Sound Medicine -- April 27, 2002

Barbara Lewis and Dr. Ora Pescovitz talk to physicians and researchers about:

Problems for clinical trials

Proteomics in breast cancer research

Breast cancer and ductal lavage

Problems for clinical trials

Two big problems face clinical researchers today. One is public concern about the safety of clinical trials and the other is a critical shortage of people willing to participate in clinical trials.

Shedding light on the topic is Dr. Bill Hendee, a member of the board of directors for the National Patient Safety Foundation. Dr. Hendee talks about the mission of the National Patient Safety Foundation, which is to improve clinical trial safety. He emphasizes the importance of researcher-patient communication in a clinical trial. He also weighs the pros and cons of using placebos in trials.

Dr. Hendee is associate dean for research and dean of the Graduate School of Biomedical Sciences at the Medical College of Wisconsin. This is an expanded interview first aired in 2001.

Resources

Dr. Hendee recommends visiting the Office for Human Research Protections (OHRP) and the Office of Human Subjects Research (OHSR), both especially good resources for medical professionals.

Get safety information on devices, such as breast implants, and procedures, such as LASIK surgery, at the Food and Drug Administration's Center for Devices and Radiological Health.

Proteomics in breast cancer research

The vocabulary of the human genome project is becoming part of the vernacular, and the newest buzzword is "proteomics." Proteomics is the study of proteins, which are the building blocks of the genes. Many scientists in this field apply their research toward understanding what makes genes go haywire, particularly in regards to cancer.

Dr. Linda Malkas, IU professor in the department of medicine, spends her days in the IU Cancer Center trying to figure out just what goes wrong in the genes that control replication in breast cancer cells, and has already found some answers.

Dr. Malkas explains in detail how her proteomic research will help future cancer patients with early detection techniques that will reveal genetic abnormalities and health risks. She explains how normal cells are different from cancer cells and how performing proteomic analyses enables researchers to find altered proteins in cancer patients. Current research is honing in on more specific causes of cancers, Dr. Malkas explains, as well as new drugs and methods to "turn off" cancer cells.

Resources

Even researchers don't know all the lingo. Look up scientific terms at the Proteomics Glossary.

Non-scientists can get a good overview of proteomics at the ABC News.com Web site.

Read more about Dr. Malkas's research, formerly at the University of Maryland, now at Indiana University.

Breast cancer and ductal Lavage

Proteomics isn't confined to the research lab and is already making a difference in cancer screening and early detection processes. Ductal lavage helps detect the earliest stages of cell abnormality in women at high risk for breast cancer, which is the first indicator that a tumor may soon follow. The procedure collects fluid from inside the breast's milk ducts, which is then analyzed for atypical cells.

Today we meet Dr. Robert Goulet Jr., who administers the test at IU. He is associate professor of surgery and medical director of the Ductal Lavage Program, part of IU's new Catherine Peachy Breast Cancer Prevention Program.

Dr. Goulet describes the procedure and patient candidates, and he explains how proteomics factor into this procedure. Researchers will soon be able to check a patient's pre-cancerous cells for susceptibility to drugs and treatments like topical chemotherapy. Dr. Goulet also explains how ductal lavage complements mammography, and other, not-yet-available exams, such using a miniature scope to survey the site in the duct where cancer may develop.

Resources

The National Cancer Institute provides a short overview of current breast cancer detection and diagnosis methodologies.

An article in the American Medical News discusses the first set of physician guidelines, released in January 2002, for the use of ductal lavage in high-risk patients.

Upcoming program:
Marriage expert Dr. Steve Bogdewic talks about what constitutes a healthy marriage.

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a. 10 percent
b. 20 percent
c. 40 percent

What's the answer?

It's springtime, and you'd like to lose a quick few pounds so you can fit into last summer's shorts. So you practically starve yourself for a few days, cut out all those carbohydrates, and sure enough you lose a bunch o' pounds fast. But as soon as you start eating a little more normally, all that weight reappears. What's going on?

Find out!

For busy people a daily walk is an excellent and manageable exercise program. A brisk walk can burn up to 100 calories per mile or 300 calories per hour. Here are some walking tips from the American Podiatric Medical Association.

• Buy a stable, well-cushioned pair of running or walking shoes.
• Wear thick, absorbent socks (acrylic is preferable to cotton).
• Start off gradually, with five or 10-minute walks three to five times a week.
• Begin your walks slowly, and gradually work up to a brisk speed that will cover a mile in 15 minutes (that's four miles per hour).
• To get significant benefits from walking, you must eventually be able to walk 20 minutes at a brisk pace without stopping. Walk no longer than an hour.
• A starting regimen should involve walking at least three times per week, but never exceeding five times a week. Walking every day denies the body the rest time it needs to repair minor injuries, and could lead to more serious ones.

Source: American Podiatric Medical Association