Aging, cancer, and cancer vaccines

World population has experienced continuous growth since 1400 A.D. Current projections show a continued increase - but a steady decline in the population growth rate - with the number expected to reach between 8 and 10.5 billion people within 40 years. The elderly population is rapidly rising: in 1950 there were 205 million people aged 60 or older, while in 2000 there were 606 million. By 2050, the global population aged 60 or over is projected to expand by more than three times, reaching nearly 2 billion people [1]. Most cancers are age-related diseases: in the US, 50% of all malignancies occur in people aged 65-95. 60% of all cancers are expected to be diagnosed in elderly patients by 2020 [2]. Further, cancer-related mortality increases with age: 70% of all malignancy-related deaths are registered in people aged 65 years or older [3]. Here we introduce the microscopic aspects of aging, the pro-inflammatory phenotype of the elderly, and the changes related to immunosenescence. Then we deal with cancer disease and its development, the difficulty of treatment administration in the geriatric population, and the importance of a comprehensive geriatric assessment. Finally, we aim to analyze the complex interactions of aging with cancer and cancer vaccinology, and the importance of this last approach as a complementary therapy to different levels of prevention and treatment. Cancer vaccines, in fact, should at present be recommended in association to a stronger cancer prevention and conventional therapies (surgery, chemotherapy, radiation therapy), both for curative and palliative intent, in order to reduce morbidity and mortality associated to cancer progression

Outcome of HIV-associated <it>Pneumocystis </it>pneumonia in hospitalized patients from 2000 through 2003

Abstract Background Pneumocystis pneumonia (PCP) remains a leading cause of morbidity and mortality in HIV-infected persons. Epidemiology of PCP in the recent era of highly active antiretroviral therapy (HAART) is not well known and the impact of HAART on outcome of PCP has been debated. Aim To determine the epidemiology of PCP in HIV-infected patients and examine the impact of HAART on PCP outcome. Methods We performed a retrospective cohort study of 262 patients diagnosed with PCP between January 2000 and December 2003 at a county hospital at an academic medical center. Death while in the hospital was the main outcome measure. Multivariate modeling was performed to determine predictors of mortality. Results Overall hospital mortality was 11.6%. Mortality in patients requiring intensive care was 29.0%. The need for mechanical ventilation, development of a pneumothorax, and low serum albumin were independent predictors of increased mortality. One hundred and seven patients received HAART before hospitalization and 16 patients were started on HAART while in the hospital. HAART use either before or during hospitalization was not associated with mortality. Conclusion Overall hospital mortality and mortality predictors are similar to those reported earlier in the HAART era. PCP diagnoses in HAART users likely represented failing HAART regimens or non-compliance with HAART.</p

Metastasis of lung cancer through Batson’s plexus: very rare but possible

Many malignancies, like prostate, colon, and breast cancer, metastasize throughBatson’s plexus (vertebral venous plexus). Although lung cancer is one of the mostcommon cancers in the United States, its spread through Batson’s plexus is consideredextremely rare. We report a 76-year-old woman with adenocarcinoma of the lung whohad metastasis affecting multiple contiguous vertebral bodies likely due to disseminationthrough Batson’s plexus of veins. This plexus is a component of the cerebrospinalvenous system (CSVS) consisting of the cranial venous system and the vertebralvenous plexus (Batson’s plexus). The CSVS is a valveless network of veins which areimportant in the venous drainage of the brain and spine. However, this venous networkprovides an easy channel for the dissemination of infections and malignant cells