Among 11 candidate biomarkers under study in the UK MRC FOCUS trial, the largest-yet trial of metastatic colorectal cancer, levels of topoisomerase-1 (Topo1) appears to be the only one that predicts response to irinotecan in combination with fluorouracil. Patients with a high response to Topo1 gained a median 5.3 months of survival.

In the other arm of the trial, Topo1's predictive value for fluoruracil-oxaliplatin was suggestive but not significant, at p = 0.05.

Oncologists have been wondering aloud how to communicate with patients when (as in the study above), continuing chemotherapy offers only a few more months of life at the cost of adverse effects.

"When is enough enough?" ask the authors of an article in a recent issue of the Journal of the American Medical Association. 

Another recent report, this one in the Journal of Clinical Oncology,assesses prognostic factors for 2-month survival among hospitalized patients with advanced solid tumors. A combination of factors proved most predictive:

* Karnofsky index
* Number of metastatic sites
* Low serum albumin, and
* LDH concentration

The patient's desire to continue treatment was also associated with survival.

Evidence-based Articles

A recent article in BMJ Clinical Evidence by authors from the UK and Canada ponders whether adverse effects data from major trials like the one above can be relevant in community practice, and how to make them more so.

Related searches

topoisomerase-1 irinotecan

chemotherapy decision aids

Image via Wikipedia

Related articles

• Flat Colon Growths A Likely Cancer Cause [via Zemanta]
• New Skin Cancer Treatment Saves Man [via Zemanta]

Regard,
<
target="_blank">
src="http://signatures.mylivesignature.com/54486/198/78B4E07C165B69BF635D52A0D8C2D526.png"
style="border: none; background: transparent;"/>>

Fait très important, il manque à ce "checkmark" une petite particule néanmoins significative: je suis de garde demain de 8 à 8, et comme il s'adonne que c'est l'équipe de chir colorectale qui est de garde, mon samedi risque de ressembler drôlement au reste de la semaine...

Aujourd'hui, par bonheur, il n'y avait pas de salle d'op l'après-midi, pas de clinique externe, et pas de garde de consultations. Après la tournée et un petit ARC sur la dysphagie, j'ai donc pu m'en aller très tôt, et me voilà à la maison à 14:00 ! Miraculeux ! Je vais en profiter pour dooooooormir...

I know that I have been guilty of praying only when I felt my needs were important or desperate. But the Lord wants us to pray to Him, believing that He will respond.

He longs to bless us - He waits for us to acknowledge His desire to bless us. This includes praying for stamina during cancer treatments - it includes asking to be healed - it includes freeing up the traffic on the highway when you are dog tired and want to get home quickly. :-) God may not heal us from cancer but He will help us through the trial.

Here's a beautiful account of what God can do with the faith of a child.

This beautiful story was written by a doctor who worked in South Africa...

One night I had worked hard to help a mother in the labor ward; but in spite of all we could do, she died leaving us with a tiny premature baby and a crying two-year-old daughter. We would have difficulty keeping the baby alive; as we had no incubator (we had no electricity to run an incubator). We also had no special feeding facilities.

Although we lived on the equator, nights were often chilly with treacherous drafts. One student midwife went for the box we had for such babies and the cotton wool that the baby would be wrapped in.

Another went to stoke up the fire and fill a hot water bottle. She came back shortly in distress to tell me that in filling the bottle, it had burst (rubber perishes easily in tropical climates).

"And it is our last hot water bottle!" she exclaimed. As in the West, it is no good crying over spilled milk, so in Central Africa it might be considered no good crying over burst water bottles. They do not grow on trees, and there are no drugstores down forest pathways.

"All right," I said, "put the baby as near the fire as you safely can, and sleep between the baby and the door to keep it free from drafts. Your job is to keep the baby warm."

The following noon, as I did most days, I went to have prayers with any of the orphanage children who chose to gather with me. I gave the youngsters various suggestions of things to pray about and told them about the tiny baby. I explained our problem about keeping the baby warm enough, mentioning the hot water bottle, and that the baby could so easily die if it got chills. I also told them of the two-year-old sister, crying because her mother had died.

During prayer time, one ten-year old girl, Ruth, prayed with the usual blunt conciseness of our African children. "Please, God," she prayed, "Send us a hot water bottle today. It'll be no good tomorrow, God, as the baby will be dead, so please send it this afternoon."

While I gasped inwardly at the audacity of the prayer, she added, "And while You are about it, would You please send a dolly for the little girl so she'll know You really love her?"

As often with children's prayers, I was put on the spot. Could I honestly say, "Amen"? I just did not believe that God could do this. Oh, yes, I know that He can do everything, the Bible says so. But there are limits, aren't there? The only way God could answer this particular prayer would be by sending me a parcel from the homeland. I had been in Africa for almost four years at that time, and I had never, ever, received a parcel from home.

Anyway, if anyone did send me a parcel, who would put in a hot water bottle? I lived on the equator!

Halfway through the afternoon, while I was teaching in the nurses' training school, a message was sent that there was a car at my front door. By the time I reached home, the car had gone, but there, on the verandah, was a large twenty-two pound parcel. I felt tears pricking my eyes. I could not open the parcel alone, so I sent for the orphanage children. Together we pulled off the string, carefully undoing each knot. We folded the paper, taking care not to tear it unduly. Excitement was mounting. Some thirty or forty pairs of eyes were focused on the large cardboard box.

From the top, I lifted out brightly colored, knitted jerseys. Eyes sparkled as I gave them out. Then there were the knitted bandages for the leprosy patients, and the children looked a little bored. Then came a box of mixed raisins and sultanas - that would make a batch of buns for the weekend. Then, as I put my hand in again, I felt the.....could it really be? I grasped it and pulled it out yes, a brand new, rubber hot water bottle. I cried.

I had not asked God to send it; I had not truly believed that He could. Ruth was in the front row of the children. She rushed forward, crying out, "If God has sent the bottle, He must have sent the dolly too!"

Rummaging down to the bottom of the box, she pulled out the small, beautifully dressed dolly. Her eyes shone! She had never doubted! Looking up at me, she asked: "Can I go over with you and give this dolly to that little girl, so she'll know that Jesus really loves her?" Of course, I replied!

That parcel had been on the way for five whole months. Packed up by my former Sunday school class, whose leader had heard and obeyed God's prompting to send a hot water bottle, even to the equator. And one of the girls had put in a dolly for an African child - five months before, in answer to the believing prayer of a ten-year-old to bring it "that afternoon."

"Before they call, I will answer." ~Isaiah 65:24

When John and I first heard the doctor say, "You definitely have cancer," it was as if we had been punched in the stomach. You've been there, haven't you? You receive the blow, the wind is knocked out of you and it seems as though you can't breathe! Instinctively, we reached for each other's hand and held on. I remember looking down at our hands intertwined and not being able to tell which were my fingers and which were his. He clutched on to me so tightly that his knuckles were turning white. This was going to prove to be one of the hardest trials we would encounter as man and wife.

The doctor's words seemed to fade as thoughts rushed into my head. The feelings of being overwhelmed came over me and it was at that moment that the Lord reminded me of who we were. We are a child of the King and the God of Glory is still on His throne. Immediately, I felt His presence like a warm blanket! I placed my other hand over John's hand and said a short prayer in my heart, "Lord, give us strength and comfort us at this hour of need." It was as if John reaped the benefit of that plea and his hand began to let go of the death grip. We were reminded of the words that God spoke to Isaiah,

"But now thus saith the LORD that created thee, ... I have called thee by thy name; thou art mine." ~ Isa. 43:1

It is at times like these that we face our own mortality. The world has no hope when they hear news of this nature. Christians, on the other hand, rest in the knowledge that we are the Lord's and He knows us intimately. He knows just when His child needs protection, comfort, and encouragement. He does not remove the trial but gives us exactly what we need at the time we need it. "He shall cover thee with his feathers, and under his wings shalt thou trust: his truth shall be thy shield and buckler." ~ Psa. 91:4. The fiery trials of cancer can be like the storms on the sea but under His wing we are protected.

Yes, cancer does cast a shadow on our day-to-day lives. However, we have the blessed light of God's Word which punches through that shadow with peace, comfort, and encouragement.

"Wherein ye greatly rejoice, though now for a season, if need be, ye are in heaviness through manifold temptations: That the trial of your faith, being much more precious than of gold that perisheth, though it be tried with fire, might be found unto praise and honour and glory at the appearing of Jesus Christ:" ~ 1 Peter 1:6-7

The Christian has God's Holy Word to turn to for comfort and encouragement while fighting the trial of cancer. Applying it to our lives brings glory to God!

Best Wishes,

Kate Plourde

*****

If you know someone who could use some encouragement in this area, please tell them about us! God bless you!

Kate

(Job 23:10) But he knoweth the way that I take: when he hath tried me, I shall come forth as gold.

I've seen study after study and devotion after devotion on this verse. But until you personally experience a series of trials in your own life, and experience this verse, you really can't fully appreciate what others are trying to explain. So it was for me! Although I was greatly blessed by reading those studies, I have to admit that it wasn't until recently that I have fully appreciated Job 23:10! For those of you who do not know, I have two sons. Aaron just joined the U.S. Army and is at Basic Combat Training in Ft. Leonard Wood, MO. Adam is a U.S. Marine and is wrapping up his MOS training in Coronado, CA. My husband and I recently sold our house and downsized to a two-bedroom apartment! We were planning our retirement and were scheduled to leave Virginia after May 1st. That is, until we found out a couple of weeks ago that John has been diagnosed with cancer. Radiation, chemo, surgery and follow-up treatments are what lie in store. I truly praise the Lord that at least I have my sons and my husband! I have not suffered as Job suffered, that is for sure! But I can surely sympathize with him and understand his account so much more as I go through these trials.

It is the first part of the verse that spoke to my heart, actually. The Lord knows the way that I take! This brings me much comfort knowing that my Shepherd knows my way. He has seen the future and knows the results of all that is going on in my life! My Creator, who has numbered the very hairs on my head, knows me intimately and cares for me. No matter how discouraged I may get, I can turn to the Word and the Lord gives me something that encourages my heart! (Psa 61:2) From the end of the earth will I cry unto thee, when my heart is overwhelmed: lead me to the rock that is higher than I. Our Heavenly Father hears our pleas of despair and comes to our rescue! (Psa 18:6) In my distress I called upon the LORD, and cried unto my God: he heard my voice out of his temple, and my cry came before him, even into his ears. Thank You, Lord! I glorify Your Name on high!

Job's reputation has followed him through the ages because he was able to claim this verse in the Bible. Even to this day, we hear the phrase "He has the patience of Job." The trials that this man suffered are unbelievable, aren't they? Job was attacked on every side by ole slew foot! The devil attacked Job's character, he attacked Job's belongings (cattle, etc.), he attacked Job's servants, he attacked Job's family, and he attacked Job's own body! There is no one, that I know of personally, who has been through each of these in his life time - let alone within just a few weeks! I have learned that the Lord never gives us more than we can bear! With each burden, he provides us encouragement along the way. It is up to us to search out that encouragement! The Word should be our main source of encouragement! The title of my blog shows who that Source is: (Psa 121:1) [A Song of degrees.] I will lift up mine eyes unto the hills, from whence cometh my help. (Psa 121:2) My help cometh from the LORD, which made heaven and earth.

I also noticed that Job did not get to the point where he cursed the day he was born until after his friends came to "comfort" him! The devil kept attacking him and saw that he could not succeed so he sent along people he could "use" to accomplish his goal - discouragement. Where do you sit today, my friend? Are you one in need of encouragement or are you to be used of God to do the encouraging? Are you the type of friend that Job had? As I searched my heart, I realized that although I was experiencing trials of my own, there are many out there who are going through things that make mine look like child's play! What kind of friend am I to those dear ones who are suffering?

If you are one who is experiencing trials today, do you surround yourself with whiners, complainers and nay sayers? It is these types of friends who will drag you down spiritually. Surround yourself with people who love the Lord, will pray for you and are there to lend an ear just in case you need one. Turn to your spiritual mentors who will not allow you to wallow in self-pity but will help you out of the pit of despair. You cannot expect someone who cannot swim to rescue you from drowning! Therefore, do not turn to those Christians who will nurture your discouragement instead of lifting you up in the Lord.

I don't know why the Lord laid this on my heart today. Maybe I will need this down the road - or maybe you are going through a similar trial and need to be encouraged! With that said, won't you say as Job did, (Job 23:10) But he knoweth the way that I take: when he hath tried me, I shall come forth as gold.

I thought it would be nice to have a place where born-again Christians with cancer, or who have family with cancer, can come together and share Scriptures, experiences, tips, encourage each other, etc. 

My husband, John, was diagnosed with stage one colorectal cancer about a month ago.  His radiation and chemo treatments begin either today or tomorrow.  Our church family has been wonderful and encouraging.  However, I must admit that it is way more encouraging to talk to those who have been through cancer.  I don't know what people do without the Lord, to be honest with you!  It has been a roller coaster ride to say the least and I know that we have just begun.  If I could take this trial away from my husband I would.  My heart breaks at what lies ahead but I know that the Lord will be there right beside him.

So, I hope that this blog will end up growing and that we can be of help to one another.  I have come to love these precious verses!

(Psa 18:6) In my distress I called upon the LORD, and cried unto my God: he heard my voice out of his temple, and my cry came before him, even into his ears. (Psa 121:1) [A Song of degrees] I will lift up mine eyes unto the hills, from whence cometh my help.

So, I am hoping that this blog can make a difference in the lives of those with cancer and those who have family with cancer.  With the Lord's help and grace, we can go through anything and He will sustain us!

Déjà pratiqué avec succès dans le Haut-Rhin depuis 2003, le dépistage du cancer colorectal se met actuellement en place dans le Bas-Rhin.

L’extension du dépistage à toute l'Alsace est d'autant plus importante que la région détient le record de France du nombre de cancer du colon !

Le dépistage s'adresse, là aussi, aux personnes âgées de 50 à 74 ans, et fait largement appel à la mobilisation des médecins généralistes.

La campagne, financée principalement par l'assurance-maladie, repose sur des lettres adressées à la population cible par l'Association pour le dépistage du cancer colorectal en Alsace (ADECA). Elles invitent les personnes concernées à aller retirer un test Hémoccult 2 chez leur généraliste. Puis à l'utiliser à domicile et à le renvoyer à un centre d'examens régional.

Les généralistes ont été formés pour sensibiliser et faire connaître le test à leurs patients, et contribuent ainsi largement au succès de cette campagne.

Etes-vous âgé de plus de 50 ans ? Vous savez ce qu'il vous reste à faire... même si vous n'êtes pas Alsacien !

Source : Le Quotidien du Médecin 29/02/08