the herbal combination] as a complex entity and using that as an agent,” says Josephine Briggs, head of the federal National Center for Complementary and Alternative Medicine, which is helping fund some of the PHY906 research. “It’s polypharmacy,” or the equivalent of several drugs being administered at once.

Dr. Cheng began his research on huang qin tang about a dozen years ago when he sought a better way of dealing with the chemotherapy’s side effects. A variety of medications are currently used to treat these symptoms, but with varying success. A more effective technique could improve patients’ quality of life and possibly allow them to tolerate a larger dose of chemo, which might speed up their course of treatment, he says.

Dr. Cheng, who grew up in Taiwan, turned to Chinese traditional medicine, which often touts holistic treatments and multiple health claims for a single herb. In herbal literature he found mention of huang qin tang, a herbal combination traditionally used in China for gastrointestinal problems, and decided to test whether it could help cancer patients without compromising the effectiveness of the chemotherapy.

Chinese licorice

The research team began by giving mice with colon cancer high doses of irinotecan, a chemotherapy drug. Some of the mice also received varying doses of PHY906, the herbal combination. After four days, the animals that got the herbs seemed to experience fewer side effects. The herbs also appeared to improve the efficacy of the chemo, restoring damaged intestinal cells faster than with chemo alone and allowing the mice to tolerate doses of the drug that otherwise might have been lethal.

They followed with another experiment treating animals in four groups. One group received just the chemotherapy drug, another received just PHY906, a third group got both and the last group got nothing. The herb and drug combination worked the best at reducing side effects. As the researchers expected, PHY906 had no impact on the cancer when used by itself.

Further testing showed that PHY906’s effectiveness was diminished if any of the four herbs was eliminated, indicating that there is an apparent synergistic effect between them. This finding “got me serious about [PHY906],” says Dr. Cheng. The work was published in the journal Science and Translational Medicine in 2010. By submitting PHY906 to the scientific rigor of clinical trials, Dr. Cheng aims to win regulatory approval for the compound’s use in cancer treatment.

One challenge with using herbal medicines is that the ratio of the chemicals they contain isn’t consistent when plants are grown under different conditions. After testing various suppliers, Dr. Cheng ended up creating a biotechnology company sponsored by Yale called PhytoCeutica to carefully monitor growing conditions to ensure plants from different batches were pharmacologically consistent and to continue clinical development of the compound.

Baikal skullcap

Why PHY906 works isn’t entirely clear, Dr. Cheng says. The herbal combination appears to have an anti-inflammatory effect on the gastrointestinal tract, according to work the group published in the journal BMC Medical Genomics last year. Dr. Cheng says he believes PHY906 works in at least three different ways in the body to control the side effects of chemotherapy, whereas conventional treatments work in just a single way.

So far, research data seem to support Dr. Cheng’s hunch about traditional medicine. “If it’s still in use after a thousand years there must be something right,” he says.

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You have a hernia? There is an app for that

New App to Forecast Pain After Hernia Operations - Health Blog - WSJ

By Laura Landro

Patients considering hernia repair can now use a free app for mobile devices, designed by a leading surgeon, which can help predict their chances of experiencing chronic pain and discomfort after an operation.

The app, CeQOL, which stands for Carolinas Equation of Quality of Life, is being officially launched tomorrow at the American Hernia Society meeting in New York, but is already available for download. It is aimed at men, who comprise the majority of hernia patients.

As reported in WSJ last month, more than 30% of patients may experience chronic discomfort and pain after hernia surgery. The pain is often linked to surgical mesh and other devices used to repair the hernia, a bulge of the intestine or body fat through a weak area in the abdomen. It can also be a result of internal damage done to the body by the hernia itself before surgery.

B. Todd Heniford, who designed the app and is chief of the division of gastrointestinal and minimally invasive surgery at Carolinas Medical Center in Charlotte, N.C., tells the Health Blog that the aim is to get both doctors and patients to use the app to help them discuss potential risks and complications prior to surgery.

“I like informed patients who come to me with questions, and the app can help us get down to what our patients want out of surgery and what they are afraid of,” Heniford says.

But physicians may often not have such conversations with patients and don’t have detailed data at their fingertips to give patients an idea of what the potential for complications are, he says.

Heniford, president of the hernia society, notes that 35% of hernia-surgery malpractice cases in the U.S. are related to post-surgical pain.

The hernia app is based on data from the International Hernia Mesh Registry, an ongoing study including hernia-surgery patients from ten countries. The registry used the Carolinas Comfort Scale — a questionnaire designed for hernia repair by the medical center — to measure those patients’ self-reported pain and quality of life before surgery, 30 days after the operation, and again at six months, a year and two years.

After patients use the app to answer questions about themselves and their hernias, the app generates a percentage chance of having some form of discomfort a year following surgery, based on data from the registry. The app also has extensive information about hernias and surgical procedures.

While his app is only for hernia patients, Heniford says he hopes more such apps will be developed that synthesize medical evidence to help patients make decisions and understand risks and side effects.

“People need this not just for hernia surgery, but for when they preparing for things like taking medicines for heart failure or undergoing chemotherapy,” he says.

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Location:Georgetown TX,United States