Dr Singh's XMRV Patents: Something for Dr Lipkin -and the NY Times- to chew on

[Cort]

If you are going to post something like this, please provide some kind of reference. What is the point of speculation based on more speculation?

Hi Diesel and everyone, something has been bugging me for some months, and this is a big piece of evidence, even if unpublished. Something like one in four breast cancer survivors develop a CFS-like illness, but its not called CFS. Coincidence? You decide.

Bye,
Alex

I agree that that sounds very speculative but it is true....

Good point Alex

.....isn;t that interesting...they carve out the cancer and yet they are left with this mysterious fatiguing and cognitively challenging illness that no one knows how to treat......because the virus involved is also doing its work someplace else???

Talk about connecting the dots - that would be scary exciting. That would completely freak out the medical world...maybe Mikovits was right! Maybe this is bigger than HIV/AIDS

That would blow everything up...the implications of that are really too exciting to think about..I do remember Annette Whittemore saying breast cancer researchers were interested....which makes sense if its a hormone triggered drug then breast cancer would fit right in there I believe.

We are definitely getting ahead of ourselves but one can wonder.....

 

[George]

If you are going to post something like this, please provide some kind of reference. What is the point of speculation based on more speculation?

Hey ya, sorry about that sometimes we forget that everybody doesn't know everything. Ya know.

heres a simple link and ya can go from there if ya want to know more

http://en.wikipedia.org/wiki/Post-chemotherapy_cognitive_impairment

The systems of the body most affected by chemotherapy drugs include visual and semantic memory, attention and motor coordination.[7] These effects can impair a chemotherapy patient's ability to understand and make decisions regarding treatment, perform in school or employment and can reduce quality of life.[7] Survivors often report difficulty multitasking, comprehending what they've just read, following the thread of a conversation, and retrieving words[8]

Breast cancer survivors who were treated with chemotherapy have to work harder to perform tasks than survivors whose treatment was surgical. A year after treatment the brains of cancer survivors treated with chemotherapy had physically shrunk while those of people not treated with chemotherapy had not.[9]

Post-chemotherapy cognitive impairment comes as a surprise to many cancer survivors. Often, survivors think their lives will return to normal when the cancer is gone, only to find that the lingering effects of post-chemotherapy cognitive impairment impede their efforts. Working, connecting with loved ones, carrying out day-to-day tasks—all can be very challenging for an impaired brain. Although post-chemotherapy cognitive impairment appears to be temporary, it can be quite long-lived, with some cases lasting 10 years or more.[10]

we've talked about some of the similarities before by I don't remember where. (grins)

 

[Cort]

It's being actively researched. Here's one study

Contemp Clin Trials. 2010 Nov 12. [Epub ahead of print]
Factors correlated with fatigue in breast cancer patients before, during and after adjuvant chemotherapy: The FATSEIN study.
Rotonda C, Guillemin F, Bonnetain F, Conroy T.

INSERM, CIC-EC CIE6, Nancy, France; CHU Nancy, Epidmiologie et Evaluation Cliniques, Nancy, France; Nancy-University, Paul Verlaine Metz University, Paris Descartes University, EA 4360 Apemac, Nancy, France; Centre Alexis Vautrin, Department of Medical Oncology, Vandœuvre-ls-Nancy, France.
Abstract
INTRODUCTION: Breast cancer is by far the most common form of cancer diagnosis in women. Cancer treatments are long, complex and often cumbersome with numerous side effects. Fatigue is now considered as the most distressing side effect of treatment. Fifty-eight percent to 94% of breast cancer patients experience fatigue during treatment with adjuvant chemotherapy.

One flaw in the XMRV is causing it all argument is that the fatigue appears to occur post treatment - not before treatment - it seems to be the chemotherapy or radiation that is causing it - not the cancer or the factors associated with it itself.

Its actually turned into a big field of study - almost overnight. It looks like there more work being done on fatigue post cancer than into CFS at this point.

 

[Sasha]

I suspect that in addition to her CFS and cadaver studies, there are studies of which we are unaware. Now that this information is public, I also suspect that we'll be seeing published articles soon. This also impacts Lipkin's work as Singh is a colleague of his and she has retained her position on Columbia's faculty even after moving to Utah. If she has figured this out, you can safely assume she's shared that with Lipkin.

As Parvo said, THIS IS HUGE!

Thanks, CBS - I've only just seen your response to my questions (I was distracted by the magic peach :worried.

 

[Sasha]

Hey ya, sorry about that sometimes we forget that everybody doesn't know everything. Ya know.

heres a simple link and ya can go from there if ya want to know more

http://en.wikipedia.org/wiki/Post-chemotherapy_cognitive_impairment



we've talked about some of the similarities before by I don't remember where. (grins)

Interesting - but the syndrome seems to be restricted to cognitive impairment (not PEM, extreme fatiguability, sleep disorders etc. that go with ME/CFS) and it seems to be related to chemo rather than the cancer as such, unless I've misunderstood (always, always possible). Am I missing something (ditto)?

 

[Jemal]

Fatigue after cancer treatment (not only breast cancer) is a big problem. It's heavily connected to the treatment, though. So like Cort I am not so sure XMRV plays a role in that. Still, research in that area might benefit us as well.

And as I stated before: if the link between XMRV and breast cancer pans out, it's going to be huge. Even more huge than a link between XMRV and autism (children!).

 

[CBS]

Interesting - but the syndrome seems to be restricted to cognitive impairment (not PEM, extreme fatiguability, sleep disorders etc. that go with ME/CFS) and it seems to be related to chemo rather than the cancer as such, unless I've misunderstood (always, always possible). Am I missing something (ditto)?

I'm of the opinion that if the cancer link holds up as broadly as Dr. Singh suggests, there will be quite a large number of assumptions that will be revisited. Chemo, cancer, disruption of life plans, financial stress; it's all so intertwined that attributing the fatigue to chemo alone might have been a bit premature or simplistic.

 

[Bob]

If breast cancer is testing at 25% for XMRV, then I think this is about the same as prostate cancer...
I reckon that it might not be a coincidence that they are both the same...
The reasons for them both having a '25%' figure might be related.

 

[urbantravels]

Do the percentages in breast cancer break down along the lines of the *type* of breast cancer?

 

[VillageLife]

I HATE the XMRV virus, but we are nailing it down and we are going to stop it!!

3 cheers to Dr Singh.

 

[George]

Hey guys I didn't post all the links to all the stuff that got talked about or anything. If ya want to know more you can Google it. (grins)

Back in the day we just talked about the possibility, that because it's not a 100% of the BC survivors, that the chemo "could" create and event like Post Viral Event that triggers those with the XMRV and the XMRV causes the ME/CFS by driving up the viral load. But this was like October 2009 after CFSAC and Dr. Coffin's Breast cancer comment. Everybody was trying to figure out what he meant or if he just misspoke. I think we decided at the time it was a misspoke. (grins) Anyway I thinks it's on one of the forever long threads somewhere.

My point was sometimes some of the talk is in short hand based on old conversations, we don't mean to leave folks outside scratching their heads or make it sound like wild speculation. Most of you all, know that Alex "always" does his homework and I've never heard him speculate without say specifically that he was going to speculate and then make a "possibility" statement. But some of the newer folks don't know some of the older folks and how they post.

It's important as we all know, (grins) from the past, that how a person posts can lead to miss understandings. This is too good a day to have any of those. (woof!)

 

[Bob]

Hi Diesel and everyone, something has been bugging me for some months, and this is a big piece of evidence, even if unpublished. Something like one in four breast cancer survivors develop a CFS-like illness, but its not called CFS. Coincidence? You decide.

Bye,
Alex

That's very interesting, thanks for pointing that out Alex.

One flaw in the XMRV is causing it all argument is that the fatigue appears to occur post treatment - not before treatment - it seems to be the chemotherapy or radiation that is causing it - not the cancer or the factors associated with it itself.

That's not necessarily a flaw, because ME is generally triggered by an event such as stress or exposure to toxins... What worse stress event, and exposure to toxins, is there than a course of chemotherapy... So maybe the chemotherapy is a trigger event for an ME-like illness in cancer patients who carry the XMRV virus.

 

[Sasha]

That's very interesting Alex.

If breast cancer is testing at 25% for XMRV, then I think this is about the same as prostate cancer...
I reckon that it might not be a coincidence that they are both the same, but the reasons for them both having a '25%' figure might be related.

Wasn't the prostate cancer a particularly aggressive form - i.e. a subset of prostate cancers? Are Dr Singh's cadavers just random people? If XMRV really is in 25% of breast cancers in random people, yes, that is huge... it's finally dawning on me...

 

[urbantravels]

Some people, on the other hand, experience remission from ME/CFS after chemotherapy. And chemotherapy is one of the treatment options currently being explored.

I think we blur the edges of discussion of ME/CFS when we start sweeping any condition involving "fatigue" into the net. As we all know all too well, "fatigue" as a symptom is as common as mud. I would also ask the question if the "post-chemo fatigue" meets the proper (i.e. Canadian Consensus) criteria in all aspects, not just that it's lingering unexplained fatigue, which could have a million causes.

 

[George]

actually I think we were more interested in post chemo cognitive dysfunction or at least I was at the time.

 

[Cloud]

I've come across a few articles over the years (sorry, no links) on the subject of chemo (particularly Interferon) patients developing CFS like symptoms. I recall some interest by researchers on how this reaction could lend some insight into the mechanism of immune dysfunction in CFS. (Interesting is that I have heard more than one PWC who was also on Interferon for HCV, claim a significant improvement in CFS symptoms while on the drug....which is very unusual since Interferon has brutal side effects.)

Anyhow, it seems that many things with profound effects on the immune system can trigger ME/CFS.....why not Interferon, or any other Immune modulating chemo agent. I guess time will tell if they developed ME/CFS as a result of XMRV, the drugs, or both.

 

[Otis]

Wasn't the prostate cancer a particularly aggressive form - i.e. a subset of prostate cancers?

Yes. From the patent.

[0106] Thus, since XMRV infection plays a role in prostate cancer promotion or progression, an association of XMRV infection with tumor grade and stage can also be made. Besides the patient's age, grade and stage have been shown to best correlate with the biological behavior of prostate cancer (Epstein 2006). Tumor grade refers to the level of differentiation of the cancer. The Gleason scoring system, the most common method for prostate cancer grading, defines patterns 1 to 5 of decreasing differentiation, with pattern 5 representing the most undifferentiated architecture. Since many prostate cancers show more than one architectural pattern, the dominant and the subdominant pattern are scored independently and added together for a combined Gleason score; with scores of 2-4 for well-differentiated cancers, 5- 6 for intermediate cancers, 7 for moderate to poorly differentiated cancer, and 8 - 10 for high-grade cancers (Robbins p. 1053). Whether XMRV DNA and protein are more frequently detected in prostate cancer tissues from patients with higher grade or stage of cancer was also determined, (summarized in Table 2). For this analysis, XMRV infection was defined by the presence of XMRV DNA and/or protein. The proportion of XMRV-infected individuals differed significantly across the groups with different Gleason scores with XMRV being more frequently identified in prostate tissues

Atty. Dkt. No. 083404-0220

from cases with higher-grade cancers. Of the 101 cases without cancer, 6% of individuals were XMRV-positive. Of the 233 cases with cancer, the following fractions were positive for XMRV: 18% of cases with a Gleason score of 6, 27% of cases with a Gleason score of 7, 29% with a Gleason score of 8, and 44% with a Gleason score of 9. Since only one case had a score of 10 (negative by IHC and PCR), it was not included in the correlation analysis. Therefore, there is a significant association of XMRV-infection with a higher- grade of prostate cancer in the cases used for the study.

 

[Sasha]

I am wondering whether the 25% of breast cancers positive for XMRV in Dr Singh's study is likely to be an overestimate of the population value due to some kind of bias in how cadavers get donated for research. For example, would you be more likely to donate your body to research if you were dying of breast cancer that had resisted treatment and therefore had more reason to think that you could especially help others by your donation? I am wondering if we are more likely to be looking at a particularly aggressive subset of breast cancers in patients, in a similar way to XMRV turning up in 25% of particularly aggressive prostate cancers in patients but in a smaller proportion of those with less aggressive tumours.

 

[George]

If the work is never published we will never know.

 

[CBS]

'Chemo Fatigue' not from Chemo? Not so fast!

As for the so called phenomena of "chemo fatigue," a recent study suggests that the fatigue may be from the cancer itself and not from the fatigue:

Cancer survivors often complain about chemo brain, a mental fog and inability to concentrate that persist long after treatment. But the problem may not be limited to cancer patients who undergo chemotherapy, a study suggests.

These problems may be related to treatment, such as chemotherapy, radiation or hormonal therapy, or to something about the disease itself which can change brain chemistry, or to psychological distress,

http://www.nytimes.com/2010/10/12/health/research/12mental.html?scp=13&sq=cancer chemotherapy&st=cse

or

http://www.aacr.org/home/public--media/aacr-in-the-news.aspx?d=2130