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Push is on to tailor cancer care to tumor's genes

This undated handout photo provided by Cole Rodger shows Clair Weinberg during a model shoot in Oxford, N.C..
(AP Photo/Cole Rodger)WASHINGTON – The days of one-size-fits-all cancer treatment are numbered: A rush of new research is pointing the way to tailor chemotherapy and other care to what's written in your tumor's genes.
Everyone with advanced colon cancer now is supposed to get a genetic test before taking two of the leading treatments. It's a major change adopted by oncologists last month after studies found that those pricey drugs, Erbitux and Vectibix, won't work in 40 percent of patients.
Scientists are furiously testing similar genetically tailored care in breast and lung cancer. It's a flurry of work that reflects a huge problem: Most medications today benefit at best about half of patients but it usually takes trial-and-error to tell.
That means a lot of people suffer side effects for nothing, and it's incredibly costly. When the American Society of Clinical Oncology recommended giving colon cancer patients that $300 test for a gene called KRAS, it estimated the move could save a stunning $600 million a year — by keeping drugs that cost up to $10,000 a month away from patients who won't benefit.
Here's the critical consumer issue: As tantalizing as this personalized medicine is, gene testing is like the Wild West. Laboratories often introduce new tests at the first clues they might work, not waiting for final proof. Few tests so far have won the backing of major medical groups like ASCO, the cancer specialists, making research studies a best bet for many patients.
"A bad test is as dangerous to a patient as a bad drug," notes Dr. Richard Schilsky, ASCO president and a University of Chicago oncologist. "The tricky part is to figure out which of those (genetic differences) are clinically important and which are just variations that exist."
This is not about testing if people carry so-called cancer genes that make them prone to illness. Instead it's about finding a tumor's genetic signature — a pattern of gene and protein activity that signals if the cancer will grow fast or slowly, be more or less likely to recur, and whether it would be susceptible to treatment.
"We're getting into science fiction sort of, if now medicine is being able to analyze things at the genome level," breast cancer patient Claire Weinberg of Oxford, N.C., says in wonder.
A community hospital initially dismissed Weinberg's breast lump but she fortunately sought a second opinion at Duke University Medical Center — where, cancer confirmed, she enrolled in a study of gene-directed chemotherapy.
"I felt it could only benefit me for them to know even more about me," she says.
The ultimate goal: "What's the right recipe for those patients?" explains Dr. Matthew Ellis of Washington University in St. Louis, co-inventor of a different breast cancer genetic approach.
Under study:
_A less precise test already can tell certain breast cancer patients if they're at high or low risk of relapsing, helping the chemo-or-not decision. But which chemo? Duke's Dr. Kelly Marcom is genetically profiling breast biopsy tissue from nearly 300 newly diagnosed patients headed for pre-surgery chemo. Some are randomly assigned to one of two standard chemotherapy cockails; the rest get the cocktail that matches their tumor profile.
It's too early to tell if the gene-directed approach helps more tumors shrink.
But, "I can have no regrets," says Weinberg, who learned after surgery that she'd been in the gene-tailored group and her tumor shrank enough to save her breast. She's also getting post-surgery chemo in case any rogue cells remain.
_Instead of custom profiling, an experimental test unveiled last week examines 50 breast cancer genes to determine which of four disease subtypes the woman has.
If it pans out — and much larger studies are planned — the Breast Bioclassifier could change breast cancer's very names. When studied on stored samples of old tumors, researchers found some women safely skipped chemo — their subtype responded better to post-surgery tamoxifen, or hormone therapy. A more aggressive type was sensitive to most chemo choices but not hormone treatment, the team reported in the Journal of Clinical Oncology.
And still another group didn't respond well to either care, a group that desperately needs new options, said Ellis, who co-developed the test with doctors at the University of Utah and University of North Carolina, Chapel Hill.
_Next up, lung cancer. Hospitals nationwide are recruiting 1,200 lung cancer patients to study who carries extra copies of the tumor-spurring gene EGFR. They'll get either of two top treatments, Tarceva or Alimta, to see which is best for which genetic condition.
Via : news.yahoo.com
America's Best and Worst Burgers
The burger industry in America is looking more and more like an arms race these days. Every few months, we watch in horror as another bacon-enhanced, cheese-embalmed, ranch-riddled weapon of mass inflation hits menu boards at the country’s largest restaurant chains.
The Baconator, the Monster Thickburger, the FlameThrower — they sound like weapons, not something you’d order for dinner.
What makes our hamburger habit particularly scary is the Super Size Phenomenon, which for years has been mutating our burgers into double burgers and our double burgers into 1,250-calorie Triple Whoppers with Cheese.
A 1957 burger contained little more than one ounce of meat, but by 1997 that same meat wad had grown to six ounces. Stack one of the bloated burgers out there next to a beverage like those among these unhealthiest drinks in America and you’re risking two days' worth of calories in a single, misguided meal.
Each year Americans eat about 40 billion burgers, which means that each of us downs nearly 150 of them. Choose better burgers, and you can save 10 or 15 pounds over the course of a year.
To get you started on your own burger war, we’ve compiled a list of the seven greasiest patties ever to be sandwiched between two buns. But because we understand you still need your burger fix, we’ve thrown in five of our favorites that you can eat with relative impunity (along with a delicious burger recipe at the end of this post).
Chili’s Smokehouse Bacon Triple-The-Cheese Big Mouth Burger with Jalapeno Ranch Dressing
2,040 calories
150 g fat (53 g saturated)
110 g protein
4,900 mg sodium
You know this burger's in trouble when it takes more than 20 syllables just to identify it. If you think the name’s a mouthful, just wait until the burger hits the table. You’ll be face to face with two-and-a-half day’s worth of fat — a full third of which is saturated. To do that much damage with roasted sirloin, you’d have to eat about eight 6-ounce steaks. It’s nearly three days’ worth of saturated fat.
T.G.I. Friday’s Cheesy Bacon Cheeseburger
1,590 calories
unknown g fat
unknown mg sodium
Although Friday’s is mum on the fat and sodium, it takes only one number to realize that this burger suffers from bigger-is-better syndrome. T.G.I. Friday's average burger has 1,250 calories, and their appetizers are some of the toughest in the country to swallow, calorie-wise, as we've shown with this America’s worst appetizers list.
Red Robbin A.1. Peppercorn Burger
1,440 calories
97 g fat
There’s hardly a burger on Red Robin’s menu that contains fewer than a thousand calories. What pushes this particular burger to the position of worst — aside from the gratuitous use of cheese and bacon — is the bed of fried onion straws wedged between patty and bun. Now we’re beginning to understand why, while researching the story 16 Secrets the Restaurant Industry Doesn’t Want You to Know, it may have taken Red Robin so long to come clean about the impact of its burgers.
Denny’s Double Cheeseburger
1,540 calories
116 g fat (52 g saturated, 7 g trans)
3,880 mg sodium
Add this to our ever-expanding list of the Trans-Fattiest Foods in America. (This burger has more than three days' worth of the stuff.) In fact, with as much saturated fat as 52 strips of bacon and more sodium than 21 small bags of Lay’s potato chips, this burger also belongs on the salt-packed list of 20 Foods Your Cardiologist Wouldn’t Eat.
Dairy Queen ½ lb. FlameThrower GrillBurger
1,140 calories
82 g fat (27 g saturated, 1.5 g trans)
1,940 mg sodium
Regular consumption of the FlameThrower will torch any hopes you have of losing weight. This potential aortic uh-oh contains 60 percent more calories than the Bacon Cheddar Grillburger and more than twice as many calories as DQ’s own Double Hamburger.
Hardee’s Two-Third Pound Monster Thickburger
1,420 calories
108 g fat (43 g saturated)
2,770 mg sodium
Hardee’s and Carl’s Jr. take a misplaced pride in their shamelessly caloric approach to everything they put under a heat lamp, which is probably reason enough for some to find another place to eat. Need more motivation? Many of their burgers break the perilous 1,000-calorie barrier; their worst bun-buster has nearly 75 percent of your entire day’s calories and as much fat as a dozen Taco Bell soft tacos.
Ruby Tuesday Bella Turkey Burger
1,057 calories
65 g fat
The scariest part about this burger is how completely harmless it sounds: a slice of Swiss melted over sautéed mushrooms and ground turkey. Yet somehow Ruby Tuesday manages to slick it up with as much fat as five Baby Ruth bars. The kid’s version of this — the Turkey Mini — has an astounding 893 calories, earning it the No. 7 spot in our list of the 20 Worst Kid’s Meals in America. (To find out what’s best (and worst) for your kids at the nation’s big restaurant chains, check out this revealing report first.)
THE EAT THIS! BURGER HALL OF FAME
DQ Original Burger
350 calories
14 g fat (7 g saturated)
680 mg sodium
Wendy’s Quarter-Pound Single
430 calories
20 g fat (7 g saturated)
870 mg sodium
Burger King Whopper Jr. w/o mayo
370 calories
21 g fat (6 g saturated)
570 mg sodium
McDonald’s Quarter Pounder
410 calories
19 g fat (7 g saturated)
730 mg sodium
In-N-Out Protein-Style Protein-Style Cheeseburger
330 calories
25 g fat (9 g saturated)
720 mg sodium
And to make your very own gourmet burger at home with great supermarket brands — with just 350 calories and $3.79 a serving — check out this great recipe.
After you’ve conquered the burger field, make sure to nail down the rest of the all-time best restaurant swaps while you’re at it. With knowledge and discipline, you can eat all of your favorite foods — without ever being on a diet — and still lose weight!
And don't forget about these 17 best fitness foods for women.
Have your own nominations for best and worst burgers? Please add a comment, and share them with the rest of us.
Eat Your Way Slim
Grab your fork: Filling up on healthy foods is the best way to say sayonara to those stubborn 5, 10 or 15 pounds. A few years ago, when I complained about the extra luggage I was carrying, a trainer told me, "That's between you and the bread basket." And she was right.
I went on to lose about 25 pounds without counting calories or cutting meals, but rather by reducing refined carbs such as pasta and bagels and increasing the amount of fruit, veggies and lean protein on my plate. Science helps me understand why: Studies suggest that we absorb 6 percent fewer calories when we follow a diet with at least 34 grams a day of fiber (which is chockablock in produce). We also know our bodies expend more energy digesting protein than fat or carbs, and eating at least 50 grams of protein a day can delay hunger pains and boost energy.
Try these other tips from our Jump Start Diet to whittle your middle and achieve the healthiest weight for you.
Ruin your appetite: If you only eat three squares a day, you might be getting too hungry between meals, causing you to overeat when you finally sit down to dine. Treat yourself to two 150-calorie snacks a day to keep your blood sugar stable and rein in hunger. Try a string cheese with an apple or lowfat yogurt and fruit.
Supersize your eats: Sometimes bigger really is better. Selecting a high-volume version of the food you want can help you eat less. People who had cheese puffs for a snack ate 21 percent fewer calories than those given denser bites, researchers at Penn State University at University Park found. Because the food looks bigger, you’re happy and satisfied with fewer calories. Try rice cakes, popcorn or puffed cereal instead of chips when you want a snack. SELF has more ways to trade up to healthier treats.
Don't fear frozen meals: Eating an entree out of your freezer isn't something you want to make a daily habit, but once in a while it can be a smart way to refresh your memory on sensible serving sizes. Choose ones with about 350 calories, at least 3 grams of protein, 1.5 grams of fiber and no more than 1.5 grams of saturated fat per 100 calories. Put it on a plate and snap a mental picture of it before digging in. This will help sidestep portion distortion in the future.
Plot your path: When you map out your meals for the day, you’re less likely to stumble on diet setbacks such as unhealthy takeout or king-size treats from the vending machine. Take a moment to jot down what you plan to nosh for the next few days, and check back to see how you did. This will help you pinpoint trouble spots (such as a few unplanned scoops of ice cream in front of the tube) and allow you to celebrate when you help yourself to healthier fare.
See a sample week of plan-ahead meals, find more healthy snack ideas and try SELF's no-cook diet suggestions at Self.com. Get more tips, tools and totally inspirational support by signing up for the Jump Start Diet at Self.com.
Detect (and Avoid) Diet Pitfalls
Skipping breakfast: If you are among the 50 percent of Americans who bypass their A.M. meal, you have an increased chance of gaining weight. Going too long without food slows your metabolism; it also causes your insulin to shoot up when you finally do eat for the day, making it harder to burn fat.
Rising without dining might also prompt you to overindulge later in the day. Late-night overeaters were more likely to skip breakfast, gulp down food too quickly and forget to plan meals. Having a hearty morning meal can also actually help you lose weight: Obese women who ate a 600-calorie breakfast shed about 40 pounds in eight months, whereas those who ate smaller meals dropped only 9 pounds, according to research from Virginia Commonwealth University in Richmond.
Fix it: Aim for a 400-calorie day starter such as a cup of oatmeal and an apple, 2 tablespoons chopped nuts, a teaspoon of honey and a cup of skim milk, or scrambled eggs on an English muffin with a cup of lowfat milk. Increase portions to bump up the calorie count to 600, if you’d like. Get more healthy breakfast ideas at Self.com.
Hitting the buffet table: The endless choices are good for your taste buds but trouble for your waistline: You’re likely to eat more when you have many options, and research shows that a cornucopia of foods in one bowl, let alone a whole spread, causes people to eat more than when only one type of food is in the bowl.
Fix it: When confronted with a buffet, help yourself to half your usual serving of two favorite dishes and round out your plate with fresh veggies, fruit or a green salad. That way, you’ll savor your yen for variety while avoiding the urge to go for round two.
Functioning on too little sleep: As if you needed another reason to squeeze in more shut-eye: People who get five or fewer hours of sleep per night are 55 percent more likely to be obese than those who log eight straight, according to a review of 45 studies published in the journal Sleep. Too few zzz's may rev your production of hunger hormones, switch off your fullness hormones and encourage cravings for sugary carbs, which perk you up.
Fix it: Turn in 15 minutes early tonight and continue to do so each night until you’re snoozing at least seven hours per night.
Using artificial sweeteners: Spooning fake sugar into your latte can be a diet buzzkill. People who rely on the colorful packets watched their BMI increase 47 percent more than than BMIs of those who refrained, according to a study in Obesity. Researchers believe that the artificial sweeteners can set off cravings for high-calorie foods.
Fix it: Keep it real by using one teaspoon of sugar in tea and coffee.
Sipping your calories: Warning! Treating yourself to regular soda or a so-called healthy smoothie could be adding hundreds of calories to your daily tally.
Fix it: Fill up on no-calorie still or sparkling water instead—add slices of fresh fruit for flavor.
Going to work: When confronted with a platter of pastries your colleague carted to work, it seems almost rude to decline--but try. Nearly 55 percent of people who regained weight they'd lost say office culture is a diet saboteur, according to research at the University of Kansas at Kansas City Medical Center. What's more, a mentally challenging job could make you reach for treats, as well. People ate 200 more calories after doing intellectual tasks than resting, according to a study in Psychosomatic Medicine. (Scientists think after a mental workout your body may beg for glucose, a sugar in carbs that fuels your brain.)
Fix it: Stash a carb-rich piece of fruit such as a pear in your desk and reach for it before entering a cruller-filled conference room or after you've completed your latest brilliant task.
Get more ideas on how to avoid the most common diet traps at Self.com or join our Jump Start Diet to lose 8 pounds this month.
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