(Press-News.org) OAKLAND, Calif. May 7, 2014 — Radiation treatment can help reduce the recurrence of Merkel cell carcinoma, a rare and aggressive skin cancer, while chemotherapy does not appear to have any impact on recurrence or survival, according to a Kaiser Permanente study published online in the current issue of JAMA Dermatology.
The study presents one of the largest single-institution datasets on Merkel cell carcinoma, which occurs in about 1,500 people in the United States annually. Most such cancers occur on the sun-exposed skin of white males and are first diagnosed at age 75, on average. Using the Kaiser Permanente Northern California Cancer Registry, the researchers found that out of 218 cases of Kaiser Permanente patients who had Merkel cell carcinoma, those who had radiation treatment had a 70 percent lower risk of disease recurrence while chemotherapy did not appear to have any impact on recurrence or survival.
"We used our database to show what characteristics impact recurrence and survival in this very rare cancer," said the study's lead author Maryam M. Asgari, MD, MPH, of the Kaiser Permanente Division of Research. "The electronic records allowed us to identify patients with Merkel cell carcinoma, see how they were diagnosed and treated, and then follow them over time to see how their care affected their outcomes."
Using an electronic health record system, Kaiser Permanente HealthConnect®, allowed the researchers to evaluate the relationships between cancer recurrence and survival with demographic information (age, sex, race, immunosuppression) and tumor characteristics (extent, size and location), as well as cancer work-ups (pathologic lymph node evaluation, imaging) and treatments (surgery, radiation and chemotherapy).
The study results also showed that immunosuppression and more advanced tumors were associated with worse survival rates related to Merkel cell carcinoma, and that pathological evaluation of the patient's lymph nodes also had a significant impact on outcomes.
Asgari noted that the success of different work-up and treatment protocols has been difficult to compare for rare cancers. "This research should help dermatologists and oncologists in caring for their patients with Merkel cell carcinomas," she said.
INFORMATION:
Kaiser Permanente can conduct transformational health research in part because it has the largest private patient-centered electronic health system in the world. The organization's electronic health record system, Kaiser Permanente HealthConnect®, securely connects 9.1 million patients to more than 16,000 physicians in almost 600 medical offices and 37 hospitals. It also connects Kaiser Permanente's research scientists to one of the most extensive collections of longitudinal medical data available, facilitating studies and important medical discoveries that shape the future of health and care delivery for patients and the medical community.
In addition to Asgari, co-authors of the study were Monica M. Sokil, BS, and E. Margaret Warton, MPH, Kaiser Permanente Division of Research, Oakland, Calif.; and Jayasri Iyer, MD, Kelly G. Paulson, MD, PhD, and Paul Nghiem, MD, PhD, Fred Hutchinson Cancer Research Center, Seattle.
The study was funded by the National Cancer Institute, Michael Piepkorn Endowment and UC MCC Patient Gift Fund.
About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR's 550-plus staff is working on more than 250 epidemiological and health services research projects. For more information, visit http://www.dor.kaiser.org or follow us @KPDOR.
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 9.1 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to kp.org/share.
Kaiser Permanente study finds radiation best treatment for a rare skin cancer
2014-05-07
ELSE PRESS RELEASES FROM THIS DATE:
Official statement by ACS: Release of National Climate Assessment demands action
2014-05-07
WASHINGTON, May 7, 2014 — Yesterday's release of the third National Climate Assessment (NCA) should serve as a claxon call for policymakers and the general public to take action to address and mitigate the observable and documented adverse climate disruption impacts being observed in every region and key economic sector of the United States.
These impacts, which have been observed and measured, are wreaking havoc with our society. This is a not a theoretical assessment; this report cites changes we are all observing and with which we are living. The future climate ...
A lab in your pocket
2014-05-07
When you get sick, your physician may take a sample of your blood, send it to the lab and wait for results. In the near future, however, doctors may be able to run those tests almost instantly on a piece of plastic about the size of credit card.
These labs-on-a-chip would not only be quick—results are available in minutes—but also inexpensive and portable. They could be used miles from the nearest medical clinic to test for anything from HIV to diabetes. But as powerful as they may be, they could be far better, says Shiyan Hu, an associate professor of electrical and ...
Pushing the boundaries of stem cells
2014-05-07
(NEW YORK – May 7) Adults suffering from diseases such as leukemia, lymphoma, and other blood-related disorders may benefit from life-saving treatment commonly used in pediatric patients. Researchers at the Icahn School of Medicine at Mount Sinai have identified a new technique that causes cord blood (CB) stems cells to generate in greater numbers making them more useful in adult transplantation.
The study, published in the May issue of The Journal of Clinical Investigation, looked at ways to expand the number of hematopoietic stem cells (HSC) in the laboratory required ...
NASA telescopes coordinate best-ever flare observations
2014-05-07
VIDEO:
Watch the movie to see the wealth of colorful NASA observations of an X-class flare on March 29 -- the most comprehensively observed flare, ever.
BROADCAST QUALITY: http://svs.gsfc.nasa.gov/vis/a010000/a011500/a011522/....
Click here for more information.
On March 29, 2014, an X-class flare erupted from the right side of the sun... and vaulted into history as the best-observed flare of all time. The flare was witnessed by four different NASA spacecraft and one ground-based ...
Glutamate imaging better than MR spectroscopy in first 3 hours after ischemic stroke
2014-05-07
Leesburg, VA, May 5, 2014—Glutamate imaging reveals ischemic lesions in the first 3 hours after stroke that are not distinguishable in T1-weighted and T2-weighted imaging.
Researchers using chemical exchange saturation transfer (CEST), an emerging MRI technology, have found that using glutamate with CEST shows high spatial resolution in vivo. The finding has the potential to speed diagnosis—and, therefore, treatment—in the critical first hours after a stroke.
"I have been interested in glutamate imaging since its inception," said researcher Zhuozhi Dai of Second Affiliated ...
New study examines premature menopause and effects on later life cognition
2014-05-07
Premature menopause is associated with long-term negative effects on cognitive function, suggests a new study published today (7 May) in BJOG: An International Journal of Obstetrics and Gynaecology (BJOG).
The average age of menopause is around 50 years in the Western World. Premature menopause refers to menopause at or before 40 years of age, this could be due to a bilateral ovariectomy, (surgically induced menopause)or non-surgical loss of ovarian function (sometimes referred to as 'natural' menopause).
The study, based on a sample of 4868 women, used cognitive tests ...
Image-guided peritoneal dialysis catheter placement significantly reduces complications
2014-05-07
Leesburg, VA, May 7, 2014— Patients undergoing peritoneal dialysis catheter placement via fluoroscopy and ultrasound-guidance experienced significantly fewer complications at 1 year post-insertion than did patients whose catheters were placed laparoscopically.
The first of two study groups received catheters using fluoroscopy and ultrasound guidance under conscious sedation by interventional radiologists. In the second group, the catheters were inserted using laparoscopy under general anesthesia by surgeons.
"Our results showed that the overall complications at 1 ...
Iterative reconstruction techniques reduce radiation dose for pediatric brain CT
2014-05-07
Leesburg, VA, May 7, 2014—A study conducted at Massachusetts General Hospital and Harvard Medical School found that estimated radiation doses are substantially lower for pediatric CT exams of the brain that used an adaptive statistical iterative reconstruction technique (ASIR) compared to those that did not use ASIR. The researchers found that the brain and salivary gland doses were much lower for ASIR-enabled exams compared to those without ASIR technique. However, no differences in the estimated organ doses were found for the thyroid gland, skeleton, and eye lenses across ...
Nonscreened patients with breast cancer need more treatment than screened patients
2014-05-07
Leesburg, VA, May 6, 2014—Screening 40- to 49-year-old women for breast cancer has additional benefits beyond the proven decrease in mortality rate. Patients screened with mammography are statistically less likely to undergo chemotherapy, avoiding the associated toxic morbidities. Screening mammography also helps identify a subset of patients at increased risk of breast cancer by diagnosing high-risk lesions.
The majority of high-risk lesions identified in a retrospective chart review were found in screened patients. Identifying patients at high risk may allow for the ...
Overestimation of radiation exposure may keep women from critical screening
2014-05-07
Leesburg, VA, May 5, 2014—Misinformation and misunderstanding about the risks associated with ionizing radiation create heightened public concern and fear, and may result in avoidance of screening mammography that can detect early cancers.
In a study to determine the baseline understanding of the radiation associated with mammography among patients presenting for initial or follow-up imaging, women were asked to rate the amount of radiation received in a single mammogram as being significantly less, slightly less, about the same, slightly more, or significantly more compared ...