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Cancer

Big data, Cancer, Cardiovascular Medicine, Fertility, Men's Health, Research, Stanford News

Male infertility can be warning of hypertension, Stanford study finds

Male infertility can be warning of hypertension, Stanford study finds

sperm graffitiA study of more than 9,000 men with fertility problems links poor semen quality to a higher chance of having hypertension and other health conditions. The findings suggest that more-comprehensive examinations of men undergoing treatment for infertility would be a smart idea.

About a quarter of the adults in the United States (and in the entire world) have hypertension, or high blood pressure. Although it’s the most important preventable risk factor for premature death worldwide, hypertension often goes undiagnosed.

In a study published today in Fertility and Sterility, Stanford urologist Mike Eisenberg, MD, PhD, and his colleagues analyzed the medical records of 9,387 men, mostly between 30 and 50 years old, who had provided semen samples in the course of being evaluated at Stanford to determine the cause of their infertility. The researchers found a substantial link between poor semen quality and specific diseases of the circulatory system, notably hypertension, vascular disease and heart disease.

“To the best of my knowledge, there’s never been a study showing this association before,” Eisenberg told me when I interviewed him for a press release about the findings. “There are a lot of men who have hypertension, so understanding that correlation is of huge interest to us.”

In the past few years, Eisenberg has used similar big data techniques to discover links between male infertility and cancer and heightened overall mortality, as well as between childlessness and death rates in married heterosexual men.

Eisenberg sums it all up and proposes a way forward in the release:

Infertility is a warning: Problems with reproduction may mean problems with overall health … That visit to a fertility clinic represents a big opportunity to improve their treatment for other conditions, which we now suspect could actually help resolve the infertility they came in for in the first place.

Previously: Poor semen quality linked to heightened mortality rate in men, Men with kids are at lower risk of dying from cardiovascular disease than their childless counterparts and Low sperm count can mean increased cancer risk
Photo by Grace Hebert

Aging, Cancer, Genetics, Research

Telomeres tell all about longevity and health

Telomeres tell all about longevity and health

10085714333_d8367dbe2a_oIf I were to go back to school for a PhD, I think I’d study telomeres. Telomeres, the protective caps at the end of each chromosome, shrink with aging and other stressors leaving an organism vulnerable to a various disorders and cancer.

So, telomere fan that I am, I was thrilled to sit in on a recent Psychiatry & Behavior Sciences Grand Rounds talk at Stanford featuring Elizabeth Blackburn, PhD. A professor of biology and physiology at the University of California, San Francisco,  Blackburn won the Nobel Prize in 2009 for her work on telomeres.

During the event, she gave the packed auditorium a whirlwind overview of telomere biology. Blackburn explained to attendees that telomere length is affected by both genes and the environment, and that some folks just start out with longer ones. Telomeres are maintained by an enzyme called telomerase. Slashing the amount of telomerase can cause early, immune dysfunction, cancer and diabetes. Some genetic telomere troubles manifest as disorders such as aplastic anemia or pulmonary fibrosis.

In general, telomere length correlates with what Blackburn called a “health span,” or duration of time someone stays healthy.

Recently she and colleagues measured telomere length in 100,000 people of all ages, a project they needed to develop a special robot to complete. They found that length of telomeres decreases into age 75. Then, it curves up to 95, accounting for the longevity of individuals with long telomeres. And yes, older women tend to have longer telomeres than older men.

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Cancer

How I've survived survivor’s guilt

How I've survived survivor’s guilt

We’ve partnered with Inspire, a company that builds and manages online support communities for patients and caregivers, to launch a patient-focused series here on Scope. Once a month, patients affected by serious and often rare diseases share their unique stories; this month’s column comes from Hope Aguilar.

When I was in my second month of treatment for late-stage ovarian cancer I read a friend’s post on Facebook about her friend passing away from cancer after just six weeks of being diagnosed. I was so sad about this news and about the fact that I had made it past six weeks and she hadn’t. Then when I was a few months out from finishing chemotherapy and back to teaching in Saudi Arabia, I found out that the woman who helped me when I was just starting treatment had passed from her five-year battle with ovarian cancer. I was again saddened, but even more so than before. This woman was just fifty years old and had a husband and children – she had so much life ahead of her. And that’s when survivor’s guilt first truly hit me.

I didn’t know that “survivor’s guilt” was the name of what I was feeling. I just knew that a part of me was torn. Torn between being so very grateful that I had made it (even though it hadn’t been very long) and anguished over knowing that I still here and this woman wasn’t. I did my best to not let the guilt bring me down too much: I kept moving forward, living each day to the fullest, and staying positive through all the post-chemotherapy problems I had. But every once in awhile I would get that feeling of sorrow from the guilt that I survived and that so many others didn’t. I would read article after article about men, women, and/or children who lost their battle, and I would start to ask “why?” even more. Why them and not me?

I had no significant other in my life. I had no children who needed me. “So, why am I still here?” is what I would ask and think about. If I thought too long about it I would start to cry, and as I cried I would call out to God and ask Him why. The answer that I believe God gave me was that that even though I didn’t have a significant other and children, I had people who loved me and needed me in their lives. And I still had some purpose here on Earth.

Did survivor’s guilt go away? No, and I don’t think it ever will – not completely. That said, something feels different each time that guilt pops up now. I don’t dwell on it. I remember those who love me. I think about all the ovarian-cancer awareness advocating I have done and will continue to do. I share my story in the hopes that other women will listen to their bodies thereby getting them to go to the doctor sooner rather than later. I share my story in the hopes that other survivors will share their stories too. Because when more people share their stories, more awareness will take place. And awareness is knowledge and knowledge is power.

For me, the way to survive survivor’s guilt is to live a life of purpose. To do more with giving back. And to remember that survivor’s guilt can rule you or you can rule it.  I’ve chosen to rule it. I know it will come and it will go, but it doesn’t have to stay. Not unless I let it. And I don’t, I won’t.

Hope Aguilar is a teacher of the English language in Saudi Arabia, and the author of  the book “HOPE through Cancer.” The native Texan is also a veteran of the U.S. Navy and Army. She loves to advocate for ovarian cancer awareness, travel, write, jog, and spend time with friends and family.

Cancer, Clinical Trials, Events, Stanford News, Women's Health

Country music stars thank Under One Umbrella for supporting Stanford Women’s Cancer Center

Country music stars thank Under One Umbrella for supporting Stanford Women's Cancer Center

7856258414_163d347129_zCombatting cancer isn’t cheap. It takes an innovative team with access to top equipment and support. A team that can provide compassionate care while developing new therapies and scouring through detailed data to uncover unknown aspects of the disease.

At the Stanford’s Women’s Cancer Center, that’s where the Under One Umbrella movement comes in. Now in its sixth year, this group has raised more than $23 million for projects benefitting women with cancer. That money pays for leading doctors and researchers, drug and clinical trials, improved facilities, new treatments, tools and more.

“Your generosity is palpable,” Mark Pegram, MD, director of the Stanford Breast Cancer Oncology Program, told the several hundred donors who gathered at Sharon Heights Golf & Country Club in Palo Alto for the group’s annual luncheon earlier this week. Researchers are making molecular “portraits” of breast cancer to determine which patients would benefit from chemotherapy, he said. They’re testing a treatment that “packs all the punch of chemo, but with no chemo side effects.”

Due to a gift from Sonoma County winery Chateau St. Jean, all of the proceeds from the luncheon were used to support the programs, according to Lisa Schatz, former chair of the steering committee.

During the event, organizers screened a video tribute to Gwen Yearwood, a former patient of the Stanford Women’s Cancer Center, featuring her daughters — singer Trisha Yearwood and Beth Bernard. Then, out came Yearwood and her husband, Garth Brooks to serenade the attendees. “Our family is so grateful,” Yearwood said. “We’re an example of the many families who have benefited from (Stanford) care.”

In appreciation of their service, each donor left the luncheon with a pink umbrella, which came in handy as the Bay Area received much-needed rain in the following days.

Additional information about the group is available on its Facebook page.

Previously: Stanford Women’s Cancer Center: Peace of mind and advanced care under one umbrella, At Stanford event, cancer advocate Susan Love talks about  “a future with no breast cancer” and Don’t hide from breast cancer — facing it early is key 
Photo by 55Laney69

Cancer, Mental Health, Research, Women's Health

Women with mental illness less likely to be screened for breast cancer

Women with mental illness less likely to be screened for breast cancer

Previous research has shown that women are up to 40 percent more likely to experience a mental-health condition than men. Now findings published in the British Journal of Psychiatry caution that women with depression, anxiety or other mood disorders are likely missing out on important breast-cancer screenings.

In the study, British researchers conducted a systematic review and meta-analysis and comparing rates of mammography screening between women with mental illness and those without. PsychCentral reports:

Researchers found that there were significantly reduced rates of mammography screening in women with mental illness, depression, and severe mental illness such as schizophrenia.

The effect was not present in women with distress alone, suggesting distress was not the explanation.

“In this study, we found that mental ill health was linked with 45,000 missed screens which potentially could account for 90 avoidable deaths per annum in the UK alone. Clearly patients with mental illness should receive care that is at least comparable with care given to the general population. Every effort should be made to educate and support women with mental illness called for screening,” [said Alex Mitchell, MD, who led the study.]

Previously: A new way of reaching women who need mammograms, Despite genetic advances, detection still key in breast cancer, Medicine X explores the relationship between mental and physical health: “I don’t usually talk about this”Examining link between bipolar disorder, early death and Examining the connection between mental and physical health

Big data, Cancer, Health Disparities, Imaging, Public Health, Women's Health

A new way of reaching women who need mammograms

A new way of reaching women who need mammograms

black Woman_receives_mammogramI’ve taken cancer screenings for granted since I’m one of those fortunate enough to have health insurance, and it didn’t occur to me that many uninsured women were going without regular mammograms to screen for breast cancer. A story today on Kaiser Health News mentions this fact and highlights a partnership that Chicago public-health officials have forged with a company named Civis. The private company includes staffers that helped with the Obama campaign’s get-out-the-vote efforts, and then moved on to help find people eligible to enroll for health insurance through the Affordable Health Care Act. The company used its expertise to identify women who were in the right age group (over 40) and were uninsured in Chicago’s South Side area; those women then were then sent fliers about free screenings available to them.

The article describes some other cities using similar “big data” efforts for public-health purposes:

This project represents a distinctive step in public health outreach, said Jonathan Weiner, professor and director of the Johns Hopkins Center for Population Health IT in Baltimore. But Chicago is not the only city investigating how population data can be used in health programs, he added, citing New York City, Baltimore and San Diego as other examples.

“It’s a growing trend that some of the techniques first developed for commercial applications are now spinning off for health applications,” he said. So far, he said, “these techniques have not been as widely applied for social good and public health,” but that appears to be changing.

The early signs say that the new effort in Chicago, which started earlier this year, is working. One hospital saw a big jump in the number of free mammograms, from 10 a month to 31, though the full impact may not be understood for a few months. It’s not “a silver bullet” as one expert cited in the story notes, but it’s a much more precise tool than most public-health outreach programs have had access to until now.

Previously: Screening could slash number of breast cancer casesDespite genetic advances, detection still key in breast cancerStudy questions effects of breast cancer screenings on survival rates and New mammogram guidelines echo ones developed by physicians group
Photo by National Cancer Institute

Cancer

My last promises to her: Advocate for lung cancer awareness and live life to the fullest

My last promises to her: Advocate for lung cancer awareness and live life to the fullest

We’ve partnered with Inspire, a company that builds and manages online support communities for patients and caregivers, to launch a patient-focused series here on Scope. Once a month, patients affected by serious and often rare diseases share their unique stories; this month’s column comes from a patient advocate from California.

Don and Penny - smallI was diagnosed with Stage 4 Non-Small Cell Lung Cancer in June 2009. I have had numerous treatments of radiation and chemotherapy for the lung cancer, and six cycles of Gemzar for metastasis to my liver. I’m one of the fortunate few because only 16.8 percent ever reach the five-year mark. I’m stable today because of the targeted therapy pill Tarceva that I’ve been taking for almost five years.

All through my journey I have kept a positive attitude, focused on good nutrition and gotten plenty of exercise. I try to live my life by spiritual principles. I feel they all play an important part in my recovery and the reason that I’m still above ground.

The bad news is that I have cancer. The good news is that cancer has taught me to live life to the fullest. I never allow cancer to define me. I rarely miss an opportunity to hike, bike, or do anything that strengthens my immune system and keeps me out in nature.

In October 2011 I met Penny Blume, the love of my life, on a lung cancer support community on Inspire. Penny left this earth on Jan. 21, 2014 after battling small cell lung cancer for 32 months. Penny and I spent our time together traveling back and forth from New York to California. She passed at my home in Santa Rosa, Calif., after trying one last clinical trial at Stanford Cancer Center.

Penny and I turned to each other for emotional support to battle our cancers and fell in love. It was after a couple of months of texting and chatting on social media that we decided to meet. Penny flew to California for her first visit in January 2012, and the rest is history.

My relationship with Penny also marked the beginning of my advocacy work for lung cancer. It started when a friend of ours asked us to post our story on a lung cancer survivors group on Facebook. I posted something, and then Penny and I decided to repost it on Inspire, since it was the site that brought us together. In September 2012 our story was shared by ABC News and Good Morning America. In the following weeks, it was shared and tweeted all over the world.

My efforts to share our story and talk about lung cancer publicly have only grown stronger since then. I support Team Draft, an initiative of the Chris Draft Family Foundation, which is dedicated to raising lung cancer awareness and increasing badly needed research funding by shattering the misconception that lung cancer is a “smoker’s disease.” I’m also an advocate for The Lungevity Foundation and have attended two of their Hope Summits in in 2012 and 2013 and participated in numerous medical advisory panels. (Penny attended our first Hope Summit in 2012 where we recorded this message of Hope.)

Two years ago I was nominated by Lungevity to be a consumer reviewer for the Medical Directed Lung Cancer Research Program for the Department of Defense. As a veteran and lung cancer survivor I’m particularly grateful I can do my part through the DOD program.

November is Lung Cancer Awareness Month, and it will be a busy month for me: I’m  doing events with Chris Draft, Genentech and the Lung Cancer Research Program.

My last promises to Penny were that I would continue to live life to the fullest and advocate for lung cancer research and awareness. One day at a time I try to keep those promises to her.

Don Stranathan is a business development manager for a technology company in Rohnert Park, Calif. who is now on disability, as “fighting my cancer has become a full time job.” When not doing advocacy work, he is at the gym spinning or out hiking, biking and fishing with friends and family.

Previously: Tackling the stigma of lung cancer – and showing the real faces of the disease and A patient’s journey with lung cancer
Photo courtesy of Lungevity

Cancer, Medicine X, Videos

Tackling the stigma of lung cancer – and showing the real faces of the disease

Tackling the stigma of lung cancer - and showing the real faces of the disease

Stanford’s Medicine X is a catalyst for new ideas about the future of medicine and health care. This new series, called The Engaged Patient, provides a forum for some of the patients who have participated in or are affiliated with the program. The second installment in our series comes from Janet Freeman-Daily.

When I first learned I would be giving an ePatient Ignite! talk at Stanford’s Medicine X, I knew I wanted to speak about the stigma of lung cancer. I had frequently heard the first question typically asked of lung cancer patients – “Did you smoke?” – and I wanted to help change public perception of my disease.

I had plenty of material and preparation. I had actively blogged about my metastatic lung cancer journey for more than a year. I had researched statistics and funding disparities. I had gleaned patient perspectives via participation in online support forums and Lung Cancer Social Media (#LCSM) tweetchats. I also had years of public speaking experience, so I wasn’t anxious about getting up in front of an auditorium full of people.

What I didn’t have was knowledge of those who typically attended Medicine X, or how best to connect with them. I had never spoken publicly about lung-cancer stigma, certainly not to an auditorium full of people unfamiliar with my disease. After MedX ePatient adviser Hugo Campos helped brainstorm ideas, I wrote a speech – but it lacked something.

To figure out what was missing, I reach out to the online lung cancer community – patients, advocates and health-care providers I knew from support groups, Facebook, and Twitter. When Chris Draft of Team Draft reviewed my speech and slides over breakfast at Denny’s during one of his trips to Seattle, he smiled tolerantly when he saw my engineer’s fascination with graphs and pie charts. Then he made a point that changed the focus of my entire presentation.

Despite the dire statistics, the public will only care about the number one cancer killer when they can see that these patients could be people they love – a parent, sibling, child, friend – or even themselves. My speech needed to show the real faces of lung cancer, he explained.

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Cancer, Research, Science, Stanford News, Surgery, Technology

New molecular imaging could improve bladder-cancer detection

New molecular imaging could improve bladder-cancer detection

Joseph LiaoThey say a picture is worth a thousand words. For bladder-cancer surgeons, an image can be worth many lives.

That’s because a crucial method for detecting bladder cancer is to produce images that allow surgeons to identify abnormal-looking tissue, a method called cystoscopy. In a study published yesterday in Science Translational Medicine, Stanford researchers developed a new way to image the bladder that they say could detect bladder cancer with more accuracy and sensitivity than the standard methods. As described in our press release:

 The researchers identified a protein known as CD47 as a molecular imaging target to distinguish bladder cancer from benign tissues. In the future, this technique could improve bladder cancer detection, guide more precise cancer surgery and reduce unnecessary biopsies, therefore increasing cancer patients’ quality of life.

Identifying cancerous tumors can be challenging — some bladder cancer treatments cause inflammation, which looks very similar to abnormal, cancerous tissue. The only way to know for sure is to perform a biopsy, which can be stressful for the patient. As co-senior author Joseph Liao, MD, explained:

 Our motivation is to improve optical diagnosis of bladder cancer that can better differentiate cancer from non-cancer, which is exceedingly challenging at times. Molecular imaging offers the possibility of real-time cancer detection at the molecular level during diagnostic cystoscopy and tumor resection.

For their work, the researchers looked for a target that would distinguish cancer cells from benign cells and found it in CD47, a protein on a cell’s surface that cancer cells produce in higher quantities than normal cells. In previous work, co-senior author Irving Weissman, MD, developed a CD47 antibody that binds to the cancer cell’s surface and blocks the signal. They hypothesized it would be a good imaging target. More from our release:

 To test their hypothesis, the researchers added a fluorescent molecule to an antibody that binds to CD47. The modified antibodies were then introduced into intact bladders, which had been surgically removed from patients with invasive bladder cancer. Because they bladders were kept in good condition, the study’s imaging methods mirrored the way an urologist might use with a real patient.

After 30 minutes, they rinsed the bladder, so only the antibodies that bound to the CD47 protein remained. When they shine the tumor was exposed to with fluorescent light, the cancer cells “lit up” whereas normal or inflamed cells did not.

“Our goal through better imaging is to deliver a higher- quality cancer surgery and better cancer outcomes,” Liao told me. “I am very excited about the potential to translate our findings to the clinics in the near future.”

Previously: Healing hands: My experience being treated for bladder cancer, Drug may prevent bladder cancer progression, say Stanford researchers, Cellular culprit identified for invasive bladder cancer, according to Stanford study and Mathematical technique used to identify bladder cancer marker
Photo of Liao by Norbert von der Groeben

Biomed Bites, Cancer, Dermatology, Genetics, Research, Videos

Spotting broken DNA – in the DNA fix-it shop

Spotting broken DNA - in the DNA fix-it shop

It’s Thursday. And here’s this week’s Biomed Bites, a weekly feature that highlights some of Stanford’s most innovative research and introduces Scope readers to innovators in a variety of disciplines.

Neon green streaks across the screen. The phrases “End mismatched ligation” and “Repair of DNA double-strand breaks” flash at me. Did I stumble across an online, genetic fix-it shop? Sort of –  in that Stanford biochemist Gilbert Chu, MD, PhD, studies broken DNA and has a website to match.

Chu describes his research in the video above: “We started out in the lab trying to understand and recognize DNA that’s been damaged by ultraviolet radiation, which causes skin cancer. This led to the discovery of a protein that turned out to be missing in patients with a very rare disease called xeroderma pigmentosum.”

XP afflicts about 1 in 1,000,000 people in the United States. Without the protein Chu mentioned, mutations and damage accumulates in sufferers DNA, causes cancers and extreme sensitivity to the sun.

Chu’s team has also developed methods that allow other researchers to examine the expression of genes across an entire genome and to determine which cancer patients might be harmed by treatment with ionizing radiation.

“The reason I got interested in this research is that as a member of the Department of Medicine, I am an oncologist and I’m very interested in trying to help cancer patients,” Chu said.

Learn more about Stanford Medicine’s Biomedical Innovation Initiative and about other faculty leaders who are driving forward biomedical innovation here.

Previously: Skin cancer linked to UV-caused mutation in new oncogene, say Stanford researchers, Radiation therapy may attact circulating cancer cells, according to new Stanford study and How ultraviolet radiation changes the protective functions of human skin

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