Archive for the ‘diagnosing’ Category

Do More Examiners Reviewing Results of Mammograms Improve Efficacy of Breast Cancer Detection?

Wednesday, August 19th, 2015

logo1267406_mdA new study published on Medical Express concluded that five independent assessments lead to better results than one or two. Previous researchers found that usually one or even two physicians in Europe review x-rays from mammograms but even when two review them, results are often wrong. About 20% of women with cancer are diagnosed as being cancer free, and about 20 % of those who are cancer free and diagnosed as having cancer. This lead to the study to evaluate collective vs individual intelligence for efficacy when reviewing x-rays.

Using a data set with a large number of mammograms with an independent assessment of each by about one hundred radiologists  as well as the actual health status with a yes or no for cancer on all patients. They found that five independent assessments lead to better results. Simple collective rules such as majority vote or quorum vote in order integrate the vote was used. Compared to the best physician, a collective intellectual vote allowed both the false positives and false negatives from mammograms to be reduced (sensitivity and specificity) ie: cancer diagnosis but no cancer and no cancer diagnosis but cancer. The collective benefit of mammograms begins to occur when three or four physicians are used for the assessment but the benefit of additional assessments significantly start to level off at about 8 or 10 assessments according to the researchers.

New Program Improves Lung Cancer Detection

Wednesday, July 22nd, 2015

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A new study on lung cancer detection presented at the American Thoracic Society International Conference in Denver concluded that long-time smokers and past smokers now have a more accurate way to detect whether or not they have lung cancer using CT scan technology. The study compared CT scans and standard chest x-rays to detect lung cancer. CT scans obtain a multiple-image scan of the entire chest, whereas a standard chest x-ray produces a single image of the whole chest. Results showed that patients receiving CT scans had a 15 to 20 percent lower risk of dying compared to those receiving standard chest x-rays.

The comparative study took place between September, 2014 and March, 2015 and gave CT scans to 375 patients of which 272 were eligible to continue in the program. Of this 272 patients, 19 had results that indicated malignant cancer.  Of those 19, 11 were confirmed malignant.  Eight of the 11 had lung cancer, and 3 had early stage lung cancer. Patients enrolled in the lung cancer detection program were considered high risk for lung cancer and all had a smoking history of at least 30 pack years that is the equivalent of smoking one pack of cigarettes a day for 30 years, and were current or former smokers without any signs or symptoms of lung cancer. The researchers said finding 3 early stage lung cancer patients  in the first 357 patients screened is incredible. Implementation of this program should save lives.

Can Imaging Techniques Identify Early Metastasis in Lymph Nodes?

Wednesday, May 27th, 2015

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A study published in Cancer Research concluded that a highly sensitive imaging technique for non-invasive screening of lymph nodes for metastatic cancer has been developed that offers a rapid tool for noninvasive identifying cancer spread at its earliest stages based upon testing in mice. The technique uses an imaging approach known as ultrasound-guided photoacoustics combined with nonosensors designed to target and identify metastatic cells in lymph nodes.

Over 90% of cancer deaths can be attributed to metastases directly or indirectly. Currently an invasive surgical procedure called sentinel lymph node (SLN) biopsy is used to identify the region and spread of tumors but the procedure has adverse side effects including pain, numbness and risk of infection. Noninvasive imaging modalities have been tested in animals and patients in order to improve the accuracy and safety of lymph node biopsies. Some imaging techniques such as position emission tomography (PET) and magnetic resonance imaging (MRI) have shown some potential but lack the specificity and sensitivity to be effective. The new technique seems to be more accurate and have improved  sensitivity. Overall, the testing in mice showed a sensitivity of 100% and a specificity of 87% for detection of lymph nodes micrometases as small as 50 micrometers, which corresponds to about 30 metastatic cells. Detection of cells in small numbers in lymph nodes offers a system having the ability to identify metastasis very early in the process, which would allow early treatment. Although these are early studies in mice, the researchers are optimistic about translating the technology for use in humans and expanding the use of the system. More research is planned.

Improving the Accuracy of Clinical Breast Exams.

Wednesday, February 25th, 2015

Improving the Accuracy of Clinical Breast Exams

A new study in the New England Journal of Medicine concluded that sensor technology has the potential to significantly improve the teaching of proper techniques for clinical breast exams. In the study researchers asked 553 practicing physicians during an annual clinical meeting to perform simulated clinical breast exams (CBE) under conditions that mimic an office visit for a symptomatic patient. participants completed a demographic survey, reviewed a clinical senario, performed the CBE on a sensor-enabled breast model, and then documented their findings. Researchers hoped to capture CBE technique while clinicians were evaluating the model for a mass. Results showed that physicians who palpated fewer than 10 newtons (a common measurement of force) were able to find two superficial masses on the breast model but missed the two deeper ones. Physicians increasing the amount of palpable pressure unproved the probability of identifying the deeper lesions. It was suggested that the optimum palpable force for deeper lesions is between 12 and 17 newtons. Researchers found that 15 percent of physicians in the study used a technique that put them at significant risk of missing deep tissue lesions near the chest wall. Researchers suggested considering mastery training in the health care professions to overcome this problem.

Can Prostate Cancer be Confirmed Without a Biopsy”

Wednesday, August 13th, 2014

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The Prostate Health Index (phi), a simple, non-invasive blood test that is three times more specific than the PSA to detect prostate cancer is now available according to a report in Science Digest. This may reduce the need for men who test positive for prostate cancer using  a PSA test  to need  a biopsy. Researchers said “The PSA test is based on the fact that men with higher levels of PSA protein are more likely to have prostate cancer.” “However. the problem is that higher levels of PSA can also be caused by a benign enlargement or inflammation of the prostate, leading to many false positives for cancer and ultimately unnecessary invasive biopsies and an increased potential for patient harm.”  Because the blood test is three times more specific in detecting prostate cancer than the PSA it may reduce the need for a biopsy and potential patient harm. Studies showed a reduction of 31% in unnecessary biopsies due to false positives on PSA’s using the phi test.

The phi test uses three different PSA markers as part of a sophisticated algorithm to increase the reliability of determining a patient with a positive PSA has prostate cancer. “The Prostate Health Index is a significant addition to our comprehensive menu of advanced clinical evidence based blood tests that aid in early cancer detection.” said the co-founder of the laboratory offering the test.

New Way to Detect Breast-Cancer Related Lymphedema.

Friday, November 22nd, 2013

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A new study reported in Lymphology discusses a new way to detect breast-cancer related lymphedema that is one of the most feared outcomes of breast cancer treatment and a condition that affects the lymphatic system and causes psychosocial distress and physical challenges for patients. The researchers believe that because low frequency electrical current cannot travel through cell membranes, using Bioelectrical Impedance Analysis (BIA) ratios to assess lymphedema could provide a direct measure of lymph fluid outside the cells. This allows for a more accurate assessment of lymphedema using a Lymphedema Index named L-Dex ratio. The objective of the study was to evaluate the reliability, sensitivity, and specificity of a cross-sectional assessment of BIA in detecting lymphedema in a large metropolitan clinical setting.

Data was collected on 250 women that included healthy adult females, breast cancer survivors with lymphedema and women at risk of lymphedema. They demonstrated that survivors with lymphedema had significantly higher L-Dex ratios showing the possibiliuty of using BIA to discriminate between these three cohorts of women. The researchers said “Our study also demonstrates that using a more sensitive L-Dex cutoff point, allowed for BIA to catch 34% of the usually missed lymphedema cases.” “This allows for earlier treatment, which naturally leads to better outcomes for at-risk patients.”  “Given that all women who are treated for breast cancer are at risk for lymphedema, using assessment methods that can accurately identify true lymphedema cases among at-risk breast cancer survivors is of ultimate importance for clinical practice.”

Is a Blood Test for Diagnosing Early Breast Cancer Possible?

Wednesday, November 20th, 2013

logo1267406_mdReported in an online edition of Clinical Chemistry researchers say that in preliminary tests they were able to detect breast cancer cells in serum biomarkers. A mixture of free-floating blood proteins created by the enzyme carboxypeptidase N (CPN) accurately predicted the presence of early-stage breast cancer tissue in mice and a small population of human subjects.

In their animal studies and human biopsies the researchers first determined the presence of breast cancer tissue, characterized each sample’s stage of development. and looked at how much CPN was being expressed. Blood samples were also taken from each individual  Six peptides (proteins) created by the enzyme CPN are believed to originate in or near cancerous cells and eventually make their way into the bloodstream. The researchers compared the stages of breast cancer tissue development in previously diagnosed patients to the presence of CPN-created peptides in their blood and found all six peptides were at detectably higher levels as early as breast cancer’s first pathological stage (cancerous cells present and a tumor 2 cm or smaller or no tumor) . They also found that CPN peptides were at a detectably higher level in blood of mice, compared to controls, just 2 weeks after introducing breast cancer cells.

CPN activity dropped significantly over the eight week study of mice suggesting the blood test as currently configured might not work as well in detecting later stages of breast cancer. This will be studied further.They said “Even at the eighth week, CPN activity was still significantly higher than baseline.”.. “However, we suspect the activity of different enzymes goes up and down as the disease progresses. We will be looking at how we might add known and future biomarkers to the blood test to increase its robustness and accuracy.”

Can a simple Test Accurately Screen Cancer Patients for Depression?

Wednesday, October 2nd, 2013

logo1267406_mdIn a new study presented at the American Society for Radiation Oncology’s 55 Annual Meeting a researcher concluded that cancer patients can accurately be screened for major depression with a simple two-question survey. The two questions were: Whether, over the past two weeks, the patient had experienced: 1) Little interest or pleasure in doing things; and 2) Feeling down, depressed or hopeless. Foe each question the patient was given the option of not at all (o pints), several days (1 point), more than half the days (2 points), or nearly every day (3 points). If a patient scored a total of 3 points or more on both questions he/she was considered to be at risk for being depressed.

Four hundred fifty five cancer patients receiving radiation therapy in 37 centers in the United States were included in the study. All were surveyed before or within 2 weeks of receiving their first radiation treatment and 16% screened positive for depression. For comparison. patients screening positiv3e for depression were administered an in-depth telephone interview using the SCID that is considered the gold standard for diagnosing depression. In addition, a random sample of those screening negative for depression received this telephone interview.

Results showed that the two question interview was as predictive of depression as the full nine question scale from which it was taken. Results also showed that the new 2 question interview more accurate than two other screening tests researchers admin9istered–the Hopkins Symptom Checklist, and the National Comprehensive Cancer Network Distress Thermometer. The study also found that 78% of the centers used routinely screen patients for depression at the radiation therapy center and 51% of these are at the initial visit. Sixty eight percent of the facilities offered mental health  services but 67% had only social workers, 17% had psychologists, and 22% had psychiatrists. The research-ers said “We think the results of this large, nationwide trial will have a major impact on how cancer patients are screened for depression,.

Can Bladder Cancer be Detected by Scent?

Friday, July 19th, 2013

logo1267406_mdPLOS ONE reports that researchers have developed a new “scent device” called the ODOREADER that may prove to be a reliable way to sniff out cancer in patients urine before it becomes a serious problem. Bladder cancer kills more than 15,000 Americans each years and it is expected to cause about 73,000 new cases in 2013. If caught early it can be treated effectively but currently there are no early screening methods other than diagnosis through urine tests at the stage when it starts to become  a problem .At that stage there is usually blood in the urine, frequent or painful urination, and back and pelvic pain as the cancer inva=des the cells lining the inside of the bladder. Although there are screening tests for risk of breast and ovarian cancers such as the BRAC nbiomarker, there currently is no reliable biomarkers or measurable molecular signs of a disease that is available for screening bladder cancer. But the ODOREADER may solve that. Following up on research that showed dogs could successfully sniff out bladder cancer researchers speculated that dogs were picking up the scent of certain gasses emitted by the urine and subsequently built a device that contains a sensor that can analyze gases and create a readout of the chemicals found in the urine within 30 minutes.

The device was tested on 24 samples taken from patients with confirmed cases of bladder cancer and 74 samples from patients who had urological symptoms, but no confirmed cancer. The ODOREADER correctly picked 100% of the cancer patients. Although the results are promising there is more work to be done.