Ray et al., pp. 13–23 Vanadium, a metallic element, is an essential component of some enzymes. Several organisms, including chicken and rat, are known to require small amounts of vanadium for growth and reproduction. In recent years, growing evidence has pointed to a protective role of vanadium in cancer development. A suppressive function of the micronutrient was uncovered for cancers of liver, lung, and the gastrointestinal tract. Ray and colleagues have now added breast cancer to this list. When vanadium in trace amounts was added to the drinking water of Sprague-Dawley rats, the incidence of chemically induced mammary adenocarcinomas was significantly reduced. While 90% of the control-treated rats developed palpable tumors after treatment with a carcinogen (DMBA), this only occurred in 50% of rats that were fed drinking water supplemented with vanadium. The authors further demonstrate that vanadium treatment reduces cell proliferation of the human MCF7 breast cancer cell line and is associated with the induction of p53-dependent apoptosis in rat mammary tissue. These results underline the potential benefit of vanadium added to vitamin and mineral preparations. Whether a vanadium supplement should be included in the therapeutic regimen of women with breast cancer should be investigated further. Incidence of palpable mammary tumors in rats treated with the DMBA carcinogen. One group (triangles) was fed drinking water supplemented with vanadium immediately after carcinogen treatment for 35 weeks, while the control group (circles) was fed regular drinking water. Rectangles indicate p values < 0.001, crosses mark p values < 0.05. Cantor et al., pp. 24–32 Several suspected tumor suppressors, including FHIT, WWOX, FRA3B and RASSF1A, are frequently silenced in lung cancer. Importantly, the expression of these genes is commonly suppressed at the level of epigenetic modifications, such as DNA methylation and histone deacetylation. These two epigenetic modifications are under the control of enzymes, DNA methylases and histone deacetylases that can be reversibly inhibited with small molecules. Reactivating the expression of such silenced tumor suppressor genes has shown therapeutic potential in hematopoietic malignancies, but no information is available on the feasibility of this approach for solid tumors, such as lung cancer. Cantor and colleagues report that conditional expression of the suspected tumor suppressors FHIT and WWOX in lung cancer cell lines using an inducible expression system is associated with inhibition of tumor growth in xenograft models. They also show that treatment of mice carrying xenograft H1299 tumors (a lung cancer cell line lacking expression of FHIT and WWOX) with an HDAC inhibitor (trichostatin A) and a DNA methylase inhibitor (5-aza-2-deoxycytidine) suppressed the growth of small tumors, but not large tumors. This inhibition of tumor growth was associated with a reactivation of expression of FHIT and WWOX and other tumor suppressor genes. While other mechanisms in addition to tumor suppressor reactivation could also play a role in the therapeutic effects of these agents, in particular induction of apoptosis via cell cycle abnormalities, these studies demonstrate the potential usefulness of these small molecule combinations for the treatment of solid tumors. Khatami et al., pp. 171–175 The number of men diagnosed with early-stage prostate cancer has dramatically increased due to a simple blood test that measures circulating prostate-specific antigen (PSA). Because of the slow growth of prostate tumors and because of the significant complications associated with treatment, men diagnosed with early-stage prostate cancer often choose to postpone active treatment. However, there are no reliable markers that can identify those patients in whom surveillance would be suitable. It is generally accepted that an average surveillance of 2 years does not reduce the chance of cure by radical prostatectomy. The study by Khatami and colleagues questions whether this is always an appropriate approach. In Sweden 10,000 men were invited to regular PSA screening tests. More than 600 were diagnosed with prostate cancer during a 10-year period, and less than half of them chose surveillance as an initial treatment option. The authors studied the risk of PSA recurrence in those patients who received radical prostatectomy after initial surveillance. They discovered that the risk of relapse was significantly associated with the PSA doubling time (PSADT) before operation. Men with a short PSADT (< 4 years) had a high risk of relapse while men with a longer PSADT were completely protected. The authors conclude that men with early-stage prostate carcinoma and a PSADT of > 4 years have an excellent chance of cure by prostatectomy after initial surveillance. However, other patients have a greater risk of disease progression and should be informed about this risk in discussions of treatment options.
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