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According to the latest data on nationwide death rates from cancer, overall mortality from cancer declined from 1999 to 2008, maintaining a trend seen since the early 1990s.

Mortality fell for most cancer types, including the four most common types of cancer in the United States (lung, colorectal, breast, and prostate), although the rate of decline varied by cancer type and across racial and ethnic groups.

The complete Annual Report to the Nation on the Status of Cancer, 1975–2008 appeared March 28 in Cancer.

The declines in cancer death rates (mortality) averaged 1.7 percent per year for men and 1.3 percent per year for women from 1999 through 2008.

Among men, the overall rate of new cancer cases (incidence) fell by an average of 0.6 percent annually from 1999 to 2008.

Among women, incidence dropped by an average of 0.5 percent annually from 1999 to 2006 but held steady from 2006 to 2008.

Cancer incidence in children ages 0 to 14 rose from 1999 to 2008 (by 0.5 percent a year), continuing a trend seen in previous Annual Reports to the Nation.

However, advances in treatment contributed to a steady decline in mortality rates for children with cancer in the last 5 years (an average of 2.8 percent per year).

“Steady progress, as measured by declines in cancer death rates for many cancers, is good because we have an aging, growing population,” said Dr. Brenda K. Edwards, NCI’s senior advisor for surveillance.

“While the number of people diagnosed with cancer or who die of the disease may be increasing, the decline in cancer death rates for more than a decade is the best indicator of progress due to prevention, screening, diagnosis, and treatment,” she added.

NCI, the American Cancer Society, the Centers for Disease Control and Prevention (CDC), and the North American Association of Central Cancer Registries (NAACCR) collaborated on the report. Cancer incidence data came from NCI’s Surveillance, Epidemiology, and End Results (SEER) database and from the CDC, with analyses of pooled data by NAACCR. Mortality data came from the CDC’s National Center for Health Statistics.

Not All Good News

There were some notable exceptions to the overall decreases in incidence and mortality. From 1999 to 2008, death rates rose for pancreatic cancer in men and women, for liver cancer and melanoma in men, and for endometrial cancer in women.

The cervical cancer death rate, which had been falling for decades, showed no further decrease over the last 5 years.

And, although incidence rates fell overall for men and women from 1999 to 2008, the decline was not distributed evenly across racial and ethnic groups.

Cancer incidence rates did not decrease significantly among American Indian/Alaska Native men and women combined or among black, Asian and Pacific Islander, and American Indian/Alaska Native women.

Although incidence rates in black men did decline, this group still had the highest cancer incidence rate of any racial and ethnic group, 15 percent higher than that of white men and nearly double that of Asian and Pacific Islander men.

Major Modifiable Risk Factors

Each Annual Report to the Nation includes a special feature that focuses on a topic of importance to the cancer research community and the public.

This year’s report featured an analysis on the contribution of excess weight (overweight and obesity) and insufficient physical activity to the nation’s cancer burden.

More than 60 percent of the U.S. adult population is estimated to be overweight or obese, and a similar percentage of adults do not get the recommended amount of physical activity.

The rates of insufficient physical activity are even worse for children; for example, up to 90 percent of high school girls do not engage in recommended levels of physical activity.

Excess weight “is a major modifiable risk factor for cancer and other diseases—probably second only to tobacco use in terms of its impact on cancer incidence and mortality,” said Dr. Edwards. “The risk may be modest but it’s so pervasive that we felt this was the time to look at [cancer] incidence in this context.” Physical inactivity not only contributes to excess weight but is itself a risk factor for several cancer types.

The report was not designed to quantitatively link the trends in excess weight and lack of physical activity to the national trends for cancer, explained Dr. Rachel Ballard-Barbash, associate director of the Applied Research Program in NCI’s Division of Cancer Control and Population Sciences.

Many other studies have shown convincing links between excess weight and several cancer types, including endometrial, postmenopausal breast, colorectal, kidney, esophageal, and pancreatic cancer.

The point of the special feature, she noted, “is to highlight specific types of cancer that are related to [excess weight and lack of sufficient physical activity], show how these behaviors relate to these cancers in terms of their relative risks, and briefly describe some of the mechanisms by which they relate.”

The special feature also highlights national- and state-level prevention strategies in policy and environmental change that are intended to help people achieve recommended changes in their diets and physical activity levels.

As the nation’s weight has risen, so has the incidence of some, although not all, types of cancer related to excess weight and lack of sufficient physical activity. From 1999 to 2008, incidence rates of kidney cancer and of adenocarcinoma of the esophagus each rose about 3 percent per year for men and women, while incidence of pancreatic cancer rose 1.2 percent per year among men and women.

In addition, incidence rates of endometrial cancer rose significantly among black, Asian and Pacific Islander, and Hispanic women. Incidence of postmenopausal breast cancer stabilized from 2005 to 2008, after a period of decline.

“Although all of these cancers are influenced by multiple factors, the high prevalence of excess weight and insufficient physical activity likely contributed to these observed increases and to the lack of decline in breast cancer,” the authors wrote. “Continued progress in reducing cancer incidence and mortality rates will be difficult without success in promoting healthy weight and physical activity, particularly among youth.”

Excess weight and lack of physical activity also influence cancer survivorship, explained Dr. Ballard-Barbash, as both can negatively affect outcomes after a cancer diagnosis, further increasing the need for these risk factors to be addressed on a personal and societal level.

The NCI Cancer Bulletin is an award-winning biweekly online newsletter designed to provide useful, timely information about cancer research to the cancer community. The newsletter is published approximately 24 times per year by the National Cancer Institute (NCI), with day-to-day operational oversight conducted by federal and contract staff in the NCI Office of Communications and Education. The material is entirely in the public domain and can be repurposed or reproduced without permission. Citation of the source is appreciated.

Prof. Bowtell

The largest grant will go to David Bowtell, PhD of the Peter MacCallum Cancer Center in Melbourne, Australia, who won the Center’s first Scientific Challenge Grant, a new award that seeks to encourage research into the origins of ovarian cancer with the goal of developing ways to diagnose the cancer early, when it is more treatable.

The two-year, $150,000 grant will fund Professor Bowtell’s to research to see whether ovarian cancers release enough of a form of DNA into the bloodstream that it might be possible to detect the cancer early with a simple blood test.

The Center also awarded one-year $75,000 Pilot Study Awards to 13 researchers conducting innovative research and three $60,000, one-year Scientific Scholar grants for promising young laboratory and clinical scientists pursuing careers in ovarian cancer research.

Dr. Salazar

Among the recipients of the Pilot Study Awards is Lupe Salazar, MD of the University of Washington’s Tumor Vaccine Group, who studies how the immune system’s white cells can be induced to attack cancer cells. For a summary of her grant click here.

Dr. Liao

Among the three Scientific Scholar grantees is John Liao, MD, PhD, assistant professor of the UW Obstetrics & Gynecology Department, who is working on developing vaccines against ovarian cancer. For a summary of his grant click here.

Ovarian cancer is the ninth most common cancer among women, excluding non-melanoma skin cancers, according the American Cancer Society.

Each year in the U.S., about 21,990 women are diagnosed with ovarian cancer and about 15,460 die from the diseases.

Only about half of women diagnosed with ovarian cancer will be alive in five years, but if the cancer is found and treated before it has spread outside of the ovary, the five-year survival rate is 94 percent.

Early diagnosis is difficult, however, because early ovarian cancers often produce no or only subtle symptoms and no screening test has yet been proven to be effective, according to American Cancer Society.

As a result, only about one in five cases of ovarian cancer are diagnosed early.

To learn more:

• Visit the Marsha Rivkin Center’s webpage.
• Visit the American Cancer Society’s webpage on Ovarian Cancer.

Pilot Study Awardees for 2011:

Karen Abbott, PhD
University of Georgia

Targeting Tumor-Specific Glycosylation: Discovery of Novel Membrane Receptors

Dr. Abbott’s work is focused on discovering new tumor-specific targets on the surface of cancer cells. Tumor-targeted therapy regimens will have less toxic side effects to normal tissues, and lead to a better quality of life for patients. This project is based on a recent discovery of a unique type of carbohydrate (glycan) found on proteins that cover the surface of ovarian tumor cells and not normal ovarian cells. The membrane receptors that help this glycan stick to the surface of tumor cells will be identified and subsequently used for the development of tumor-targeted therapeutics in the future.

Karen Cowden Dahl, PhD
Indiana University

The role of ARID3B isoforms in ovarian cancer and chemoresistance

Around 70% of women diagnosed with ovarian cancer have advanced disease and the prognosis is very poor. Treatment for ovarian cancer consists of surgery followed by chemotherapy. One of the contributing factors to the poor prognosis for advanced ovarian cancer is due to tumor cells becoming resistant to chemotherapy. This project aims to understand how a new overexpressed gene (ARID3B) is regulated in ovarian cancer and how different forms of this gene contribute to chemoresistance. These studies will further the understanding of genes that are involved in ovarian cancer and chemoresistance in order to better treat ovarian cancer patients.

Daniela Dinulescu, PhD
Brigham and Women’s Hospital

Experimental Models to Validate a Tubal Cell of Origin for Serous Ovarian Cancer

Too little is known about the genetic lesions responsible for ovarian cancer tumor initiation, and uncertainty remains over the specific cell or cells of origin. Data emerging from The Cancer Genome Atlas (TCGA) on the many genomic alterations in serous ovarian carcinoma has delivered a treasure trove of new candidates for investigation, but discerning which gene alterations are critical early events in cancer pathogenesis, how tumors evolve to their highly aggressive state, and which pathways represent the best therapeutic targets will require a large scale collaborative research effort. Animal models developed in Dr. Dinulescu’s lab, which accurately recapitulate the human disease, constitute great tools for defining the key roles that ovarian cancer cells in the ovarian surface epithelium and distal fallopian tube play in tumor initiation and resistance to chemotherapy. Furthermore, they provide us with unique, relevant in vivo systems in which to screen novel molecularly targeted therapies as they become available.

Thuy-Vy Do, PhD
University of Kansas Medical Center

Preclinical Evaluation of Aurora A Kinase and PARP Inhibitor Combination Therapy

Women carrying mutations in the breast-cancer associated 1 or 2 (BRCA1/2) genes are at higher risk for developing epithelial ovarian cancer. BRCA1/2 play critical roles in repairing DNA and helping genes avoid mutation. Interestingly, BRCA1/2 is not functioning optimally in cases of sporadic epithelial ovarian cancer, and BRCA2 and Aurora A interact in cells to regulate genomic stability. Dr. Do will test the hypothesis that Aurora A and BRCA1/2 interact to mediate DNA repair and cell growth. An Aurora A kinase inhibitor and a PARP inhibitor will be tested as therapies for ovarian cancer.

Alexander Nikitin, MD, PhD
Cornell University

Role of Stem Cells in Ovarian Cancer

Understanding of epithelial ovarian cancer development is critical for designing effective diagnostic and therapeutic approaches. During recent years it has become increasingly clear that cancers may arise from stem and progenitor cells. However, the location of the stem cell compartment of the ovarian surface epithelium that give rise to cancer cells remains unknown. Dr. Nikitin will explore a newly identified stem cell compartment in the ovary and determine properties of these stem cells and their contributions to epithelial ovarian cancer.

Daniel Powell, PhD
University of Pennsylvania

Preclinical Evaluation of Costimulated CIR Therapy for Ovarian Cancer

Adoptive immunotherapy is extremely effective for triggering tumor regression in patients with malignant melanoma. To develop adoptive T-cell therapy for epithelial ovarian cancer, we have created a chimeric immune receptor (CIR) that redirects the immune system against alpha-folate receptor, a protein on the surface of 90% of epithelial ovarian cancer cells. In designing this therapy, other strategies that will be taken into account including promoting growth and survival of the body’s own immune cells to fight ovarian cancer. The results of Dr. Powell’s work will provide preclinical data essential for clinical development.

Carrie Rinker-Schaeffer, PhD
University of Chicago

Milky Spot Macrophages: Co-Conspirators in Omental Metastasis Formation

No one knows what microenvironmental interactions control ovarian cancer metastasis. Getting this crucial information requires a fresh look from a new perspective. Recently Dr. Rinker-Schaeffer’s lab made a novel connection between ovarian cancer metastatic colonization and structures on the omentum (tissues in the abdomen) that contain immune cells and are called milky spots. It is suspected that cancer cells take advantage of milky spots to promote their own survival and growth. This project will identify interactions between omental immune cells and cancer cells that can be targeted in combination with current therapies in order to suppress metastatic growth, improve quality of life, and extend disease-free survival.

Lupe Salazar, MD
University of Washington

Adoptive transfer of tumor specific Th1 cells derived from vaccine-primed patients achieved clinical benefits

Adoptive immunotherapy can induce cancer regression but rarely results in cure. We have infused HER2-specific Th1 cells in breast cancer patients, and 50% of patients had a partial or complete response to the treatment. Dr. Salazar hypothesizes that Th1/Th17 immune cells that can recognize tumor cells can have enhanced therapeutic efficacy. This project will determine the optimal conditions to grow these multifunctional immune cells in the lab in order to enhance their ability to identify and target cancer cells using IGFBP2. Results from this project will lead to a phase I study of adoptive immunotherapy in ovarian cancer after priming with an IGFBP2 vaccine.

Janet Sawicki, PhD
Lankenau Institute for Medical Research

Utilizing HuR to Combat Chemotherapeutic Resistance in Ovarian Cancer

The molecular basis underlying the range of ovarian cancer patient responses to chemotherapeutic agents is poorly understood. This project will address the urgent need to stratify ovarian cancer patients for therapy and enhance currently available treatment strategies. Recently, Dr. Sawicki’s lab discovered that the stress response protein, HuR, can mediate therapeutic efficacy of gemcitabine and a PARP inhibitor, two drugs currently used to treat ovarian cancer, by rapidly binding and regulating cancer-associated mRNA transcripts. Therefore, HuR may serve as both a potential predictive marker for drug efficacy and a promising target for therapeutic manipulation for the treatment of epithelial ovarian cancer.

Kavita Shah, PhD
Purdue University

Chemical genetic dissection of Aurora A Kinase in ovarian cancer

The function of kinases is to turn proteins on and off in cells. Aurora A kinase is one such kinase whose levels increase early in ovarian cancer and are associated with poor prognosis. By identifying the proteins that Aurora A kinase turns on and off in ovarian cancer cells that are not affected in normal cells, Dr. Shah can design drugs to inhibit Aurora A kinase from doing its job and reverse the cascade of proteins that are involved in progression of ovarian cancer. Safer drugs can be developed which target only ovarian cancer cells while avoiding normal cells.

Barbara Vanderhyden, PhD
Ottawa Hospital Research Institute

Role of PAX2 in the etiology of ovarian and fallopian tube cancers

The origins of ovarian cancer are poorly understood but most cancers seem to arise from the surface layer of cells on the ovary or the fallopian tube. Ovarian surface epithelial cells have the ability to develop into ovarian cancer subtypes that fall into two broad categories: low-grade and high-grade. Previous work shows that changes in a protein, PAX2, occur in the earliest cancerous structures in both ovaries and fallopian tubes. Dr. Vanderhyden’s lab has developed methods to isolate both ovarian and fallopian tube cells from mice and will determine how changes in PAX2 contribute to the early stages of ovarian cancer.

 Christine Walsh, MD
Cedars-Sinai Medical Center

Genetic Modifiers of BRCA1-Associated Gynecologic Cancer Penetrance

Women who inherit a mutation in the BRCA1 gene have a 40% risk of developing ovarian, tubal, or peritoneal cancer. Dr. Walsh is seeking to shed light on genetic and molecular events that lead to tumor development in some women in this high-risk population but not in others. A significant difference in the genetic sequence of the PARK2 gene distinguishes BRCA1 mutation carriers that do develop cancer from those who do not develop cancer. This project will further investigate PARK2, which is mutated in other cancers and has a tumor suppressor function, by looking at its role in the biology of BRCA1-associated gynecologic cancer development.

Jian-Jun Wei, MD
Northwestern University

MiR-182 overexpression in early tumorigenesis of high grade serous carcinoma

High grade papillary serous carcinoma may arise from serous tubal intraepithelial carcinoma in the fallopian tube. MiR-182 is a small RNA molecule that is significantly overexpressed in both types of carcinomas. Dr. Wei hypothesizes that miR-182 overexpression is a critical and early molecular change in papillary serous carcinoma. He will use normal fallopian tube secretory epithelial (FTSE) cell lines to investigate whether adding miR-182 in large amounts will result in tumors and whether miR-182 causes tumors via target genes BNC2 and MTSS1 known to be involved in papillary serous carcinoma. The results will provide a new marker in early detection and a potential therapeutic target for PSC.

Scientific Scholar Awardees: 

Young Min Chung, PhD
Stanford University School of Medicine

Targeting Ovarian Cancer with Combination of Olaparib and Trifluoperazine

Dr. Chung is developing innovative therapeutic strategies by combining a clinically used small-molecule drug called trifluoperazine (TFP) and a chemical compound named Olaparib, which is an inhibitor of an enzyme called PARP, to suppress advanced ovarian cancer and to overcome PARP inhibitor-unresponsive ovarian cancer. In addition, novel biomarkers will be identified for monitoring therapeutic sensitivities in ovarian cancer. Ultimately, the results of this project will be used to design a clinical trial to treat patients with advanced ovarian cancer.

John Liao, MD, PhD
University of Washington

Development of a polyepitope DNA vaccine for ovarian cancer immunotherapy

While ovarian cancer patients can respond to chemotherapy and achieve remission, the majority of advanced stage patients succumb to recurrent disease. Strategies harnessing the immune system have the potential to augment available therapies, prolong remissions, and prevent relapses. Vaccines generating immune responses against proteins in ovarian cancer cells could offer a possibility of selectively killing those cells. Dr. Liao has identified 6 proteins associated with poor prognosis. Vaccines targeting fragments of these 6 proteins will then be tested in a mouse model for ovarian cancer to evaluate safety and effectiveness in preparation for clinical trials.

Fiona Simpkins, MD
University of Miami

Characterization of subpopulations capable of self-renewal in ovarian cancers

Most ovarian cancer patients suffer disease recurrence, and most available chemotherapies are toxic and stop working. Cancer stem cells comprise a subpopulation of cells capable of self-renewal and are resistant to chemotherapy. By characterizing such subpopulations and determining which signaling pathways drive their growth, Dr. Simpkins would like to develop better strategies to target these subpopulations and overcome drug resistance. This project will characterize the self-renewal potential of cell populations expressing different surface markers suggestive of “stemness” in ovarian cancer, determine developmental and mitogenic signaling pathways unique to these populations, and determine how targeted treatments effect these subpopulations.

The club’s services are free and include support and networking groups, lectures, workshops and social events in a nonresidential, homelike setting.

The club is named in honor of Gilda Susan Radner was an American comedienne and actress, best known for her years as a cast member of Saturday Night Live.

Radner, who died at 42 of ovarian cancer, helped raise the public’s awareness of the disease and the need for improved detection and treatment.

Lectures are held on Thursday evenings at Gilda’s Club, 1400 Broadway, Seattle.

All lectures are open to the public. There is no cost to attend the lectures.

Refreshments served 6:45-7:00 pm

Lecture begins 7:00-8:30 pm

Please RSVP to attend.

(Please RSVP 24+ hours in advance to attend and pre-register for Noogieland childcare a minimum of 72 hours in advance.)

1/13/2011

Reduce your cancer risk — Dr. Julie Gralow, member of Gilda’s Club Medical Board, will review steps YOU can take in 2011 to reduce your cancer risk.  Learn about important cancer risk reduction strategies – including reducing risk of cancer returning after cancer treatment.  Find out about community resources to motivate you to action on your 2011 resolutions.

1/20/2011

ASK THE DOCTOR: Gynecologic Cancer – Come hear from Dr. Kathryn McGonigle, named Top Doc by Seattle and Seattle Metropolitan Magazines. Learn about the HPV vaccine and how it prevents cervical cancer.  Learn what type of symptoms women should be aware of that might be associated with uterine, cervical or ovarian cancer.  When should you alert your physician about a symptom? Get a general overview on management of gynecological cancers.

1/27/2011

NOTE: THIS LECTURE IS NOT AT GILDA’S CLUB – TO BE HELD AT SCCA HOUSE at 207 Pontius Ave N 2^nd Floor

Breast Cancer Screening – Why One Size Doesn’t Fit All

This presentation is part of Seattle Cancer Care Alliance’s series Discovering Hope: A Decade of Cancer Advances—celebrating SCCA’s 10th anniversary

What’s the most effective way to screen for breast cancer? And how should screening guidelines impact women in our community? Should women wait until 50 to start mammography, or start earlier? Does it make a difference if you are high-risk or have already had a diagnosis? Join Dr. Connie Lehman, an expert in the field of breast imaging and intervention, as she explains her research in the area of early detection.

CLICK HERE TO REGISTER FOR LECTURES

The UW Tumor Vaccine Group will hold an open house in the afternoon and evening of October 14, a Thursday.

There will be two sets of lab tours: one, at 5:30 p.m. and, the second, at 8 p.m.

UW Medicine scientists will discuss the latest research on cancer vaccines and provide updates on breast and ovarian cancer research projects taking place right here in Seattle.

In addition, there will be a change with cancer advocacy group representatives from the Puget Sound area.

Click on image to learn more.

Learn what it takes to make clinical trials happen—from the patient and research perspective.

The event is open to the public and refreshments will be provided.

Free parking is available on site and the UW Medicine research complex is close to several bus lines.

Who:

• Dr. Mary “Nora” Disis, Tumor Vaccine Group founder

• Researchers Dr. Lupe Salazar and Dr. Hailing Lu

• Staff, patients, cancer advocacy group members

What:

• Two sets of lab tours at 5:30 and 8 p.m., presentations and a chance to talk with patients and researchers.

When:

• Thursday, October 14, 2010 –  5 to 9 p.m.

Where:

• UW Medicine Research facility, 815 Mercer Street, Seattle, 98109

To learn more:

• For updates and to learn more about the event, visit the Tumor Vaccine Group web site.

• Questions? Call 206.543.8557.

PHOTO CREDIT: Thumbnail is a scanning electron micrograph of a breast cancer cell courtesy of the National Cancer Institute.

The Marsha Rivkin Center for Ovarian Cancer Research at Swedish Medical Center is hosting its 2010 Ovarian Cancer Research Symposium in Seattle, October 28-29.

Topics:

• Origins of Ovarian Cancer

• Developing Therapeutics

• Biomarkers for Ovarian Cancer Diagnosis, Prognosis and Treatment

• Novel Therapeutics in Ovarian Cancer

Keynote Speakers:

• David Huntsman, M.D., University of British Columbia British Columbia Cancer Agency

• Weiping Zou, M.D., Ph.D., University of Michigan

• Ernest Hawk, M.D., M.P.H., University of Texas, MD Anderson Cancer Center

• Deborah Armstrong, M.D., Johns Hopkins Sidney Kimmel Comprehensive Cancer Center

To learn more:

• Visit the events page of the Marsha Rivkin Center.