BRCA1 mutations account for less than 5% of breast cancers, but up to 1% of the Jewish population has such a mutation. Up to 80% of BRCA1 carriers can go on to devlop breast cancer.

The BRCA research group in Toronto looked at which chemotherapy works best in patients with a BRCA1 mutation and breast cancer. The paper is published in this week's JCO.

NEJM has a pair of papers this week about two new drugs for multiple sclerosis: cladribine, which I use as a chemotherapy drug, and fingolimod, which is an immunosuppressive drug affecting lymphocyte function.

Here's a quote from NYT today: "Stomach cancer patients who received Herceptin in addition to standard chemotherapy lived a median of 13.8 months compared with 11.1 months for those who treated with standard chemotherapy alone." Herceptin? So this is a survival improvement of almost three months in a tough to treat area. If true this result makes herceptin FDA approvable for gastric cancer. It appears that the drug is being used in patients with a high Her-2 level in their original tumors though details are scanty.

The problem of nausea associated with chemotherapy has been with us for at least fifty years. Though we have better medications to fight chemo nausea the medications are sometimes inconvenient and expensive. Researchers have found that acupressure wristbands work better than placebo in relieving chemo nausea. The effect is around 25% relief. The medications zofran and compazine have about a 50% relief rate while the placebo rate was less than 10%. Patients given papers promising a good response were just as likely as patients not "primed" to get a good reaction to the wristbands.

From the 2009 meeting of the Society of Gynecological Oncology an abstract showing that as few as 20% of patients make it all the way through a protocol of intraperitoneal chemotherapy for ovarian cancer. Two years ago we had a "back to the future" moment when it was revealed that intraperitoneal chemotherapy was superior to regular chemo in patients successfully treated surgically for ovarian cancer.

Add green tea to the list of substances that interact with chemotherapy. Velcade also known as bortezomib is an important treatment for multiple myeloma. It seems to interact with green tea "products " according to a new report in the journal Blood. The report indicates that levels of polyphenols in green tea extracts could be high enough to interact with boron-containing medicine such as Velcade and researchers urge clinicians to warn patients against using these supplements if they are on this chemo treatment.

A report out this week presents results of bone marrow stem cell transplant to treat multiple sclerosis. This is the second report this week showing that techniques usually reserved for malignancy are also useful for multiple sclerosis. Bone marrow stem cells are used to rescue the immune system after high dose chemotherapy is given to MS patients--similar to treatments usually reserved for patients with lymphomas and other types of malignancies. Are MS and lymphoma really the same disease just different manifestations?

Bisphenol A (BPA) is an industrial chemical typically used in making plastic stronger. It is also utilized in sealing food cans baby bottles water bottles some food containers CDs and dental sealants and prevents liquid leaking out of bottles. It actually persuades a group of proteins that defend cancer cells from the toxic effects of chemotherapy. BPA falls under the “some concern” categories. BPA has been in the news recently because of its probable health vulnerability.

You read it here first: the marketplace has taken the place of academic research centers when it comes to testing the relative worthiness of new drug treatments at least in oncology and hematology. We used to do comparative studies in oncology: the great studies of the 1980s and 1990s trying to figure out the best way to treat lymphoma or breast cancer were very instructive to us clinicians (even those of us who were in high school when they came out!) They don't seem to do studies like that any more.

Blood transfusion is the method of moving blood or blood-based products from one person into the circulatory system of another. A transfusion is the inoculation of a blood product by way of a needle inserted into a patient’s vein.