MONDAY, Nov. 28 -- If cancer survivors develop a second cancer, it's most likely to be the same type of cancer as the first, researchers report.

About 15 percent of cancer survivors worldwide are diagnosed with a second primary cancer, the authors of the new report pointed out.

In the study, investigators analyzed data from the entire population of Denmark (7.5 million) from 1980 to 2007 and found that about 10 percent (765,255 people) had one or more diagnoses of primary cancer, for a total of 843,118 diagnoses.

Cancer survivors had a 2.2-fold risk of developing a second primary cancer of the same type as the first type of cancer, and a 1.1-fold risk of developing a different type of second primary cancer, the findings showed.

The risk varied, depending on the type of cancer. The risk of a second cancer of the same type was greatest among sarcoma survivors and lower among prostate cancer survivors. The risk of a second cancer of a different type was highest among larynx cancer survivors and lower among prostate cancer survivors, according to the report published Nov. 28 in CMAJ (Canadian Medical Association Journal).

"The striking contrast between the 2.2-fold increased risk of a second primary cancer being the same type as the first and the 1.1-fold increased risk of it being different from the first cancer suggests that characteristics of the individual patient were involved," wrote study author Dr. Stig Bojesen of Herlev Hospital, Copenhagen University Hospital and the University of Copenhagen, and colleagues. "The risk of a second primary cancer seems to be specific to cancer type and is probably driven by the patient's genetic and lifestyle risk factors."

-- Robert Preidt

SOURCE: Canadian Medical Association Journal, news release, Nov. 28, 2011

Study Shows Some Success in Using High-Energy Waves to Treat Lung Cancer Patients

By Charlene Laino
WebMD Health News

Reviewed by Laura J. Martin, MD

Nov. 28, 2011 (Chicago) -- Researchers are using high-energy waves similar to those used to make microwave popcorn to destroy inoperable lung tumors.

In a preliminary study, the technique, called microwave ablation, eliminated lung tumors in 19 of 28 patients. Eight months later, none of the tumors had come back.

Tumors shrank or stopped growing in the other nine patients, says study researcher Claudio Pusceddu, MD, a specialist in radiation and oncology at Oncological Hospital in Cagliari, Italy.

During microwave ablation, radiologists place a thin microwave antenna directly into the tumor. An electromagnetic wave then agitates water molecules in the surrounding tumor tissue, producing friction and heat that eventually destroy the tumor.

The procedure, which costs about $2,000, takes about an hour, and the patient is typically kept overnight in the hospital for observation.

U.S. researchers say the technique certainly shows promise. But more patients have to be followed for far longer to see if they stay in remission, they say.

The findings were presented here at the annual meeting of the Radiological Society of North America.

Microwave Ablation for Lung Cancer

About 373,000 Americans are living with lung cancer, according to the American Cancer Society.

Standard treatment options include surgery, chemotherapy, and radiation. Researchers are looking at a number of ways of destroying tumors with heat from radiofrequency waves or by freezing it, for example.

It remains to be seen which of these newer techniques, if any, will keep cancer from coming back, says American Society of Clinical Oncology spokesman Gregory Masters, MD, a medical oncologist at the Helen F. Graham Cancer Center in Newark, Del.

Masters tells WebMD that in one study, cancer stopped growing for a year or more in two-thirds of patients who underwent microwave ablation. "But we need to follow them for five or seven years."

Pusceddu says that the major advantage of microwave ablation is that it works quickly to heat tumor cells to high temperatures. As a result, it can be used to destroy larger tumors than other ablation techniques, he says.

None of the patients in the study suffered major complications. Eight had temporary trouble breathing due to a partially collapsed lung, but all got better on their own within a week.

In addition to lung tumors, microwave ablation is being studied for the treatment of liver, kidney, and bone cancers.

These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

SOURCES: Radiological Society of North America 97th Scientific Assembly and Annual Meeting, Chicago, Nov. 27-Dec. 2, 2011.Claudio Pusceddu, MD, Oncological Hospital, Cagliari, Italy.Gregory Masters, MD, Helen F. Graham Cancer Center, Newark, Del.

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WEDNESDAY, Nov. 23 -- A 36-year-old husband and father of two children with an inoperable tumor in his trachea (windpipe) has received the world's first artificial trachea made with stem cells.

A report published online Nov. 23 in The Lancet described the transplant surgery, which was performed in June at the Karolinska University Hospital in Stockholm, Sweden.

Without the transplant, the authors of the report explained, the man from Reykjavik, Iceland would have died. A golf ball-sized tumor on his trachea had begun to restrict his breathing. In a 12-hour procedure, doctors completely removed the affected area of his trachea and replaced it with an artificial one.

The artificial trachea was custom-made using three-dimensional imaging. First, a glass model was built to help shape an artificial scaffold. Stem cells were then inserted into the scaffold to create a functioning airway, the authors explained in a journal news release.

The scientists said their technique is an improvement over other methods because they used the patient's own cells to create the airway so there is no risk of rejection and the patient does not have to take immunosuppressive drugs.

In addition, they noted, because the trachea was custom-made it would be an ideal fit for the patient's body size and shape, and would eliminate the need to remain on a waiting list for a human donor.

"The patient has been doing great for the last four months and has been able to live a normal life. After arriving in Iceland at the start of July, he was one month in hospital and another month in a rehabilitation center," a co-author of the study and the physician who referred the patient for the procedure, Tomas Gudbjartsson, of Landspitali University Hospital and University of Iceland, Reykjavik, said in the news release.

The transplant team has since performed another transplant on a second patient from Maryland with cancer of the airway. This patient's bioartificial scaffold, however, was made from nanofibers. They now hope to treat a 13-month-old South Korean infant also using this method.

"We will continue to improve the regenerative medicine approaches for transplanting the windpipe and extend it to the lungs, heart and esophagus. And investigate whether cell therapy could be applied to irreversible diseases of the major airways and lungs," said Gudbjartsson.

Although the technique shows promise, Dr. Harald C. Ott and Dr. Douglas J. Mathisen, from Massachusetts General Hospital and Harvard Medical School in Boston, cautioned that more research must to be done to fully evaluate its safety and effectiveness.

"To be adjudged successful, bioartificial organs must function over a long time -- short-term clinical function is an important achievement, but is only one measure of success. Choice of ideal scaffold material, optimum cell source, well-defined tissue culture conditions, and perioperative management pose several questions to be answered before the line to broader clinical application of any bioartificial graft can be crossed safely and confidently," Ott and Mathisen concluded in the news release.

-- Mary Elizabeth Dallas

SOURCE: The Lancet, news release, Nov. 23, 2011

THURSDAY, Nov. 24 -- Higher doses of chemotherapy with less time between treatments may benefit younger people suffering from aggressive lymphomas, such as diffuse large B-cell lymphoma (one of the most common and aggressive forms of non-Hodgkin's lymphoma), according to new research.

A study published online Nov. 24 in The Lancet found this intensive form of chemotherapy, when combined with the monoclonal antibody drug rituximab, may reduce recurrence of the disease and increase survival rates among patients under 60 years of age.

The researchers said these younger patients are about twice as likely to remain in remission after three years versus those given rituximab plus the standard chemotherapy treatment known as CHOP ( cyclophosphamide, doxorubicin, vincristine, and prednisone).

In conducting the study, researchers led by Dr. Herve Tilly of the University of Rouen in France gave 379 patients with diffuse large B-cell lymphoma either four cycles of higher-intensity chemotherapy (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone) plus rituximab at two-week intervals, or eight cycles of the standard treatment (CHOP plus rituximab) at three-week intervals.

The study found the risk of experiencing an "event-free survival" (which means avoiding unplanned treatments or cancer recurrence) after three years was 44 percent lower among patients on the more intensive regimen than among those receiving standard treatment.

Patients assigned to the aggressive treatment also had a 56 percent lower risk of death and were 52 percent less likely to have their disease progress compared to those on the standard treatment, the researchers found.

There was a downside to the more aggressive approach, however. The study found that the strategy significantly boosted the likelihood that patients would experience serious side effects, particularly negative hematological and mucosal effects, as well as febrile neutropenia (a complication of chemotherapy that involves a reduction in immune white blood cells, accompanied by fever).

For that reason, "this dose-intense regimen should only be used in patients in whom the expected relapse rate is sufficient to justify the higher toxic effects and cost profile," Julie Vose from the Nebraska Medical Center in Omaha wrote in a journal commentary accompanying the study.

One expert agreed that the regimen's benefits must be weighed against its risks.

"The results are impressive, but caution should be used while using this regimen," said Dr. Jasmine Zain, assistant professor in the department of medicine at NYU Langone Medical Center in New York City. She noted that the study was conducted in young patients with a form of lymphoma that already has an "excellent" prognosis. "This regimen should only be considered in a young, healthy patient where the risk of relapse is high enough to warrant a more intensive regimen," she added.

Another lymphoma specialist said the more intensive approach may prove successful.

"Even though the intensified regimen is associated with more toxicity, there is a significant improvement in survival in this adult population between ages 18 and 60 years of age," said Dr. Arlene Redner, associate chief of oncology at Steven and Alexandra Cohen Children's Medical Center of New York, in New Hyde Park, N.Y. "This is a concept that pediatric oncologists have been using and which has been responsible for some of the excellent results that have been seen in pediatric lymphoma trials," she noted.

The study's authors stressed that some patients can still relapse even after responding to the more aggressive treatment, and the ideal chemotherapy regimen to combine with rituximab has not yet been established. They add that more research is needed to identify patients who are most likely to benefit from this more intensive treatment.

The study was funded by The Study Group on Adult Lymphomas and drug maker Amgen.

-- Mary Elizabeth Dallas

SOURCES: Jasmine Zain, M.D., assistant professor, department of medicine, NYU Langone Medical Center, New York City; Arlene Redner, M.D., associate chief, oncology, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, N.Y.; The Lancet, news release, Nov. 24, 2011