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Twin Has Stomach Removed After Genetic Cancer Tests BOSTON--Watching her twin sister die of a rare hereditary stomach cancer pushed Natasha Benn into a life altering decision--surgeons removed her healthy stomach before she also fell victim to the genetic disease. A report in The New England Journal of Medicine discussed Benn's decision eight years ago and how others in her family have also chosen to have their healthy stomachs removed. The pre-emptive surgery has been performed on Benn's older sister, and three members of another family. They are hoping to protect themselves from the same lethal form of stomach cancer that killed Benn's mother when she was 29, along with her grandmother, great-grandfather, and great-aunt. The cancer is caused by the gene known as E-cadherin. Those born with a mutated form of the gene are unable to produce a necessary protein. Cells that need this protein then break free and invade other body tissues as cancer. The stomachs of all five patients that underwent the removal surgery showed previously undetected early traces of the cancer. The disease had gone undetected by all other methods of examination. Genetic tests helped these five individuals determine whether or not to have the surgery. The mutated gene had left them with an 80% chance of developing stomach cancer. It is not known how long they would have lived if they hadn't chosen the pre-emptive surgery. Afterward, patients must learn to eat differently. Without stomachs, people lose weight and must eat in smaller quantities. However, the small intestine can generally digest food without the stomach present. Stomach cancer is the 13th most common cancer. Information from www.cnn.com For more information about stomach cancer or pre-emptive surgeries, visit: FDA Approves First
Oral Chemotherapy
for Colorectal Cancer PHOENIX, Ariz--The Food and Drug Administration (FDA) has approved Xeloda (capecitabine) as the first oral chemotherapy to treat metastatic colorectal cancer. The drug, manufactured by Hoffman-La Roche, is the second treatment for colorectal cancer approved in the US in more than 40 years. As an oral drug, colorectal cancer patients can now take their treatments while living everyday lives. The FDA decided to approve the drug after results of two studies showed Xeloda shrinks tumors more effectively than traditional treatments for colorectal cancer. The drug has shown to reduce tumors by 50% in 21% of patients treated. The most common adverse events, which are more common in patients 80 or older, include: diarrhea, nausea, vomiting, stomatitis, abdominal pain, upset stomach, constipation, loss of appetite, and dehydration. Side effects include hand-foot syndrome, rash, dry, itchy, or discolored skin, nail problems, and hair loss. Frank J. Brescia, MD, said the drug brings convenience into the treatment of cancer. "It is an extremely useful agent. First, it is an oral agent, which patients can take themselves and not need to stay in a clinic with an IV. It works in a variety of tumors including colon, and breast (25%), and there are a number of studies (examining) other tumors--ovarian, liver, and pancreatic, (where) it also may be effective," he said. The executive director of oncology at Roche said the drug allow those who need treatment to continue with their regular daily schedules. "As an oral medication, Xeloda provides a lifestyle benefit by allowing patients with colorectal cancer greater flexibility since they can take the drug on the go and do not have to endure time-consuming intravenous chemotherapy at a hospital or clinic," said Amar Singh. "Xeloda is also covered by Medicare." Colon cancer is the third most common cancer in the US, with an estimated 130,000 new cases reported annually. For more information about Xeloda, visit:
Endo All Star: Debbie ZinkEach month, EndoNurse® would like to highlight outstanding endoscopy team members.
This month's nominee is from Thunderbird Samaritan Hospital in Phoenix, Ariz. Debbie Zink has been working as an acute care nurse for 21 years, with 15 years in the endoscopy suite. She is an RN and the endoscopy supervisor for the hospital. She received her associate degree in nursing at Northern Arizona University and was the 2001 recipient of the SGNA's Crohn's/Colitis Foundation GI Nurses of the Year Award. Her life goal is to make each day count. "This isn't a dress rehearsal," she said. She also prides herself in trying to always wear a smile. Debbie has been married for 20 years and has one daughter. Congratulations to Debbie for being an Endo All Star! If you would like to nominate someone you know, email kdonley@vpico.com for more information. Crohn's Disease Linked to Gene WASHINGTON, DC--Crohn's disease keeps more than 500,000 Americans close to their bathrooms each day. It causes severe diarrhea, bleeding, fever, and malnutrition and it usually strikes those under 30. With researchers decoding the human genome, scientists are trying to pinpoint the genetic origin of many diseases, including Crohn's. They have found an abnormality that exists in plants as well as humans that may increase a person's risk of developing Crohn's disease. The disease, which causes chronic inflammation and shedding of the digestive tract lining, may be connected to a gene mutation on chromosome 16. American and French researchers are trying to understand why the mutation seems to make some people very ill with the disease, while others remain healthy. The Nod2 gene encodes a protein that helps the body's innate immune system. Without this protein, the body has a more difficult time fighting off bacteria. This same protein also helps plants fight off sickness. Of those Crohn's patients researchers have examined, 15% carry the altered gene. Although it is unclear why the gene could lead to the disease, it is believed that when the gene is damaged, the immune system overreacts and may attack healthy intestinal cells. This could lead to the chronic inflammation and shedding attributed to Crohn's. Information from www.cnn.com For more information on Crohn's disease visit: www.ccfa.org/, www.healingwell.com/ibd Talk Back! Endoscopy team members share some of their more bizarre foreign body removal stories... Mark DeLegge, MD, associate professor of medicine at the Medical University of South Carolina, once removed a screwdriver from the colon. Manuel Marcelo Antequera Villagra, MD, from Hospital Getulio Vargas in Rio de Janeiro, Brazil, removed pens and knives from the stomachs of psychiatric patients. David Weinberg, MD of Methodist Hospital in St. Louis Park, Minn, once removed an intact bay leaf from a patient's stomach. Debbie Zink, RN, endoscopy supervisor at Thunderbird Samaritan Medical Center in Phoenix, Ariz, once removed a stainless steel fork from a prisoner's stomach. Next issue's talk back: What is your favorite endoscopy joke? Submit your entries to: kdonley@vpico.com
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