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Transcript for Summary of Issue 24

Steve Graff: Hi and welcome to the JNCI podcast, a production of the Journal of the National Cancer Institute. I’m Steve Graff, JNCI’s assistant news and media editor, and I’ll be taking you through Issue 24 of the journal.

The first study found that long-term testicular cancer survivors are at high risk for Raynaud-like phenomena and neurological side effects. The next study and accompanying editorial dealt with arsenic biomethylation and oxidative DNA damage, while another found that funeral industry workers exposed to formaldehyde face higher risk of leukemia. One study analyzed data from the Childhood Cancer Survivor Study Report and found that late recurrence is a risk for some cancers. In the last study, researcher found evidence of a statistically significant survival benefit from adjuvant tamoxifen among patients whose estrogen receptor (ER)-positive tumors had high levels of phosphorylation of ER-alpha at serine-118. And finally, this issue’s brief communication looked at trends in brain tumor incidence in 4 Scandinavian countries during a time when cell phone usage sharply increased.


All that in more detail coming up next….

Long-term survivors of testicular cancer who were treated with cisplatin-based chemotherapy had more severe side effects, including neurological side effects and Raynaud-like phenomena, than men who were not treated with chemotherapy, according to a new study published online November 25.

Marianne Brydøy, of the Department of Oncology, Haukeland University Hospital, in Bergen, Norway, and colleagues conducted a cross-sectional study to assess the prevalence of these known side effects among long-term testicular cancer survivors in Norway according to the treatment they had received. Side effects include sensory neuropathy, hearing impairment, and Raynaud-like phenomena (discoloration of the hands or feet on exposure to cold).

Researchers invited 1,814 men who were treated for unilateral testicular cancer during 1980–1994 to participate in a national multicenter follow-up survey conducted during 1998–2002. A total of 1,409 participants, who were allocated to three groups based on cisplatin administration, were assessable in this study.

The researchers found that at 4–21 years after the initiation of treatment for testicular cancer, men who had received any chemotherapy had statistically significantly higher odds for increasing severity of all assessed symptoms compared with men not treated with chemotherapy. Treated men also had more hearing impairment, as measured by audiometry, particularly those who had received dose-intensive chemotherapy.

Biomethylation of arsenic compounds appears to cause oxidative DNA damage and to increase their carcinogenicity, according to a new study published online November 23.

Although biomethylation was once believed to detoxify inorganic arsenic, it is now thought to enhance its toxicity and potentially its carcinogenicity.

To assess the role of arsenic biomethylation in oxidative DNA damage in mice, Michael P. Waalkes, of the National Cancer Institute at the National Institute of Environmental Health Sciences, and colleagues compared oxidative DNA damage in methylation-competent cell lines vs. methylation-deficient cell lines exposed to arsenic.

Exposure of the methylation-competent cells, but not methylation-deficient cells, was followed by a sharp rise in oxidative DNA damage. Subsequent to the peak of oxidative DNA damage, methylation-competent cells, more rapidly than methylation-deficient cells, acquired the in vitro characteristics of cancer cells.

In an accompanying editorial, Michael F. Hughes, of the Environmental Protection Agency, in Research Triangle Park, N.C., reviews the history of research concerning arsenic methylation and its role in carcinogenesis. He notes that future investigations will need to determine whether arsenic-induced oxidative stress contributes to arsenic–induced toxicity and carcinogenesis by affecting cell signaling pathways and/or apoptosis.

Long durations of exposure to formaldehyde used for embalming in the funeral industry were associated with an increased risk of death from myeloid leukemia, according to a new study published online November 20.

Previous studies have shown excess mortality from lymphohematopoietic malignancies and brain cancer in anatomists, pathologists, and funeral industry workers, all of whom may have worked with formaldehyde.

For this study, researchers at the Division of Cancer Epidemiology and Genetics at the National Cancer Institute, and colleagues investigated the relation of mortality to work practices and formaldehyde exposure levels among these professionals. In a case–control study among funeral industry workers who had died between 1960 and 1986, researchers compared those who died from lymphohematopoietic malignancies and brain tumors with those who died from other causes. Lifetime work practices and exposures to formaldehyde were obtained by interviews with next of kin and coworkers.

This study was the first epidemiological investigation, to the authors’ knowledge, to relate cancer risk to duration of employment, work practices, and estimated formaldehyde exposure levels in the funeral industry.

The number of years of embalming practice and related formaldehyde exposures were associated with statistically significantly increased mortality from myeloid leukaemia, with the greatest risk among those who practiced embalming for more than 20 years. No associations were observed with other lymphohematopoietic malignancies; associations with brain cancer were unclear.

Late recurrence is a risk for some pediatric cancers, particularly Ewing sarcomas and tumors of the central nervous system, according to a new study published online December 4.

This study was undertaken because there is limited research on late recurrence (after 5 years and up to 20 years) for pediatric cancer patients.

Karen Wasilewski-Masker, of the Aflac Cancer Center and Blood Disorders Service, Children’s Healthcare of Atlanta at Scottish Rite, and colleagues analyzed data from the Childhood Cancer Survivor Study for 12,795 five-year survivors of the most common pediatric cancers. Cumulative incidence of late recurrence at 5, 10, 15, and 20 years after diagnosis was calculated using death as a competing risk.

The overall pediatric cancer recurrence rate was 4.4% at 10 years and 6.2% at 20 years among 5-year survivors. Thirteen percent of Ewing sarcomas and 14.4% of astrocytomas had recurred by 20 years. Only 0.9% of pediatric kidney tumors, 2.4% of Non-Hodgkin lymphomas, and 2.6% of neuroblastomas had recurred in 5 year-survivors by 20 years after treatment.

Researchers have found evidence of a statistically significant survival benefit from adjuvant tamoxifen among patients whose estrogen receptor (ER)-positive tumors had high levels of phosphorylation of ER-alpha at serine-118 (ERαS118-P), according to a brief communication published online November 25.

Approximately 50% of breast carcinomas are resistant to tamoxifen. Preclinical studies have shown that ERαS118-P is required for response to tamoxifen.

Göran Landberg, M.D, of the Breakthrough Breast Cancer Research Unit at the University of Manchester, and colleagues evaluated data from 239 premenopausal patients with breast cancer who participated in a randomized trial of 2 years of adjuvant tamoxifen treatment vs. no systemic treatment. The association between recurrence-free survival and ERαS118-P expression in tumor tissue was investigated.

Researchers found evidence of a statistically significant recurrence-free survival benefit from adjuvant tamoxifen among patients whose tumors had high ERαS118-P expression. ERαS118-P was not associated with a benefit among untreated patients.

There was no substantial change in brain tumor incidence among adults 5 to 10 years after cell phone usage sharply increased, according to a new brief communication published online December 3.

Although cell phone use has been proposed as a risk factor for brain tumors, a biological mechanism to explain this association is not known.

Isabelle Deltour, of the Institute of Cancer Epidemiology, Danish Cancer Society, in Copenhagen, and colleagues analyzed annual incidence rates of glioma and meningioma among adults aged 20–79 years from Denmark, Finland, Norway, and Sweden. Researchers identified 60,000 patients who were diagnosed with these types of brain tumors between 1974 and 2003.

The researchers found that incidence rates over this 30 year-period were stable, decreased, or continued a gradual increase that started before the introduction of cell phones. They also found no change in incidence trends in brain tumors from 1998 to 2003. The authors say this finding may be due to one of several reasons: that the induction period relating cell phone use to brain tumors exceeds 5–10 years; that the increased risk in this population is too small to be observed; that the increased risk is restricted to subgroups of brain tumors or cell phone users; or that there is no increased risk.

The authors did not assess cell phone usage at the individual level during this time period, only brain tumor incidence.

“Because of the high prevalence of mobile phone exposure in this population and worldwide, longer follow-up of time trends in brain tumor incidence rates are warranted,” the authors write.

That’s it for this edition of the JNCI podcast. As always, find these studies online at jnci.oxfordjournals.org or listen to more podcasts at oxfordjournals.org/podcasts.

Let us know how we’re doing by emailing podcasts@oxfordjournals.org or follow us on twitter @JNCI_Now

I’m Steve Graff, and thanks for listening…