Focus on Cancer

What does microarray-based gene expression profiling tell us in terms of diagnosing and treating breast cancer? How is this technology changing our perceptions of breast cancer? Dr. Lajos Pusztai, associate professor of medicine at the University of Texas M.D. Anderson Cancer Center, discusses some clinical applications of a multigene assay. Dr. Lee Freedman hosts.

The widespread use of mammography to screen for breast cancer has resulted in a decrease in breast tumor detection, as well as decrease in mortality rates associated with the disease. But the natural course of malignant diseases such as different types of cancer can vary considerably. Is it possible-even common-for some invasive breast tumors to regress without treatment? And if this is the case, how could this impact our strategies for screening, diagnosing and treating breast cancer? For more on these intriguing ideas, host Dr. Jennifer Shu welcomes Dr. Per-Henrik Zahl, epidemiologist and senior statistician at the Norwegian Institute of Public Health in Oslo, Norway, and lead author of a study published in the Archives of Internal Medicine that "raises the possibility that the natural course of some screen-detected invasive breast tumors is to spontaneously regress."

Despite our best efforts at surgery and chemotherapy for patients with glioblastoma, survival time is often far too limited. One novel weapon in our arsenal could be a vaccine that bolsters the immune system in the body's fight against these tumors. As we move forward with research toward a vaccine, what are the keys to boosting its efficacy? How much additional time could a vaccine buy for our glioblastoma patients? Host Dr. Mark Nolan Hill probes these questions and more with Dr. Keith Black, professor of neurosurgery and chair of the department of neurosurgery, and director of the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical Center in Los Angeles. Dr. Black also describes the fascinating process by which the research team collects tissue from each patient, which is subsequently applied toward the formation of a vaccine customized for the individual's condition.

Whether cancer originates in the colon, breast, or elsewhere in the body, the liver is one of the most common places to which a malignancy will spread. When this occurs, if it's possible to control the metastasis in the liver, we may have a much better shot at holding the original tumor at bay. A technique called hepatic perfusion may help us do this. For more on hepatic perfusion and its potential role in the chemotherapeutic process, host Dr. Mark Nolan Hill talks with Dr. H. Richard Alexander, associate chairman for clinical research in the department of surgery at the University of Maryland School of Medicine. How might this technique, which affords us the opportunity to deliver high-dose therapy while circumventing most side effects, begin to change our perspective on the limitations of chemotherapeutics?

Early diagnosis of bladder cancer is a significant step toward survival. Over the years, findings have suggested that women and African-Americans are particularly vulnerable to the disease, and often times, we are delayed in our diagnosis and subsequent treatment of these more highly susceptible populations. What are the most effective steps we can take to improve our recognition of bladder cancer earlier in its progression? Host Dr. Mark Nolan Hill welcomes Dr. Gary Steinberg, professor and vice chairman of urology, and director of urologic oncology at the University of Chicago Pritzker School of Medicine, to discuss the key issues relative to gender and race, as well as awareness among patients and primary care physicians toward prevention of a delayed diagnosis of bladder cancer.

Survival rates for retinoblastoma now approach 100 percent, but in years past, enucleation was the only sure way to cure this rare pediatric malignancy. We're now seeing advances in chemotherapy that not only spare the child's eye, but can preserve vision as well. What makes this chemotherapy regimen so effective, and how can we build on its effectiveness to enhance the vision and the livelihood of children affected by retinoblastoma? Dr. David Abramson, chief of the ophthalmic oncology service at Memorial Sloan-Kettering Cancer Center in New York, joins host Dr. Jennifer Shu to talk about the breadth of retinoblastoma research that has helped us take important strides toward remediation of this disease.

Lymphedema is a condition faced by many breast cancer survivors, and it can be debilitating for one in five of these women. But lymphadema can be detected early. Greg Brown, chief executive officer of Australia-based ImpediMed tells host Bruce Japsen about the benefits of early detection and the coming technology platforms to assist doctors in this regard.

For breast cancer patients, there is often an untold story after mastectomy and treatment. Greg Brown, chief executive officer of ImpediMed, tells host Bruce Japsen about how women can suffer a debilitating complication known as lymphedema and how test makers are moving to help diagnose the problem early.

The need to manage the health of patients with cancer, and at risk for developing cancer, has given rise to the field of cancer genomics. What is this field? What are the roles within the specialty? And how do they work with patients?Host Dr. Bruce Bloom talks with Dr. William Foulkes, director of the cancer genetics program at McGill University in Montreal, Canada.

What has genetic research taught us about the inheritance of common cancers? And how can we use this knowledge to help patients? Dr. William Foulkes, director of the cancer genetics program at McGill University in Canada, talks with host Dr. Bruce Bloom about the questions raised and the answers revealed when we look at cancer risk from a genetic perspective.