Gene Variation Linked to Neuroblastoma, a Childhood Cancer

By Steven Reinberg
HealthDay Reporter Wed May 7, 11:46 PM ET

WEDNESDAY, May 7 (HealthDay News) -- For the first time, a gene linked to the often fatal childhood cancer neuroblastoma has been identified, researchers report.

"This is the first paper that helps us understand what causes this childhood cancer," said lead researcher Dr. John M. Maris, director of the Center for Childhood Cancer Research at The Children's Hospital of Philadelphia. "We expected for decades that this cancer was a genetic disease, but we have had a hard time understanding what abnormalities in our genetic makeup lead to this cancer."

Neuroblastoma, a cancer of the peripheral nervous system that usually appears as a solid tumor in the chest or abdomen, is the most common solid tumor malignancy seen in early childhood. Among infants, it can disappear with minimal treatment, but in older children, it can be an aggressive cancer spreading throughout the body. Neuroblastoma accounts for 7 percent of all childhood cancers but causes 15 percent of all childhood cancer deaths. There are about 700 new cases diagnosed each year in the United States, the researchers said.

Maris' team found a common genetic variation of the gene 6p22 on chromosome 6, which doubles the risk of getting this disease. "This finding supports our assumption that there are a number of minor variations that work together -- in sort of a perfect storm -- to give a child this disease," he said. "This finding is the discovery of the first of these genetic variants."

Maris noted that this is the first time a childhood cancer has been found to be influenced by rather common genetic changes "that can be in you or me or anyone."

In addition, Maris said that having this particular genetic variation not only increases the risk of developing neuroblastoma, but also increases the risk of developing the more aggressive form of the disease. "This leads us to believe that the disease we call high-risk or low-risk neuroblastoma are really different diseases," he said.

The findings were published in the May 7 online edition of the New England Journal of Medicine.

For the study, Maris' team analyzed blood samples from 1,032 children with neuroblastoma and 2,043 children without the disease. The researchers honed in on three single nucleotide polymorphisms (SNPs) -- which are variations in DNA -- that were more common in patients with neuroblastoma than in patients without the disease. The three SNPs were clustered in the 6p22 region of chromosome 6. There are two genes in this region, but exactly what they do is unknown, the researchers said.

To confirm their findings, Maris' group analyzed blood samples from additional neuroblastoma patients and children without the disease. Among these additional patients, the researchers also found that variants in the 6p22 region were associated with increased risk for neuroblastoma.

"This finding gives us the motivation to continue this line of research to discover all of the different genetic variations that work together," Maris said. "We have already discovered additional variations."

Knowing the complete genetic influences on neuroblastoma may eventually lead to new treatments, he said.

Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, said that the new findings could one day lead to better diagnosis and treatment of the malignancy. "We still need to understand what these genes do, because little is known about these genes," he said.

Lichtenfeld added that, while the new research is important, it's still very preliminary. "Ultimately, what you want to do is to analyze the cancer and gain clues as to what the prognosis may be and what the appropriate treatment may be," he said. "This does not get us there, but it is one step along that pathway."

Childhood anxiety may worsen anorexia

Fri May 16, 3:58 PM ET

NEW YORK (Reuters Health) - Anorexic women with a history of childhood anxiety may have particularly severe symptoms of the eating disorder, a study suggests.

It's known that anxiety disorders, like social phobia and obsessive compulsive disorder, are far more common among people with anorexia than in the general population. Often, these anxiety disorders appear before the eating disorder does.

In the new study, published in the International Journal of Eating Disorders, researchers looked at whether a history of childhood "overanxious disorder" was related to the severity of women's anorexia.

Dr. Cynthia M. Bulik, of the University of North Carolina at Chapel Hill, and colleagues found that of 637 women with anorexia, 39 percent reported symptoms of childhood overanxious disorder. In nearly all cases, those symptoms arose before the onset of their anorexia.

In general, the researchers found, women with a history of childhood anxiety exhibited "more extreme personality traits" and attitudes -- like perfectionism and obsessive tendencies related to food -- than women without a history of early anxiety disorders.

They were also more likely to purge, by vomiting or abusing laxatives, in addition to strictly limiting their food intake.

According to Bulik's team, childhood anxiety disorders "may represent one entree" into anorexia. This, they say, underscores the importance of recognizing and treating these conditions early on.

SOURCE: International Journal of Eating Disorders, May 2008.

Health Tip: Traveling During Pregnancy

Thu May 15, 11:47 PM ET

(HealthDay News) -- If you're planning to take a trip while pregnant, you should check with your doctor to be sure it's safe for you to travel. Unless you have complications with your pregnancy, most women can travel safely.

Here are some travel tips to keep you safe and comfortable during pregnancy, courtesy of the American Pregnancy Association:

* Travel during the second trimester is usually most comfortable -- after morning sickness has passed and the fatigue of the third trimester is still ahead.
* Wear comfortable, loose clothing and comfortable shoes.
* Take things to make you more comfortable, like a pillow from home and some snacks that satisfy you.
* If you're driving, stop to get up and stretch often and take plenty of bathroom breaks.
* Always take your prenatal records with you on the road.
* Be safe: Wear your seat belt and follow safety instructions for whatever transportation you use.

Heart risks high in childhood cancer survivors

By Julie Steenhuysen Thu May 15, 9:27 PM ET

CHICAGO (Reuters) - Children who survive cancer while they are young are five to 10 times more likely than their healthy siblings to develop heart disease, U.S. researchers said on Thursday.

The finding comes from a study of more than 14,000 survivors of childhood cancers, and suggests that cancer survivors and their doctors need to be vigilant about heart risks.

"This study clearly shows for children, and particularly children treated with radiation therapy to the chest or certain drugs that are particularly toxic to the heart, there are significant risks of cardiovascular disease at a far younger-than-expected age," said Dr. Richard Schilsky of the University of Chicago.

The preliminary results were released ahead of a meeting later this month of the American Society of Clinical Oncology.

Schilsky, who is president-elect of ASCO, said the study highlights the challenges faced by cancer survivors, who have to live with the health consequences of having had cancer and having been treated for cancer.

Dr. Daniel Mulrooney of the University of Minnesota and colleagues conducted the study, which looked at 14,358 survivors of childhood leukemia, central nervous system tumors, Hodgkin's and non-Hodgkin's lymphoma, kidney tumors, bone cancers, neuroblastoma and soft-tissue sarcoma between 1970 and 1986.

They compared these to 3,899 of their siblings. Cancer survivors on average were 7 years old at diagnosis and 27 at follow up.

The cancer survivors were 10 times more likely to have clogged arteries, 5.7 times more likely to have heart failure, 4.9 times more likely to have heart attacks, 6.3 times more likely to have pericardial disease -- affecting the sac surrounding the heart -- and 4.8 times more likely to have diseased heart valves compared with their siblings.

"We found 5-year survivors of childhood and adolescent cancers are at an elevated risk for early cardiovascular disease," Mulrooney told reporters in a telephone briefing.

They also found the risks were two to five times greater in people who had been treated with chest radiation and chemotherapy from the anthracycline class of drugs, such as doxorubicin, compared to survivors who did not have those treatments.

Mulrooney said there are about 270,000 childhood cancer survivors in the United States, or about 1 in every 900 young adults. He said the findings may lead to better cancer treatments that protect the heart.

"We still use radiation therapy," he said, but newer radiation treatments are more targeted, and he hopes they will have less impact on the heart.

Schilsky said other studies have found long-term cancer survivors are at greater risk of premature osteoporosis, infertility, thyroid problems, anxiety and depression and the risk of another cancer.

"It becomes incumbent on the patient and the primary care physician to be aware of their cancer history and the potential consequences of their treatment," Schilsky said.

(Editing by Maggie Fox)

Study finds heart risks in young cancer survivors

By MARILYNN MARCHIONE, AP Medical Writer Thu May 15, 9:03 PM ET

Children who survive cancer face a much greater risk of heart problems later in life than their brothers and sisters who did not have cancer, new research shows.

Doctors have long known that certain chemotherapy drugs and radiation can harm the heart, but it has been seen as a relatively small price to pay for beating cancer. Cancer itself may damage the heart. And even though the risk was higher, heart problems still were relatively rare.

The study used a national registry to track 14,358 cancer survivors diagnosed in the 1970s and 1980s, when treatments were harsher than those commonly used today, and compared them to about 4,000 healthy siblings.

The survivors had one of eight forms of the disease, including leukemia, brain tumors, Hodgkin's or non-Hodgkin's lymphoma and kidney tumors.

Compared to their healthy siblings, they had five to 10 times greater risk of heart problems, ranging from clogged arteries to heart failure and valve disease.

The risk often showed up when they were still young adults — an age when few doctors would think to check them for heart problems. The survivors were diagnosed with cancer at an average age of 8, and their average age was 28 when the follow-up study was done.

There are about 270,000 childhood cancer survivors in the United States today, said the study's leader, Dr. Daniel Mulrooney at the University of Minnesota.

"They have to live with the health consequences of having had cancer and having been treated for cancer," he said.

Still, the incidence of problems was low: 2 percent had hardening of the arteries, 4 percent had heart failure, 1 percent suffered a heart attack and 4 percent had a valve problem.

Study results were released Thursday by the American Society of Clinical Oncology and will be presented at the group's annual meeting later this month.