New Concepts in Breast Cancer Emerge from Analyzing Clinical Data Using Numerical Algorithms

A small international group has recently challenged fundamental concepts in breast cancer. As a guiding principle in therapy, it has long been assumed that breast cancer growth is continuous. However, this group suggests tumor growth commonly includes extended periods of quasi-stable dormancy. Furthermore, surgery to remove the primary tumor often awakens distant dormant micrometastases. Accordingly, over half of all relapses in breast cancer are accelerated in this manner. This paper describes how a numerical algorithm was used to come to these conclusions. Based on these findings, a dormancy preservation therapy is proposed

Comments on John D. Keen and James E. Keen, What is the point: will screening mammography save my life? BMC Medical Informatics and Decision Making, 2009

This paper by John D. Keen and James E. Keen addresses a thorny subject. The numerical findings and commentaries in their paper will be disturbing to some readers and seem to defy logic and well established viewpoints. It may well generate angry letters to the editor. However such numerical analysis and reporting including civil discussion should be welcomed and are the basis for informed decision making – something that is highly needed in this field

Teaching collaboration for the performing arts : program design that creates a bridge between Monterey Peninsula College and California State University, Monterey Bay while giving the community voice

The purpose of this Action Thesis is to research, design and implement an ancillary drama program for the proposed Education Center of Monterey Peninsula College at the former Fort Ord. The author hopes that research will uncover the District\u27s expectations of the new campus and its programs, areas of current programs that are open to improvement by a secondary program and ways of including methods of teaching that foster collaboration both within the art form and with the community. The final product should be a program design that draws students and source material from the underserved local communities, teaches basic skills and collaborative techniques, feeds interested students to programs at the MPC Main Campus as well as California State University, Monterey Bay and opens up new and different opportunities for current MPC and CSUMB students

Metronomic Chemotherapy Was Originally Designed and First Used in 1994 for Early Stage Cancer -- Why Is It Taking So Long to Proceed?

This is a personal case history from a researcher who was studying tumor growth when diagnosed in 1994 with stage IIIc colon cancer. The risk of relapse was 80% without therapy and 50% with conventional therapy. However his previous research led him to challenge the idea that tumor growth was described by the Gompertz equation. This is the fundamental theory underlying the concept that adjuvant chemotherapy should be started as soon as possible after primary surgery and should be administered at maximum tolerated dose and repeated when the patient’s immune system recovers from the last course of therapy. It turns out that Gompertz growth is based on a study by Laird in the 1960s that consisted of measuring tumor growth on 18 rodents and one rabbit. On the basis of those data and a fundamental mathematical error, Laird claimed “The pattern of growth defined by the Gompertz equation appears to be a general biological characteristic of tumor growth.” But then if the Gompertz equation assumption is wrong, how should adjuvant therapy be given? Patient/researcher opted for a low dose long term continuous infusion therapy with the mainstay colon cancer drug 5-flourouracil. This therapy had previously been used in late stage disease but never in early stage disease. Patient used this non-toxic therapy 6 hours a night for 2.5 years. Patient was on the staff of Judah Folkman and after discussing this with Folkman, oncologist-researcher Tim Browder tested low dose long term continuous infusion 5- fluorouracil to determine if it is antiangiogenic. It was found to be so. This therapy is now called metronomic chemotherapy and is slowly being tested in laboratory, clinical and veterinary situations. Patient/researcher remains disease free 17 years later and asks why it is taking so long to proceed

How Long Should Adjuvant Chemotherapy Be Given in Early Stage Colon Cancer?

After diagnosis of colon cancer, the tumor is removed and the stage of the disease is provided by a pathologist. If the stage indicates relatively high risk of relapse, adjuvant chemotherapy is used for 6 or so months to reduce the probability of such relapse. This is a very common situation in oncology – used for many early stage colon cancer patients of whom there will be 143,000 in 2013 in US. This therapy is only partially effective since 52,000 patients will die of metastatic colon cancer in 2013. Despite being used for decades, there is much room for improvement

Guest Editor's Concluding Remarks—Advances in Usage of ANN, Discussion of an Unsolved Problem, and Some Differences between Papers Written by Engineers and by Physicians

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Multimodal Hazard Rate for Relapse in Breast Cancer: Quality of Data and Calibration of Computer Simulation

Much has occurred since our 2010 report in Cancers. In the past few years we published several extensive reviews of our research so a brief review is all that will be provided here. We proposed in the earlier reports that most relapses in breast cancer occur within 5 years of surgery and seem to be associated with some unspecified manner of surgery-induced metastatic initiation. These events can be identified in relapse data and are correlated with clinical data. In the last few years an unexpected mechanism has become apparent. Retrospective analysis of relapse events by a Brussels anesthesiology group reported that a perioperative NSAID analgesic seems to reduce early relapses five-fold. We then proposed that primary surgery produces a transient period of systemic inflammation. This has now been identified by inflammatory markers in serum post mastectomy. That could explain the early relapses. It is possible that an inexpensive and non-toxic NSAID can reduce breast cancer relapses significantly. We want to take this opportunity to discuss database quality issues and our relapse hazard data in some detail. We also present a demonstration that the computer simulation can be calibrated with Adjuvant-on-line, an often used clinical tool for prognosis in breast cancer

Breast Cancer Relapse, Post-Surgical Confusion, and Dementia in the Elderly : An Unexpected Connection but with the Same Proposed Solution

Peer reviewedPublisher PD

Hypothesis: primary antiangiogenic method proposed to treat early stage breast cancer

<p>Abstract</p> <p>Background</p> <p>Women with Down syndrome very rarely develop breast cancer even though they now live to an age when it normally occurs. This may be related to the fact that Down syndrome persons have an additional copy of chromosome 21 where the gene that codes for the antiangiogenic protein Endostatin is located. Can this information lead to a primary antiangiogenic therapy for early stage breast cancer that indefinitely prolongs remission? A key question that arises is when is the initial angiogenic switch thrown in micrometastases? We have conjectured that avascular micrometastases are dormant and relatively stable if undisturbed but that for some patients angiogenesis is precipitated by surgery. We also proposed that angiogenesis of micrometastases very rarely occurs before surgical removal of the primary tumor. If that is so, it seems possible that we could suggest a primary antiangiogenic therapy but the problem then arises that starting a therapy before surgery would interfere with wound healing.</p> <p>Results</p> <p>The therapy must be initiated at least one day prior to surgical removal of the primary tumor and kept at a Down syndrome level perhaps indefinitely. That means the drug must have virtually no toxicity and not interfere meaningfully with wound healing. This specifically excludes drugs that significantly inhibit the VEGF pathway since that is important for wound healing and because these agents have some toxicity. Endostatin is apparently non-toxic and does not significantly interfere with wound healing since Down syndrome patients have no abnormal wound healing problems.</p> <p>Conclusion</p> <p>We propose a therapy for early stage breast cancer consisting of Endostatin at or above Down syndrome levels starting at least one day before surgery and continuing at that level. This should prevent micrometastatic angiogenesis resulting from surgery or at any time later. Adjuvant chemotherapy or hormone therapy should not be necessary. This can be continued indefinitely since there is no acquired resistance that develops, as happens in most cancer therapies.</p