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Aging: How growing older affects Cancer
risk and outcomes
SAN DIEGO -- As our
population ages and senior citizens become a
larger demographic, cancer researchers are
focusing on the links between aging and
cancer. Studies presented at the 2008 Annual
Meeting of the American Association for
Cancer Research, April 12 – 16, highlight
the biological aspects of aging that are key
to greater risk and poorer prognosis, and
surgical outcomes.
Although fewer of them
undergo surgery, lung cancer patients in
their 80s fare equally well following
surgery as their younger counterparts,
researchers report. The findings offer
doctors potentially valuable guidance in
treatment options for elderly patients,
according to researchers.
A research team from
the Hoag Cancer Center in Newport Beach,
California, observed 1,293 patients with
lung cancer, 482 of whom underwent surgical
treatment.
The oldest patients
were more likely to be male. Older patients
were also more likely to have localized
disease.
Overall, the rate of
surgery did not differ by age group.
However, when primary lung cancer was
considered separately, only 31.7 percent of
patients older than 80 underwent surgery for
their primary lung cancer compared with 38.5
percent of patients younger than 80.
For patients with
non-small cell lung cancer, the rate of
surgery was 64 percent for those older than
80 and 83 percent for those younger than 80.
For patients with
regionally advanced disease, the rate of
surgery for patients age 80 or older was 35
percent compared with 49 percent for those
younger than 80 years old.
The five-year survival
rate following surgery was 62 percent for
those patients older than 80 compared with
53 percent for those aged 70 to 79 years.
Among patients age 60
to 69 years and 50 to 59 years, the survival
rate was 63 percent. For the youngest
patients, those younger than 50, the
survival rate was 79 percent.
“Although a smaller
proportion of patients over the age of 80
underwent this type of surgery, their
survival rate was comparable to the younger
age groups,” said lead author Robert O.
Dillman, M.D., medical director of the Hoag
Cancer Center in Newport Beach, California.
New research has
established that elevated blood levels of
interleukin-12, which rise as we age,
independently predicts poor prognosis in
patients with melanoma.
Interleukin-12 is a biological therapeutic
agent that has been shown to act on the
immune system and increase the body’s
ability to fight disease. It has also
previously been shown to interfere with
blood flow to the tumors
However, the current
study suggests that elevated interleukin-12
may play a role in poor prognosis for
melanoma.
“This marker tends to
increase with age, which could explain the
link between age and poorer prognosis of
this type of skin cancer,” said lead author
Yun S. Chun, M.D., a surgical oncology
fellow at the University of Texas M. D.
Anderson Cancer Center.
As they predicted, Chun
and colleagues found that blood levels of
interleukin-12 rose with age.
Among patients younger
than 40, the average level of interleukin-12
was 75 pg/ml, those aged 40 to 59 had a
average level of 84 pg/ml, those from 60 to
79 years had a level of 96 pg/ml and
patients older than 80 had an average level
of 112 pg/ml.
When researchers
estimated risk factors for mortality among
patients with melanoma, older age by itself
did not predict risk.
However, late stage
disease and an elevated level of
interleukin-12 did predict mortality.
Specifically, for
patients with late stage disease and an
interleukin-12 level above 150 pg/ml, the
risk of mortality was four times higher than
that for patients with levels of
interleukin-12 that were below 150 pg/ml.
“Among patients with
melanoma, it is possible that elevated
interleukin-12 may be a marker of a tumor
promoting, rather than a tumor inhibiting,
response,” Chun said.
Aging and DNA
methylation in Alu and LINE-1 repeated
elements: Abstract 557
An age-related decrease
in DNA methylation, the process whereby
genes are shut off and chromosomes packed up
in complex strictures, could potentially
lead to cancer development, according to
researchers.
Approximately 55
percent of the human genome consists of
repetitive elements, including approximately
500,000 long interspersed nucleotide
elements (LINE) and 1.5 million repetitive
elements of the Alu DNA sequences.
Typically, these
sequences undergo heavy methylation.
Previous human studies
have linked a lack of methylation among LINE
and Alu repetitive elements with disease.
However, whether the unsteadiness of these
elements is unrestrained with age had not
yet been established.
For the current study,
researchers from the Center of Molecular and
Genetic Epidemiology at the University of
Milan in Italy, in collaboration with
investigators at the Harvard School of
Public Health, Boston, MAmeasured DNA levels
in 693 patients.
Patients gave up to
three blood samples, taken approximately
three years apart from each other.
Overall, the older a
patient grew, the less likely these elements
were to methylate. Specifically, researchers
found a 0.016 percent decrease for LINE-1
elements and a 0.015 percent decrease for
Alu repetitive elements for each year of
increased age.
The mission of the
American Association for Cancer Research is
to prevent and cure cancer. Founded in 1907,
AACR is the world's oldest and largest
professional organization dedicated to
advancing cancer research.
The membership includes
nearly 27,000 basic, translational, and
clinical researchers; health care
professionals; and cancer survivors and
advocates in the United States and more than
70 other countries. AACR marshals the full
spectrum of expertise from the cancer
community to accelerate progress in the
prevention, diagnosis and treatment of
cancer through high-quality scientific and
educational programs.
It funds innovative,
meritorious research grants. The AACR Annual
Meeting attracts more than 17,000
participants who share the latest
discoveries and developments in the field.
Special Conferences throughout the year
present novel data across a wide variety of
topics in cancer research, treatment, and
patient care. AACR publishes five major
peer-reviewed journals: Cancer Research;
Clinical Cancer Research;
Molecular Cancer Therapeutics;
Molecular Cancer Research; and Cancer
Epidemiology, Biomarkers & Prevention.
Its most recent
publication and its sixth major journal,
Cancer Prevention Research, is the only
journal worldwide dedicated exclusively to
cancer prevention, from preclinical research
to clinical trials.
The AACR also publishes
CR, a magazine for cancer survivors,
patient advocates, their families,
physicians, and scientists. CR provides a
forum for sharing essential, evidence-based
information and perspectives on progress in
cancer research, survivorship, and advocacy.
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