What do you think is the best way to choose an experienced and quality surgeon? Some researchers think it's by reputation. That's how I got mine. A friend told me who he'd use if his wife or mother developed breast cancer and then more and more people began recommending the same surgeon. It seemed logical I'd use him too. And I'm glad I did.

A study published in the January 20 Journal of Clinical Oncology reveals that women who actively choose their surgeons by reputation are more likely to be treated by experienced surgeons in hospitals with comprehensive cancer programs. Reputation even beat out accepting referrals from other doctors or health plans.

Researchers are reporting that a new vaccine designed to treat breast cancer appears to be safe in women with advanced disease. It showed signs of slowing down tumor growth too.

The Neuvenge vaccine, made by Dendreon Corporation -- maker of the Provenge prostate cancer vaccine -- targets the aggressive Her-2 positive form of breast cancer, which affects 20 to 30 percent of breast cancer patients. Using immune cells from a cancer patient's own body, Neuvenge is a tailor-made therapy.

Reports about Neuvenge, published in the Journal of Clinical Oncology, indicate the vaccine did not cause any serious side effects and of the 18 women who participated in the Phase I study, there was a reduction in the size of a tumor in one patient. In three other women, the disease seemed to stabilize for as long as a year.

Herceptin (trastuzumab) is a targeted therapy used for treatment of HER2 positive breast cancer. Results of a Phase II clinical trial showed that Herceptin might have a roll in treating patients with HER2 positive advanced bladder cancer.

The researchers conducted the clinical trial to examine the effectiveness of Herceptin along with chemotherapy in a little under fifty patients with advanced bladder cancer. The chemotherapy given with the Herceptin was paclitaxel, carboplatin, and gemcitabine.

This was a small study and research will have to continue to see if this treatment is something that will be put into mainstream use. The study concluded that:

• 11 percent of patients experienced a complete disappearance of detectable cancer.
• 59 percent of patients experienced a partial disappearance of detectable cancer.

Cancer on my mind is an article written by Dr. Albert Lim Kok Hooi, a consultant oncologist. He opens his article by saying:

As a doctor, I am interested in how the human mind works. As an oncologist, I am interested in the lure of alternative medicine. And so I have tried to understand why, in spite of all the scientific evidence at hand, there are many amongst us who do not want to undergo conventional cancer treatment – surgery, radiotherapy, chemotherapy and targeted therapy – but instead risk being treated by unproven and potentially dangerous alternative therapies.

He goes on to say that this happens because sometimes science is not very well understood. He talks about confirmed bias, a phenomenon in cognitive science, the science of how the mind works. He describes it as a person that -- notices the hits and ignores the misses in support of his own beliefs. So, basically someone might have a strong bias against chemotherapy, for no other reason than what they have seen on television, without really knowing the true facts.

Axitinib is an agent that targets angiogenesis -- blood supply to a tumor. It disrupts blood vessels that grow and provide nutrients to cancer cells. Without the nutrients and oxygen supplied by blood vessels, cancer cells cannot grow or replicate.

Researchers conducted a trial to evaluate axitinib in the treatment of metastatic breast cancer. Patients were either given Taxotere or Taxotere plus axitinib. Anticancer responses were achieved in 40 percent of patients treated with the addition of axitinib to Taxotere, compared with only 23 percent of patients treated with Taxotere alone.

The researchers concluded -- that the addition of axitinib to Taxotere improves anticancer responses and delays cancer progression compared to Taxotere alone in the treatment of metastatic breast cancer.

A report published in the Journal of the National Cancer Institute has stated that cisplatin has better response rates than carboplatin in the treatment of advanced non-small cell lung cancer.

The two main types of lung cancer, accounting for over 90 percent of all lung cancers, are non-small cell and small cell cancer. Non-small cell lung cancer (NSCLC) accounts for most of that 90 percent.

Advanced NSCLC means that the patient's cancer has spread to other organs or areas of the body. There has been research done to evaluate which drug is better for NSCLC -- cisplatin or carboplatin. Nine clinical trials were analyzed to see what regime is a better treatment option.

Now here's some good news for Tamoxifen-taking, hot-flash suffering women. A new study finds women who have lots of hot flashes during treatment with the breast cancer drug Tamoxifen have a lower risk of recurrence than women who don't suffer from the annoying waves of heat commonly associated with menopause.

"This study provides the first evidence that hot flashes may be an indicator of a better prognosis in women with early stage breast cancer," said study author John P. Pierce, Ph.D., from the University of California at San Diego. "Our data supports the possibility of a significant association between hot flashes and disease outcome."

More study is necessary to determine whether or not hot flashes -- which may predict better outcomes than severity of cancer, hormone receptor status, and age -- are associated with Tamoxifen and breast cancer progression.

Interferon is an immune stimulating agent. According to an article recently published in the Annals of Surgery, administration of interferon following surgery may improve survival among patients with advanced hepatitis B-related hepatocelluar carcinoma.

Hepatocelluar carcinoma (HCC) is the most common type of liver cancer. Unfortunately for this disease, recurrences often happen after surgical removal of the cancer. Researchers continue to evaluate ways to reduce these recurrences.

A clinical trial was conducted to evaluate the use of interferon following surgery in patients with HCC. The trial included 80 patients, one group received the interferon after surgery and the other group received no further treatment. The researchers found that the group treated with interferon experienced better survival rates.

Join Living Beyond Breast Cancer (LBBC) for a free educational teleconference titled Medical and Quality-of-Life Updates from the 43rd Annual Meeting of the American Society of Clinical Oncology.

The teleconference will be held on Monday, June 11, 2007 at 12:00 p.m. - 1:30 p.m. (EDT). You can participate by using any telephone or by computer using Real Network Player or Windows Media Player. Register online at www.lbbc.com or call 610-645-4567.

This teleconference brings to you groundbreaking research presented at the largest annual conference of cancer professionals in the United States. Some topics discussed will be:

• Advances in surgical, hormonal and chemotherapy treatments
• Using diet and nutrition to improve quality of life
• Clinical trials measuring the long-term impact of treatment on health and well-being
• New information on how to treat and manage metastatic breast cancer

Following the speaker presentation there will be an interactive question and answer session.

Femara (letrozole) is an aromatase inhibitor that works by suppressing the production of estrogen. In postmenopausal women estrogen is still produced in the body by the adrenal gland. Decreasing this production is a way of decreasing the risk of recurrence.

Tamoxifen on the other hand works by blocking the estrogen receptors on the cancer cell itself resulting in slower growth of the cell or cell death. Tamoxifen can be given to post or premenopausal women but Femara would only be prescribed to women that are postmenopausal. The reason being, is that a premenopausal women will still have estrogen produced by the ovaries. Femara would not be effective in this instance.

A Phase III clinical trial that is ongoing shows preliminary results that Femara is superior than Tamoxifen in women with early stage disease that are postmenopausal. The results of the study were published in the Annals of Oncology.

Ovarian cancer clinical trial to test the drug Phenoxodiol was a post I did back in November of 2006.

Its back in the news again saying that so far the studies have shown Phenoxodiol to have an excellent safety profile, with few patients experiencing side effects.

New studies are also being done to help explain the mechanism by which Phenoxodiol induces cancer cell death. This drug interacts with a tumor specific protein and blocks cancerous cells from dividing, causing it to die.

Phenoxodiol also has showed some promise of restoring drug sensitivity in patients that have become resistant to treatment. The OVATURE trial that was discussed in my November post should have results out within 18 months.

Chemotherapy given before surgery to remove cancer is called neoadjuvant treatment. An oncologist might recommend this based of the size of the tumor -- it being very large. The idea is to shrink the tumor and then have surgery to remove the cancer.

Having chemotherapy administered while the tumor is still there can show what drugs are working and what drugs have no effect on the tumor. Chemotherapy when started immediately, not after surgery with healing time needed, gives the patient systematic treatment right away. This could be beneficial and is why physicians might recommend this form of treatment. The truth is they don't know if it is better or not.

Of course, every case of breast cancer is different. We all need to make tough decisions regarding our treatment plan. The facts are that currently there is no evidence that survival is improved with neoadjuvant verses adjuvant (after surgery) chemotherapy in women with locally advanced breast cancer.

The clinical trials that are done help physicians understand what treatments are more effective. Results from a Phase II clinical trial was published in the Journal of Clinical Oncology. It stated that neoadjuvant treatment with Taxotere, Navelbine, and Herceptin resulted in a complete disappearance of detectable cancer in 39 percent of women with locally advanced HER2 positive breast cancer.

The study showed that after two years followup, on the thirty one women with locally advanced breast cancer involved in the study, the overall survival was 97 percent and cancer free survival was 84 percent.

So, the message here is that, even though the study group was small, the results showed a good response to this treatment plan.

Breast cancer drug Herceptin has been approved in Europe for use with hormonal therapy for postmenopausal patients with HER2 and hormone receptor positive metastatic disease.

Herceptin, made by Swiss drugmaker Roche Holding AG, is already approved in Europe for early and metastatic HER2-positive breast cancer.

This new approval is based on data from an international late stage clinical trial showing the combination of Herceptin with hormonal therapy doubled the median progression-free survival time.

Cancer is a scary word -- pancreatic cancer is beyond scary. It has one of the highest mortality rates of all cancers. Symptoms of the disease usually are hard to recognize and most patients are diagnosed in the advanced stages.

Anytime I read about a new drug that can increase the survival of this deadly disease I get excited. An early online publication of the Journal of Clinical Oncology states that the addition to the targeted agent Tarceva (erlotinib) to Gemzar (gemcitabine) can improve survival in patients diagnosed with advanced pancreatic cancer.

The Phase III clinical trial included 569 patients who were either treated with Tarceva plus Gemzar or Gemzar plus placebo. At one year the survival of those treated with the drug combination reached 23 percent. Gemzar alone had a 17 percent survival rate at one year. The study also said that more patients treated with the combination of Tarceva/Gemzar achieved stabilization of their disease.

I am hoping that sooner, rather than later this disease will not be beyond scary and will be something that can be treated, controlled and one day cured.

New hope may be an injection away for patients living with glioma, a terminal brain cancer that comes with a life expectancy of about 25 weeks post-diagnosis.

A new vaccine called Vitaspen is made by using tissue extracted from each person's cancerous tumor. The tissue is used as a unique footprint for the vaccine that targets destructive tumor tissue while sparing healthy tissue in the same region.

Vitaspen is only in the first stage of clinical human trials, but researchers are pleased with the promise of the new drug -- particularly the benefits trial participants are gaining form the treatment. They have reported no adverse side effects, and the drug has increased the overall survival rate.

Results of stage one trials will determine if the drug warrants stage two testing.