Western Mail (Mar 22, 10:02 AM)  Traffic fumes have long been linked to respiratory disease but now scientists have found they may even damage DNA.

The results of a recent study in Taiwan strengthen earlier claims that air pollution in cities can cause cancer.

And one of the study's authors told the Western Mail traffic fumes could have a similar effect on unborn babies to smoking during pregnancy.

Scientists tested the urine of 47 women who work in motorway toll booths in Taiwan for a chemical known to damage DNA.

When compared with samples from a group of female Taiwanese office workers, the toll-booth operators were found to have 90% more of the chemical.

Smoking also increases the concentration of the chemical, known as 8-0HdG, and there were smokers among the toll-booth operators. But the 90% figure relates to toll-booth workers who do not smoke.

The chemical is an indicator of DNA damage caused by oxygen free- radical activity in the

body. That damage could affect the body's ability to produce replacement cells, increasing the chances of cancer.

Prof Jouni Jaakkola, one of the study's authors, said research had indicated that traffic fumes had carcinogenic effects.

'These findings are consistent with the epidemiological findings,' said Prof Jaakkola, who is now based at the University of Birmingham. 'They don't point to one type of cancer. They indicate that such underlying mechanisms are possible.'

The findings could have serious implications for Wales, one of few European countries with no electric transport in its cities and large towns.

Independent, The; London (UK) (Mar 16, 04:53 AM)  The tragic case of the Hashmi family has reignited the debate over what is meant by "designer babies". Raj and Shahana Hashmi want to have a baby by in vitro fertilisation (IVF). Not only do they want the baby to be free of genetic disease; they also want it to be screened so that it will match the tissue of their six-year-old son Zain, who suffers from a rare blood disorder. If Zain does not receive a stem-cell transplant from his "saviour sibling", he'll almost certainly die. Their case is now being considered by the House of Lords.

The term "designer baby" has been widely used in the context of a range of difficult issues surrounding developments in reproductive medicine. Pre-natal genetic diagnosis (PGD) - when a single cell from an early IVF embryo is removed and genetically analysed - enables doctors to test for a range of inherited disorders, as well as carry out tissue typing.

In 2000, Lisa and Jack Nash of Denver, Colorado were the first couple to benefit from the idea of creating "saviour siblings" by PGD when their son Adam was born. The Nashes, both carriers of Fanconi anaemia, had a six-year-old daughter, Molly, who was born with the rare inherited bone- marrow disease. Scientists tested 15 of the Nashes' embryos for the presence of the diseased gene. They then went a step further to see which one also had the same tissue type as Molly. The result was Adam, who donated a stem-cell transplant that helped his sister to recover.

For some, the idea of creating a baby to order is anathema. For others, it is nothing more sinister than planning a family with the benefits of modern medicine. However, the tortuous ethical and legal arguments over designer babies such as Adam will seem relatively trivial compared to the impending debate over the technological developments in reproductive genetics that are now on the horizon.

Some scientists believe we are on the verge of being able to engineer the human gene-pool for the first time. They're not talking about straightforward gene therapy, but something called germline gene therapy, when the genes of future generations can be changed for ever. This would make today's "designer babies" appear decidedly low-tech compared with what might be possible in years to come.

We are, to some extent, already accustomed to the idea of tinkering with genes. Last week, doctors in London said they had successfully cured a second child of a fatal inherited condition with the help of gene therapy, a technique that replaces - or, more correctly, augments - a faulty gene with a normal, healthy version.

Gene therapy has had mixed results. Early experiments led to some disastrous outcomes. One of the most infamous was the case of Jesse Gelsinger, who died in 1999 after undergoing gene therapy that involved infecting him with a genetically engineered virus. The intention was that the virus would carry healthy genes into his liver. Instead, he suffered liver failure.

This sort of gene therapy targets only the tissues damaged by the faulty gene. Germline gene therapy involves tinkering with genes at the stage of the embryo, so that each and every cell of the resulting baby carries the newly inserted gene. This more radical modification would have far- reaching consequences because it would also include changing the sperm and eggs of the mature adult. It would mean that their children would also inherit the altered genes, which is why it's called "germline" gene therapy. Potentially, it has the power of changing the genetic make-up of the human species for good.

In Britain, germline gene therapy is not allowed under current legislation, but there may soon be calls to look again at the ban, especially in the light of recent work into artificial human chromosomes (HACs). The idea is to add an extra chromosome to the complement of 46 that normally reside in most cells of the body. Some scientists believe that many of the safety concerns about germline gene therapy can be addressed by refinements in the technology of making this putative "cousin 47" - the 47th human chromosome.

Proponents say HACs are inherently safer than other ways of introducing foreign genes into the body, because the DNA of the artificial chromosomes is not "naked" but enclosed in a structure that mimics the way human DNA is naturally stored in each of our 46 chromosomes. They believe HACs can be made to replicate faithfully each time cells divide, and it could be possible to turn their genes on or off at will. It might also be possible to include a self- destruct mechanism that prevents the HAC from being passed on to future generations if this is of concern.

The neurobiologists Gregory Stock and John Campbell of the University of California at Los Angeles have been at the forefront of promoting the idea of using HACs for human germline gene therapy. "In discussions of cloning and germline modifications of animals, it's easy to pretend that human manipulations can be ignored," they say. "But it seems virtually certain that, as these technologies evolve, their focus will swing back towards ourselves. The real question is not whether they will be applied to humans, but when, how and to what extent."

Artificial chromosomes have been used in genetics for years, notably those that mimic yeast chromosomes. Huntington Willard of the Case Research University School of Medicine in Cleveland, Ohio made the first artificial human chromosome in 1997. He put three types of DNA in a test tube, and the primitive "chromosome" self- assembled. It survived in the cells for six months, apparently retaining its integrity during cell division.

Chromosomes are complex structures, but there seem to be three crucial components necessary for them to replicate each time the cell divides. One is the centromere, a structure at the centre of the chromosome that plays a vital role in aligning the chromosome on the protein "spindles" involved in cell division. Then there are the telomeres at the end of the chromosome (like the plastic tips of shoelaces that prevent them from fraying). And there are the so- called origins of replication, the DNA sequences that initiate duplication of the chromosome during cell division.

Stock and Campbell believe it will soon be possible to consider radical therapies that involve inserting specially-designed HACs into human embryos. They suggest, for instance, that an HAC could be built containing genes that confer life-long resistance to HIV. Another idea is to introduce into male embryos an HAC containing a series of genetic switches that can, when turned on, trigger the destruction of prostate cancer cells.

If preventative treatments such as these are shown to work safely, it is not difficult to envisage an array of treatments delivered as a "gene cassette" on a single HAC. Perhaps anti-ageing genes could be added to every embryo's extra chromosome. "Two things will be necessary before human germline engineering can occur broadly," Stock and Campbell say. "A safe, reliable way of delivering genetic changes to a human embryo, and genetic modifications so compelling that large numbers of parents will want them."

They argue that both are nearer than many people believe because of recent developments in human artificial chromosomes. "The time to examine and discuss the realistic benefits and challenges these new reproductive technologies embody is now, while they are still nascent. And to keep such discussion focused on realistic possibilities rather than science fiction, it is imperative that active researchers in the field participate," they say.

One scenario that has been envisaged if germline gene therapy goes ahead is the idea of human society being divided between the "gene enriched" and the "naturals" - some people having the resources to exploit all aspects of the technology to improve the lives of themselves and their children, with others left to live and breed naturally. Princeton University's Lee Silver believes that although such a dystopia is not imminent, it is plausible and could eventually lead to two species of humans.

"If the accumulation of genetic knowledge and advances in genetic enhancement technology continue at the present rate," Silver says, "then by the end of the third millennium, the genrich class and the natural class will become the GenRich humans and the Natural humans - entirely separate species with no ability to cross-breed and with as much romantic interest in each other as a current human would have for a chimpanzee."

Albuquerque Journal (Mar 24, 06:21 PM)  * Completing an advance directive regarding health care can help families avoid battles

Few people relish the thought of contemplating their own death or the circumstances that may lead to it.

Taking some time to do so, though, and talking to family members about it could help avoid a public battle like the one being waged over Terri Schiavo.

The Florida woman's husband and parents are embroiled in a legal battle over whether her nutrition and hydration should be withdrawn. She has been in a vegetative state for years.

The basic question is: Would she have wanted to live this way?

New Mexicans who take time to talk with their loved ones and to sign a document outlining their wishes can provide an answer to that question for themselves.

"New Mexico really is quite a leader, progressive in the ability of citizens to make their advance directives known," said the Rev. Bill Dorman, director of pastoral care at Presbyterian Hospital.

An advance directive here doesn't need to be witnessed, notarized or even filled out on a specific form, he said. Of course, it doesn't hurt if it is.

One critical piece of the directive is to assign someone to make health care decisions on your behalf if you are unable to communicate.

If you don't name someone, according to Secretary Debbie Armstrong of the state Department of Aging and Long-Term Services, state law calls for the decision-maker to be, in order of priority: your spouse; an individual in a long-term relationship similar to a spouse; an adult child; a parent; a sibling; a grandparent or a friend.

An advance directive makes clear whether you want everything possible to be done to keep you alive; whether you want only the accepted medical practice; or whether your designee should decide, Dorman said.

Since it's impossible to predict every contingency, many people leave that decision to their designee, he said.

People also can indicate whether they want artificial nutrition and hydration.

Those checking into a hospital are given the option of filling out an advance directive, Dorman said. Making those choices in a hospital bed, though, can be emotional, he said.

"It's preferable to do it at home around the kitchen table," he said.

You can get forms on the Internet or at a number of places -- for example, the Department of Aging and Long-Term Services, the state Bar Association and the Senior Citizens Law Office, Armstrong said.

You should give copies of your advance directive to the person designated to make your health care decisions, your family members, your physician and others who might be called in if you are incapacitated.

You don't need a lawyer to fill out an advance directive, and you can get the form at no cost.

Find form online

You can get a form for an advance directive online

from the University of New Mexico Health Sciences Center's Institute for Ethics at http://hsc.unm.edu/

ethics/advdir/adv dir.shtml.

That site also gives access to a "values history form," which will help guide a discussion with your designee about your values and how they could be carried out if you are incapacitated.

Associated Press/AP Online (Mar 27, 01:01 AM)  RED LAKE, Minn. - The obituary in the small town paper was heartbreaking: Chase Albert "Beka" Lussier, born Dec. 23, 1989, died March 21 at Red Lake High School. A freshman who played basketball and loved computer games. Six paragraphs down, beside the photograph of a chubby-cheeked, smiling boy, came this sentence: "He spent his time juggling life between his family and his son."

A father at 15. Dead three months later. Shot with eight others by an alienated, despondent upperclassman who, at the end of his 10-minute walk through Red Lake High School, turned one of his guns on himself.

The deaths, conspicuous in their senselessness, highlight the problems that American Indian teenagers have been quietly suffering in greater numbers than most adolescents: suicide, violence, depression and pregnancy.

By themselves, the numbers for the Red Lake Indian Reservation are staggering. A state survey conducted last year of 56 ninth-graders showed that 81 percent of the girls, and 43 percent of the boys, had considered suicide.

Nearly half the girls said they'd actually tried to kill themselves. Twenty percent of boys said the same - numbers about triple the rate statewide.

"I don't have an explanation for that," said Brenda Child, who teaches American Indian history at the University of Minnesota and grew up on the reservation. Her cousin, 14-year-old Ryan Auginash, was shot in the chest during 16-year-old Jeff Weise's march through the campus.

She doesn't want to view the shootings through the prism of American Indian troubles. "I see it as a problem of a young man who was deeply depressed," she said. "Sadly, that can happen anywhere."

Here, where the Red Lake band of Chippewa has lived in isolation on more than 830,000 acres in northern Minnesota since 1889, such things are not openly discussed.

It simply is not their way. For much of the week, they slammed the door of their reservation to the prying eyes of television cameras and reporters who wanted to know why Weise shot his grandfather, a tribal policeman everyone knew as "Dash," and the man's girlfriend, then drove to the high school entrance behind the wheel of his grandfather's police car. Weise, wearing his grandfather's gunbelt and toting a shotgun, opened fire at the front door, by the lone metal detector.

Tribal elders have said little, as have residents. Some students have been more open, describing Weise as a depressed, friendless boy who talked of shooting people.

On Web site postings, Weise described himself as "nothing but your average Native-American stoner" and described his life on the reservation as "every man's nightmare. This place never changes and it never will."

Weise had not always lived on the reservation. He arrived after his father committed suicide four years ago. His mother, a heavy drinker, was severely injured in an alcohol-related auto accident. The boy had nowhere else to go.

Some on the reservation say Weise had been seeing a professional and taking medication for his depression, which is evident on Internet postings such as this one, where under a section titled "A Little About Me," he typed "16 years of accumulated rage suppressed by nothing more than brief glimpses of hope, which have all but faded to black."

On Thursday, outside the hospital in Bemidji, a small town 32 miles south of the reservation, Andrew Auginash was there to visit his wounded brother, Ryan. "I don't want anything bad said about our reservation," he said. "It's like any other place."

The Minnesota survey of Red Lake students said they assaulted other classmates and used more alcohol and drugs than other students across the state.

Nationwide figures show that American Indian teenagers commit suicide at three times the national rate; are involved in alcohol-related arrests at twice the national average, and die in alcohol-related incidents at 17 times the national average.

They are third-highest in teen pregnancies, behind Hispanics and blacks.

"My mother moved us off the reservation when I was very young. And I am very glad she did that," says Bill Lawrence, publisher of the Native American Press-Ojibwe News, a 5,000-circulation weekly newspaper in Bemidji.

"The kids there come from drugs, alcohol, broken families, abuse," he says sadly. "To grow up under these circumstances is a tremendous ordeal. And to consider suicide means you think there is no other way out."

Lawrence is a member of the Red Lake band and has relatives and friends on reservation, he says. "Only the most gifted students can overcome this stuff. A lot of kids don't go to school. About 50 percent don't graduate. How do you go on after that? They're not qualified to get a job or go to college."

Sister Patricia Wallis has lived at the reservation, off and on, since 1951, working at a mission that has a school and convent. To Wallis, the problems here come from grinding, dehumanizing, relentless poverty.

"They're not able to succeed in school. If something happens, or someone dies, or there's been an accident, they don't come regularly. Some stay at home because they have to baby-sit their siblings or they have to help out."

Another problem is housing, she said. There aren't enough places to live on the reservation, so families and cousins and children live crowded together in single homes. This has worsened lately, Wallis said, because many who left to make their way in the outside world are now returning in large numbers after failing to find any kind of work because they have no experience or training.

"When you put a lot of adults and children together in one house, you get bedlam," Wallis said. "The children get no rest, they get no sleep, arguments break out between the adults and they come to school carrying all this."

Wallis has not lost hope, and she is careful in choosing her words to describe life here for young people. "I love these people with all my heart," she says.

Then she tells the story of a sixth-grade boy whose father got a new girlfriend. The woman didn't like the boy. "She said "Either he goes, or I go.' And guess who had to go? Now he's living with his cousins and he's suffering."

The boy grew angry in class at the reservation, she said, and he was pulled out by his relatives and sent to public school.

Children and teenagers here, despite the isolation and the cultural importance of turning inward, have only to sign on to the Internet, or turn on the satellite TV, to see that other people, in places not that far way, have things they don't.

"If you've never really been loved, how can you love yourself?" she asks. "How can you make something out of yourself?"

---

Associated Press writer Joshua Freed contributed to this report from Bemidji, Minn.

PRNewswire (Mar 10, 07:18 AM)  DUBLIN, Ireland, March 10 /PRNewswire/ -- Research and Markets (http://www.researchandmarkets.com/reports/c13775) has announced the addition of Gene Therapy - Technologies, Markets and Companies to their offering.

(Logo: http://www.newscom.com/cgi-bin/prnh/20040820/RESEARCH )

Gene therapy can be broadly defined as the transfer of defined genetic material to specific target cells of a patient for the ultimate purpose of preventing or altering a particular disease state. Genes and DNA are now being introduced without the use of vectors and various techniques are being used to modify the function of genes in vivo without gene transfer. If one adds to this the cell therapy particularly with use of genetically modified cells, the scope of gene therapy becomes much broader. Gene therapy can now combined with antisense techniques such as RNA interference (RNAi), further increasing the therapeutic applications. This report takes broad overview of gene therapy and is the most up-to-date presentation from the author on this topic built-up from a series of gene therapy report written by him during the past decade including a textbook of gene therapy and a book on gene therapy companies. This report describes the setbacks of gene therapy and renewed interest in the topic

Gene therapy technologies are described in detail including viral vectors, non-viral vectors and cell therapy with genetically modified vectors. Gene therapy is an excellent method of drug delivery and various routes of administration as well as targeted gene therapy are described. There is an introduction to technologies for gene suppression as well as molecular diagnostics to detect and monitor gene expression.

Clinical applications of gene therapy are extensive and cover most systems and their disorders. Full chapters are devoted to genetic syndromes, cancer, cardiovascular diseases, neurological disorders and viral infections with emphasis on AIDS. Applications of gene therapy in veterinary medicine, particularly for treating cats and dogs, are included.

Research and development is in progress in both the academic and the industrial sectors. The National Institutes of Health of the US is playing an important part. Worldwide, there are 918 clinical trials of which two-third are in the US. In the US, there are protocols for 572 clinical trials excluding the gene marker studies and non-therapeutic trials, of which 200 are actively pursued currently. The largest number of clinical trial protocols (405 out of 572) is for cancer. The report identifies the areas for future research.

Since the death of Jesse Gelsinger in the US following a gene therapy treatment, the FDA has further tightened the regulatory control on gene therapy. A further setback was the reports of leukemia following use of retroviral vectors in successful gene therapy for adenosine deaminase deficiency. Several clinical trials were put on hold and many have resumed now. The report also discusses the adverse effects of various vectors, safety regulations and ethical aspects of gene therapy including germline gene therapy.

The markets for gene therapy are difficult to estimate as there is only one approved gene therapy product and it is marketed in China since January 2004. At least two products are expected to be approved by 2005 and gene therapy markets are estimated for the years 2005-2015. The estimates are based on epidemiology of diseases to be treated with gene therapy, the portion of those who will be eligible for these treatments, competing technologies and the technical developments anticipated in the next decades. In spite of some setbacks, the future for gene therapy is bright.

Profiles of 180 companies involved in developing gene therapy are presented along with 196 collaborations. There were only 44 companies involved in this area in 1995. In spite of some failures and mergers, the number of companies has increased more than 4-fold within a decade. These companies have been followed up since they were the topic of a book on gene therapy companies by the author of this report. John Wiley & Sons published the book in 2000 and from 2001 to 2003, updated versions of these companies (approximately 160 at mid-2003) were available on Wiley's web site. Since that free service was discontinued and the rights reverted to the author, this report remains the only authorized continuously updated version on gene therapy companies

Benefits of this report

Up-to-date on-stop information on gene therapy with 67 tables and 12

figures

Evaluation of gene therapy technologies

Estimates of gene therapy markets from 2005-2015

Profiles of 180 companies involved and collaborations in this area

Who should read this report?

Biotechnology companies developing gene therapy

Academic institutions doing research in gene therapy

Drug delivery companies

Pharmaceutical companies interested in gene therapy

Gene therapy companies

Venture capital and investment companies

This report is updated on a monthly basis.

For more information visit http://www.researchandmarkets.com/reports/c13775

Laura Wood

Senior Manager

Research and Markets

press@researchandmarkets.com

Fax: +353 1 4100 980

Photo: http://www.newscom.com/cgi-bin/prnh/20040820/RESEARCH

Research and Markets

CONTACT: Laura Wood, Senior Manager of Research and Markets,press@researchandmarkets.com, Fax: +353-1-4100-980

Web site: http://www.researchandmarkets.com/reports/c13775

HealthSCOUT (Mar 28, 12:35 PM)  MONDAY, March 28 (HealthDayNews) -- Surgery to remove the prostate and radiation therapy are the two recommended treatments for prostate cancer, but a man's race and marital status appear to influence which of these treatments he will ultimately prefer, researchers find.

Blacks are more likely to choose radiation therapy, while whites more often opt for invasive surgery to eradicate prostate cancer, according to a new study. It also found that single men are more likely to undergo radiation compared to married men, who are more likely to choose surgery to fight their disease.

Despite these differences in treatments, all groups studied ended up receiving equal levels of care, according to the report in the March 28 online edition of Cancer.

"We looked at men over 65, white, black and Hispanic," said lead author Dr. Thomas Denberg, an assistant professor at the University of Colorado and Health Sciences Center, both in Denver. All of the men had been diagnosed with early stage prostate cancer.

In its study, Denberg's team collected data on nearly 28,000 men registered in the Surveillance, Epidemiology, and End Results (SEER) cancer database. "We wanted to see what treatment these men received," he said.

The researchers found that, for all groups, access to curative therapy was equal. However, "African-Americans were significantly less likely to get prostatectomy as a form of curative treatment," Denberg said. About 14 percent of blacks underwent surgery compared with 22 percent of whites. Among Latinos, 28 percent underwent surgery, according to the study.

"Being married also seems to be associated with higher rates of receiving curative therapy," Denberg said. In addition, married men were more likely to undergo surgery than radiation, he noted.

As to why these trends exist, Denberg said, it's impossible to know for sure. He speculates that two factors -- what doctors recommend, and patient differences -- may be at play. "Most likely, it's a combination of both," he said.

Denberg noted that "African-Americans as a group tend to be more fearful of surgery, or perhaps more distrustful of physicians. There may be issues related to impotence. African-Americans are more worried about impotence as a side effect of surgery," Denberg suggested. It's also possible that doctors are stereotyping their patients and not presenting all the treatment options, he added.

As far as marriage is concerned, Denberg believes married men are getting more input about treatment from their wives. "Wives tend to think that surgery is the better option," he said. "There is this notion that you are 'getting the thing out,' whereas with radiation it's invisible and [there is] a lack of certainty from the lay person's perspective."

Denberg is quick to point out that there is no basis for preferring surgery over radiation. Both treatments appear to be equally successful, he said.

The findings suggest doctors should "pay more attention" to patient factors such as race or marital status "if we want to maximize the ability of people to participate in their own care decisions," Denberg said.

These findings are not true of prostate cancer alone, said Dr. Herman Kattlove, a medical oncologist and spokesman for the American Cancer Society. "It's true of all disease."

Married men may also be more likely to have surgery because there is someone to help them recuperate afterwards, Kattlove pointed out. "You need help in recovering from surgery."

In terms of African-Americans, Kattlove agreed that they tend to be less trustful of doctors. "My experience in dealing with African-American patients is that they didn't trust the system, they didn't trust doctors."

Kattlove thinks there is no demonstrated difference in results between surgery and radiation for prostate cancer. However, "people tend to favor surgery because they want to get the cancer out. It's much more concrete than to depend on the effect of some unknown, magical principle of radiation," he said.

Side effects of surgery are seen immediately, while those from radiation may take longer to develop, Kattlove said. "After surgery men are impotent, incontinent, but some of that gets better in time; whereas, after radiation men do fine, but the effect of radiation begins to tell after a year or two. When you look at impotence rates [of both treatments], they are about the same after a couple of years."

More information

The American Cancer Society can tell you more about prostate cancer.

SOURCES: Thomas Denberg, M.D., Ph.D., assistant professor, University of Colorado and Health Sciences Center, both in Denver; Herman Kattlove, M.D., M.P.H., medical oncologist, spokesman, American Cancer Society, Atlanta; March 28, 2005, online edition, Cancer~RAC-~~MENS~~-PRO~~SURG~~DOCS~

Associated Press/AP Online (Mar 26, 12:24 PM)  ORLANDO, Fla. - It's the most common major cancer in America, even though it affects only one sex. Lifetime odds of getting it are 1 in 6. Testing for it is controversial, and treating it robs many of a body part that's important to their sexuality.

This isn't breast cancer, a disease tattooed into the American psyche. It is its male counterpart, which has made a much fainter mark.

Prostate cancer gets a fraction of what is spent on breast cancer research, and virtually nothing is known about what causes it.

It is the only cancer that doctors debate not just how to treat but whether they should at all. Nine out of 10 men don't need treatment but the rest will die, and there's no good way to tell them apart. It also kills at a higher rate than breast cancer. Nearly 32 men out of 100,000 will die of prostate cancer; 27 women out of 100,000 die of breast cancer.

Advocacy has been weak. Men don't like to wear little blue ribbons, and the field has suffered from lack of support.

Consider Dr. Ernie Bodai's situation. The California surgeon got a special postage stamp that has raised a whopping $50 million to fight breast cancer, a disease he cuts out of dozens of women's bodies each year. But he's been unable to win a similar stamp for his own cancer.

"The prostate cancer community is 10 years behind the breast groups in terms of being acknowledged and coming forward," he lamented.

Now, many are trying to catch up.

More than a thousand specialists, from surgeons to radiologists to dietitians, met in Orlando recently for a first-of-its-kind conference similar to the breast cancer symposium that's been held in Texas for 27 years.

"As San Antonio is to breast cancer, we want this to be for prostate cancer," said Dr. Eric Small of the University of California in San Francisco, who organized the meeting with several big cancer organizations.

What emerged from the three-day conference was a clearer picture of this murky disease and new insights into preventing, detecting and treating it. Among them:

-The immune system might be more effectively harnessed to fight this cancer than many other types. Doctors reported the first success using this approach.

-Smoking has less of an effect on prostate cancer risk than other cancers.

-Obesity affects the odds of dying from the disease more than the odds of getting it.

-Diet may play a key role. More is known about how specific nutrients affect the risk of prostate cancer than any other cancer type. Diet might even help explain why blacks have double the rate of the disease than whites.

-Treatments are improving. New techniques are minimizing surgery's side effects, and newer ways of giving radiation are allowing higher doses and better control of the disease.

-Use of the PSA blood test is being refined. Studies are evaluating whether a rising score means more than the score itself, and other ways to fine-tune interpretation. Other potentially better biomarkers for prostate cancer also are being studied.

-Doctors are starting to prescribe finasteride for some men at high risk of the disease after a big study found the drug could prevent prostate cancer, much as tamoxifen prevents breast cancer. The study was notable not just for its outcome, but also because 18,000 men took part, after years of studies begging for participants.

"This was a real question in the 1990s: If you gave a party, would the men show up?" said Dr. Howard Parnes, director of cancer prevention at the National Cancer Institute, which funded the study.

"Only one patient with prostate cancer is entered into a clinical trial for every four patients with breast cancer. That's our biggest challenge," Small said.

More than 232,000 American men are expected to be diagnosed this year with cancer of the prostate, a walnut-shaped gland beneath the base of the penis that makes seminal fluid. About 30,000 will die of it. Worldwide, 680,000 cases and 221,000 deaths are projected - figures that seem low primarily because in many poor countries men don't live long enough to develop it.

Cases climbed dramatically in the United States in 1988 and 1989 with the advent of the PSA blood test, which measures a protein the prostate makes when it's inflamed. The test is controversial because PSA can be high for many reasons, and there's no proof that screening saves lives.

In most men, prostate cancer grows so slowly that it will never threaten their lives. Treatment often leads to problems having sex or controlling the bladder, so finding a way to distinguish which tumors can safely be left alone is the field's top priority.

"We need to know who those people are so they can be spared unnecessary treatment," said Dr. Philip Kantoff, a prostate specialist at the Dana-Farber Cancer Institute in Boston.

It would help to know what causes the disease. It regresses when men are given drugs to block testosterone, yet the incidence of the disease rises as men age, when levels of the male hormone diminish.

"We still don't understand it to the degree we do any other cancer," said Dr. Durado Brooks, who heads prostate cancer research for the American Cancer Society.

Two genes have been implicated, and both are linked to inflammation, said Dr. William Nelson of Johns Hopkins University. Chronic inflammation or infection may set the stage, and a carcinogen, like smoking, may finish the job.

Scientists have done elaborate studies on carcinogens, like those generated by cooking meat at high heat. One even examined whether flipping burgers once or multiple times made a difference. The bottom line: Charring meat isn't good.

Diet is emerging as a possible way to prevent the disease. June Chan, a dietitian at the University of California in San Francisco, summarized studies on risk.

Bad: diets high in fat, red meat, dairy products and calcium.

Good: fish, soy, vegetables like broccoli and Brussels sprouts, and cooked tomato products rich in lycopene. Diet may be especially important in later life; a Harvard study found that most of the benefit of lycopene was in men 70 and older.

"This is the only cancer that I'm familiar with where we have this sort of micronutrient information," Brooks said.

Can diet prevent prostate cancer?

"The short answer to that is 'probably yes,'" said Dr. Meir Stampfer, chief of epidemiology at Harvard Medical School, where the possible benefit of selenium was first seen in studies in the 1980s.

"It's taken 25 years to get a randomized trial off the ground," he complained.

Michael Milken wants to help change the situation. The former Wall Street junk bond king founded the Prostate Cancer Foundation after his diagnosis in 1993.

"There was very little support for prostate cancer research," with the National Cancer Institute spending a mere $37 million, Milken said at the Orlando meeting, which his foundation helped sponsor.

A decade later, federal spending had risen to $390 million, but trailed breast cancer's $699 million. The pattern is the same at the American Cancer Society, which made 175 grants totaling $98 million this year for breast cancer, and 63 worth $36 million for prostate.

Milken's foundation says it has raised more than $230 million in roughly a decade and provided funding to more than 1,200 researchers around the world.

It's also trying to bring celebrity power to the disease. Bob Dole, Rudy Giuliani, Colin Powell and John Kerry have talked about having prostate cancer, but more voices are needed, said Leslie Michelson, the foundation's chief executive.

The National Basketball Association recently started airing "Act Like a Man" commercials to foster awareness. Fortune magazine is donating $750,000 and has made prostate cancer its charity of the year. New York and California have started income tax checkoffs for donations to research.

A more subtle sign is the box that recently landed on Thomas Kirk's desk in Chicago. Inside were hundreds of pale blue wristbands like the yellow Lance Armstrong ones that have become must-haves of fund-raisers and fashion. Kirk said the prostate cancer support group he heads, Us TOO, has learned a lot from Y-ME, the breast cancer group led by his wife, Margaret Kirk.

Advocacy "is part of our mission. It's not one of the ones we're strongest in," he admitted.

The prostate foundation also is working on a lapel pin it hopes men will be willing to wear, shaped like a blue necktie instead of a ribbon.

"We're starting to beat the drums, to get a voice for this important cause," Michelson said.

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On the Net:

Prostate Cancer Research Institute: www.pcri.org

Prostate Cancer Foundation: www.prostatecancerfoundation.org

American Cancer Society: www.cancer.org

National Cancer Institute: www.cancer.gov

Support group: www.ustoo.com

Birmingham Post; Birmingham (UK) (Mar 05, 06:15 AM)  Pregnant women, across Birmingham, have been urged to have HIV tests so doctors can help prevent it being passed on to their unborn child.

The Health Protection Agency (HPA) has revealed that nearly one in 100 children in the city has more reason than most to appreciate their mothers tomorrow.

They are now free fromHIV, following a joint venture by the HPA and the National Blood Service.

These infants were fortunate enough to have mothers, who agreed to be tested for the virus through a city-wide antenatal screening process.

Since the programme began in 2001, more than 65,000 women have been tested for the condition. Of those, nearly 100 (0.15 percent) were HIV positive. Diagnosing HIV early in pregnancy allows for 12 weeks of treatment to minimise the risk of passing it on to an unborn baby.

If a mother-to-be is tested positive, the Health Protection Agency (HPA) will monitor their response - and the baby's - to treatment. The agency will continue to observe the child's health for its first 18months, only after this time can they be sure they are not infected with HIV.

Without effective screening to control the virus, one in 54 of the babies would contract HIV, but with treatment only one in 100 are affected.

Dr Liz Boxall, consultant clinical scientist with the HPA and National Blood Service, said: 'Midwives from all Birmingham'smaternity units and local health advisers have done a fantastic job helping mothers decide on whether to take up the offer of screening.

'We are delighted at the take up levels in the city, which are as high as 95 per cent.

'This means in Birmingham mother-to-baby transmission of HIV will be a rare thing in the future

HealthSCOUT (Mar 02, 04:35 PM)  WEDNESDAY, March 2 (HealthDay News) -- The adage "practice makes perfect" may hold true for mammography, too: A new study suggests doctors become more accurate at interpreting mammograms as their experience increases.

Increasing the minimum number of mammograms a physician is required to read annually could improve his or her success at locating tumors, say researchers at the University of California, San Francisco.

The findings appear in the March 2 issue of the Journal of the National Cancer Institute.

U.S. doctors specializing in breast cancer are required by law, under the Mammography Quality Standards Act, to read at least 960 mammograms over a two-year period to maintain their qualifications for that task.

That number can be much higher in other countries, however. In Great Britain, for example, doctors are required to interpret 10 times that number per year.

Examining data from the Breast Cancer Surveillance Consortium and the American Medical Association Masterfile, the researchers found that the most accurate doctors were those who read between 2,500 and 4,000 mammograms per year and performed more regular screening mammography, rather than just diagnostic mammography.

Those doctors had 50 percent fewer incorrect diagnoses of cancer (false positives) than less-experienced physicians, and they missed only about one cancer per 2,500 examinations.

"Raising the annual volume requirements in the Mammography Quality Standards Act might improve the overall quality of screening mammography in the United States," the study authors concluded.

More information

The National Library of Medicine has more about mammography.

SOURCES: Journal of the National Cancer Institute, news release, March 1, 2005~WMEN~~MAMO~~-BRS~~DOCS~