Public Release: 29-Jul-2015

Cancer Research UK

Cancer Research UK scientists have for the first time identified that there are five distinct types of prostate cancer and found a way to distinguish between them, according to a landmark study* published today in EBioMedicine.

The findings could have important implications for how doctors treat prostate cancer in the future, by identifying tumours that are more likely to grow and spread aggressively through the body.

The researchers, from the Cancer Research UK Cambridge Institute and Addenbrooke’s Hospital, studied samples of healthy and cancerous prostate tissue from more than 250 men.

By looking for abnormal chromosomes and measuring the activity of 100 different genes linked to the disease they were able to group the tumours into five distinct types, each with a characteristic genetic fingerprint.

This analysis was better at predicting which cancers were likely to be the most aggressive than the tests currently used by doctors – including the PSA test** and Gleason score. But, the findings need to be confirmed in clinical trials with larger groups of men.

Study author Dr Alastair Lamb, from the Cancer Research UK Cambridge Institute, said: “Our exciting results show that prostate cancer can be classified into five genetically-different types. These findings could help doctors decide on the best course of treatment for each individual patient, based on the characteristics of their tumour.

“The next step is to confirm these results in bigger studies and drill down into the molecular ‘nuts and bolts’ of each specific prostate cancer type. By carrying out more research into how the different diseases behave we might be able to develop more effective ways to treat prostate cancer patients in the future, saving more lives.”

Prostate cancer is the most common cancer in men in the UK, with around 41,700 cases diagnosed every year. There are around 10,800 deaths from the disease each year in the UK.

Professor Malcolm Mason, Cancer Research UK’s prostate cancer expert, said: “The challenge in treating prostate cancer is that it can either behave like a pussycat – growing slowly and unlikely to cause problems in a man’s lifetime – or a tiger – spreading aggressively and requiring urgent treatment. But at the moment we have no reliable way to distinguish them. This means that some men may get treatment they don’t need, causing unnecessary side effects, while others might benefit from more intensive treatment.

“This research could be game-changing if the results hold up in larger clinical trials and could give us better information to guide each man’s treatment – even helping us to choose between treatments for men with aggressive cancers. Ultimately this could mean more effective treatment for the men who need it, helping to save more lives and improve the quality of life for many thousands of men with prostate cancer.”

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For media enquiries contact the Cancer Research UK press office on 020 3469 8300 or, out of hours, on 07050 264 059.

*Ross-Adams et al. Integration of copy number and transcriptomics provides risk stratification in prostate cancer: a discovery and validation cohort study. EBioMedicine. DOI: 10.1016/j.ebiom.2015.07.017.

This work was funded by Cancer Research UK with support from Prostate Cancer UK.

**http://www.cancerresearchuk.org/about-cancer/type/prostate-cancer/about/screening-for-prostate-cancer

• Men deserve better. Men United is Prostate Cancer UK’s movement for everyone who believes that men are worth fighting for, to help us beat prostate cancer and keep friendships alive. Some 230,000 people have engaged with Men United since 2014.
• This summer Men United has tons of fun ways for people to see their mates, from bike rides, sponsored walks, BBQs and quiz nights – all whilst doing something great for Prostate Cancer UK.
• Search Men United, or visit prostatecanceruk.org/menunited
• Prostate Cancer UK works to get men in all areas of the country the early detection, effective diagnosis and better treatments that will beat this disease.
• Prostate cancer is the most common cancer in men. More than 10,000 men die every year from this male-only disease, and 330,000 men are living with and after prostate cancer in the UK.
• Anyone with concerns about prostate cancer can contact Prostate Cancer UK’s Specialist Nurses in confidence on 0800 074 8383 or via the online Live chat, instant messaging service: http://www.prostatecanceruk.org. The Specialist Nurse phone service is free to landlines and open from 9am to 6pm Monday to Friday with late opening until 8pm on Wednesdays.

• Cancer Research UK is the world’s leading cancer charity dedicated to saving lives through research.
• Cancer Research UK’s pioneering work into the prevention, diagnosis and treatment of cancer has helped save millions of lives.
• Cancer Research UK receives no government funding for its life-saving research. Every step it makes towards beating cancer relies on every pound donated.
• Cancer Research UK has been at the heart of the progress that has already seen survival in the UK double in the last forty years.
• Today, 2 in 4 people survive their cancer for at least 10 years. Cancer Research UK’s ambition is to accelerate progress so that 3 in 4 people will survive their cancer for at least 10 years within the next 20 years.
• Cancer Research UK supports research into all aspects of cancer through the work of over 4,000 scientists, doctors and nurses.
• Together with its partners and supporters, Cancer Research UK’s vision is to bring forward the day when all cancers are cured.

For further information about Cancer Research UK’s work or to find out how to support the charity, please call 0300 123 1022 or visit http://www.cancerresearchuk.org. Follow us on Twitter and Facebook.

Contact: Chukuka Enwemeka enwemeka@uwm.edu 414-229-4712 University of Wisconsin – Milwaukee

Light as medicine?

Multiple sclerosis (MS) causes progressive paralysis by destroying nerve cells and the spinal cord. It interrupts vision, balance and even thinking.

On a suggestion from a colleague, Jeri-Anne Lyons decided to test how the disease responded to a radical therapy – exposure to a certain wavelength of light called near-infrared (NIR).

“Never in a million years did I think it would help,” says Lyons, an associate professor of biomedical sciences at the University of Wisconsin-Milwaukee (UWM), who studies the role of the immune response in MS.

But it did. In rodent models, early MS-like symptoms were treated with exposure to NIR light for a week, alternating with a week of no light. The clinical condition of the mice improved.

Professor Janis Eells, who shared the idea with Lyons, had the same initial reaction after she used NIR therapy on rats to treat blindness caused by poisoning, a condition thought to be permanent. Repeating experiments again and again, she found that certain doses of NIR light allowed lab animals to regain their sight.

Scientists have known for years that certain wavelengths of light in certain doses can heal, but they are only now uncovering exactly how it works, thanks in large part to three UWM faculty researchers, including Chukuka S. Enwemeka, dean of UWM’s College of Health Sciences who is internationally known for his work in phototherapy.

Enwemeka researches the effects of both NIR and blue light in the visible range on healing wounds. Among his discoveries is that some wavelengths of blue light can clear stubborn infections – even MRSA, the antibiotic-resistant “superbug” form of Staphylococcus aureus.

Together, the UWM cluster has found that NIR and blue light repair tissue in dramatically different ways, but both act on the same enzyme in the cell’s energy supply center: the mitochondria.

The studies have revealed key information about managing the effects of aging and disease.

A bodyguard

So how is light accomplishing such wonders?

In applying NIR light therapy to MS, Lyons has identified the right timing and dose. But she’s also dug deeper, analyzing the effect the light had on the activities of the animal’s genes. It turns out, molecules that would make the disease worse were weakened after exposure to the light, and the ones responsible for improvement were strengthened.

Eells says NIR light acts on the mitochondria and a particular enzyme, cytochrome C oxidase, to stimulate cell repair.

Light can do all that?

“We’re not talking about white light [all wavelengths in the visible spectrum combined] as treatment, but only certain wavelengths, at a certain intensity, for a certain amount of time,” says Lyons. “Like ingested medication, it’s all about the dose.”

Determining the best wavelength of light for phototherapy is a difficult task. Studies show that 670 nanometer (nm) and 830 nm light are beneficial, but 730 nm is not. The other difficult task is determining the appropriate dose and dose regimen for delivering the light.

Promising leads

Even more exciting is phototherapy’s potential to improve a host of other degenerative diseases. Damaged mitochondria lead to a rise in destructive “free radicals,” which play a key role in aging and cancer.

“It’s why we try to put antioxidants into our diets,” says Lyons, “to fight that process.”

One source of free radicals comes from the inflammation caused by the body’s immune response. The researchers have found that after an injury or illness triggers the immune response, NIR light resets the mitochondria so they function normally again.

“NIR reduces inflammation,” says Eells. “If you can tone down the inflammation in an eye disease like retinitis pigmentosa, you slow the progression of the disease.”

A similar observation with inflammation occurred in a study on recalcitrant bedsores, she adds. Wounds treated with phototherapy healed two and a half times more quickly than untreated wounds.

“Chronic non-healing wounds are ‘stuck’ in the inflammatory phase of wound healing” The light removes that obstacle,” says Eells.

She has been working with Tim Kern at Case Western Reserve in treating an animal model of diabetic retinopathy with NIR light, which has been shown to slow progression and reduce the severity of the condition.  Kern hopes to initiate a clinical trial in the near future.

A killer

NIR light heals by ensuring that cytochrome oxidase binds with oxygen to turn on protectors and stimulate cell metabolism. Blue light, on the other hand, causes a toxic environment when the immune response has been triggered. That poisonous effect hastens healing of topical wounds by killing bacteria that cause infection.

The question is, “What gives light in the longer wavelength its antibiotic effect?”

Enwemeka’s studies suggest that blue light also acts on the mitochondrial enzyme site, but allows cytochrome oxidase to bind with nitric oxide, a free radical that is elevated in the immune response. It’s a pairing that poisons the invader.

This theory is still unproven, but the therapy has achieved undeniable results in the lab with antibiotic-resistant MRSA. Enwemeka demonstrated that one dose of irradiation killed as much as 92 percent of two pervasive strains of MRSA.

He is working to improve that success rate by getting the light to penetrate deeper in order to finish off the few colonies that survive irradiation.

Limited availability

Enwemeka is leading a research effort in Brazil and at UWM that he hopes will ultimately lead to clinical use of NIR and blue light in the U.S. for the treatment of wounds.

In the six years since he was asked to test the effects of blue light on MRSA, he says, research on the topic has picked up. But currently, the U.S. Food and Drug Administration (FDA) has not sanctioned the use of blue light in treating wounds, or NIR light for conditions other than wounds and pain.

With so much success, why isn’t phototherapy being used more widely?

“It’s considered alternative therapy in Western medicine. It seems too simple for people to accept,” says Lyons.

What the FDA is waiting for, says Enwemeka, is confirmation from a large-scale clinical study before approving phototherapy for a wider variety of ailments. It’s something Enwemeka and Harry Whelan, a UWM alumnus and physician-researcher at the Medical College of Wisconsin, are determined to accomplish.

“To see people who have not had relief see their wounds heal and not return,” says Enwemeka of the Brazilian patients who have benefited from therapy, “is very touching.”

Additional study: Photobiomodulation Induced by 670 nm Light Ameliorates MOG35-55 Induced EAE in Female C57BL/6 Mice: A Role for Remediation of Nitrosative Stress

KA Muili, S Gopalakrishnan, JT Eells, JA Lyons

PLoS ONE 8(6): e67358. doi:10.1371/journal.pone.0067358  [2013]

Contact: Kim Modory 847-938-4696 Fleishman-Hillard, Inc.

Analysis of more than 1 million adult hospital cases revealed 21 percent reduction in length of hospital stay and cost with nutritional intervention

ABBOTT PARK, Ill., Aug. 30, 2013 – Abbott (NYSE: ABT) A recent health economics and outcomes study, conducted by leading health economists and supported by Abbott, found that oral nutritional supplements provided to patients during hospitalization were associated with significant reductions in length of stay and hospitalization cost. Additionally, the 30-day readmission risk was significantly reduced for patients with at least one known subsequent readmission.

The study is being presented this weekend at the European Society for Clinical Nutrition and Metabolism (ESPEN) annual congress in Leipzig, Germany, where it will be highlighted as one of the conference’s three “Best Abstracts.” The meeting is a leading conference in clinical nutrition, bringing together participants from more than 80 countries.

The study analyzed more than 1 million adult inpatient cases in the U.S., and found that patients provided oral nutritional supplements during hospitalization benefited from:

• 21 percent, or 2.3 day, reduction in length of stay
• 21.6 percent, or $4,734, reduction in patient hospitalization cost 

Additionally, there was a 6.7 percent reduction in the probability of a 30-day readmission in patients who had at least one known subsequent readmission and were provided oral nutritional supplements during the previous hospitalization.

The study, which also was recently published in the American Journal of Managed Care, provides insights into the economic benefits of prescribing oral nutritional supplements to adult patients in the hospital setting.

“Patients identified as having nutritional deficiencies often face a longer and more difficult recovery process, resulting in higher health care costs and an increase in complication rates,” said Marinos Elia, MD, BSc Hon, FRCP, Professor of Clinical Nutrition and Metabolism at University of Southampton. “Research demonstrates that oral nutritional supplementation can lead to highly positive economic benefits and improved patient outcomes.”

In the study, investigators were able to determine differences in length of stay and costs by comparing hospital stays where oral nutritional supplements were prescribed to patients with similar conditions where oral nutritional supplements weren’t prescribed.

“Because oral nutritional supplements are formulated to provide advanced nutrition and calories for patients and are relatively inexpensive to provide, the sizeable savings they generate make supplementation a cost-effective therapy,” said study co-author, Tomas Philipson Ph.D., Daniel Levin Chair of Public Policy at the University of Chicago.

“In today’s outcome conscious hospital environment, Abbott is committed to delivering products that improve the quality of care for patients and also help reduce health care costs,” said Robert H. Miller, Ph.D., divisional vice president, Global R&D and Scientific Affairs for Abbott Nutrition. “In addition to the numerous retrospective studies focused on health economics and outcomes research in our pipeline, nearly all of our clinical research studies now include an economic analysis to help demonstrate a nutritional therapy’s total value proposition.”

About the Study

The ″Impact of Oral Nutritional Supplementation on Hospital Outcomes” study is a retrospective data analysis on the effect of oral nutritional supplements on hospital economic outcomes. The study compared hospital stays where oral nutritional supplements were provided with similar hospital stays that did not provide oral nutritional supplements. The difference between length of hospital stay and cost of treatment (including supplies, labor, depreciation of equipment, etc.) were measured. The probability of 30-day hospital readmission also was calculated.

The retrospective analysis utilized information from more than one million adult inpatient cases found in the Premier Research Database from 2000 – 2010, maintained by the Premier healthcare alliance – representing a total of 44 million hospital episodes from across the United States or approximately 20 percent of all inpatient admissions in the United States. The full sample consisted of adults 18 years and older and focused on oral feeding interventions only. The matched sample ultimately included: 1,160,088 total episodes (oral nutritional supplements episodes N= 580,044 and non-oral nutritional supplements episodes N=580,044), where propensity score matching and instrumental variables were used to address potential bias due to non-random selection.

About Abbott Nutrition

For more than 85 years, Abbott Nutrition has been developing and marketing science-based nutritional products to support the growth, health and wellness of people of all ages. Internationally recognized brands include the Similac® brand of infant formulas; the Gain® brand of growing-up milks; the PediaSure® brand of complete and balanced nutrition for children; and the Ensure® brand of complete and balanced nutrition for adults.

The company is a leader in nutritional products clinically shown to address the distinct dietary needs of people with serious health conditions or special nutrient requirements, such as the Glucerna® brand of nutrition shakes and bars for people with diabetes.

About Abbott

Abbott is a global healthcare company devoted to improving life through the development of products and technologies that span the breadth of healthcare. With a portfolio of leading, science-based offerings in diagnostics, medical devices, nutritionals and branded generic pharmaceuticals, Abbott serves people in more than 150 countries and employs approximately 70,000 people.

Visit Abbott at http://www.abbott.com and connect with us on Twitter at @AbbottNews.