CANCER IN INDIA

Three IITs to help government regulate tobacco industry (Yahoo News-09/09/2008)

The central health ministry has roped in three Indian Institutes of Technology (IITs) to test tobacco products of their toxic contents and help the ministry in regulating the tobacco industry. “We have already received acceptance from IIT Guwahati, Chennai and Roorkee,” said Jagdish Kaur, chief medical officer, Directorate General of Health Services (DGHS). “We are setting up tobacco testing laboratories in these IITs, which will work as regional tobacco testing centres. Each laboratory will be set up with an investment of Rs.55 million,” Kaur told IANS. “These laboratories will have smoke machines to simulate smoking and give details of toxic contains of cigarettes, bidis and other chewing tobacco products.” Kaur said initially they would search for seven toxic elements like nicotine, tar, carbon monoxide and arsenic. K. Srinath Reddy, head of the Public Health Foundation of India and adviser to Health Minister Anbumani Ramadoss, said these IITs will send the toxic content test reports to the health ministry. “The ministry will then ask the tobacco manufacturers to write the ingredients and percent of toxicity on their packets. This will be mandatory for tobacco companies,” Reddy said. Binayak Prasad, director public health, in the health ministry said: “Since, IITs have competent authorities, it will be easier for the ministry to start the regional labs there only.” “Besides, two more labs - one at Ahmedabad and another at Rajamundry in Andhra Pradesh are coming up. These five will work as regional hubs in regulating tobacco industries. These five centres are likely to be operational in another five-six months time,” Prasad told IANS.

A central lab is also proposed to come up in the national capital region of Delhi with an investment of Rs. 120 million. “The capacity of the central lab will be double the capacity of regional hubs and help other south Asian countries to test their tobacco products,” Kaur added. She, however, said that they are yet to find land for the central lab in NCR region and weighing the option of setting it up at an Indian Council of Medical Research (ICMR) building in Noida. India is currently home to over 250 million smokers. According to government estimates nearly 1 million people die of tobacco related diseases in the country every year. While the revenue from tobacco industry is nearly Rs. 350 billion per year, the disease-treatment cost is little over this amount. The central government is set to ban smoking in public places from Oct 2, the birth anniversary of Mahatma Gandhi. 

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Breakthroughs seen in cancer spread and stem cells (Yahoo News-09/09/2008)

On a visit to Bangalore, India, in 1998, Robert Weinberg, one of the leading cancer researchers in the United States, met a voraciously curious young doctoral student from a South Indian village so remote that he grew up without phones or television, studying by kerosene lamp. He had no Western-style last name, only a first - Mani. Mani's parents, rice and peanut farmers, had never been to school at all. But Weinberg sensed such scientific promise in Mani, who was then at the Indian Institute of Science, that he invited him to join his prestigious Whitehead Institute laboratory in Cambridge, Massachusetts. Now, Weinberg says his lab has come up with possibly its most exciting discovery since it found the first cancer gene nearly three decades ago, and much of the credit goes to that young Indian researcher, Sendurai (the name of his village) Mani. Mani and his colleagues at the MIT-affiliated Whitehead Institute found what appears to be a key to metastasis, the insidious process by which cancer spreads throughout the body and often kills. And, in a surprising spinoff, that same discovery also may lead to a relatively safe, simple way to transform normal adult cells into stem cells that could be used to treat other diseases. 
The scientists believe their one-step method may avoid the risk of random mutation (and possibly cancer), a stumbling block for therapies based on other recently developed techniques for creating stem cells. The new findings by no means translate into a cure for cancer or an instant recipe for stem cell therapies, cautioned Weinberg, who first came to national prominence in the 1970s for his work on genetic mutations that cause normal cells to become cancerous. But, he said, visibly struggling to convey his enthusiasm without resorting to hyperbole, "I just think this is extremely interesting."

Other researchers who study stem cells and cancer concur, though the work is still in progress. "I think it's fabulous," said Michael Clarke, director of the cancer stem cell program at Stanford University. Weinberg's lab, he said, has pinpointed a "stem cell program that cancer cells use to spread. So I think that's incredibly important." As Weinberg tells the tale, ensconced in a brown leather armchair near a tangled jungle of window plants in his office, metastatic cancer cells and stem cells used to occupy separate halves of his brain, with no bridge between. But that bridge is emerging from yet a third field: the study of embryos. In earliest human life, some cells undergo a dramatic metamorphosis. From squarish, stuck-together cells of the kind that grow in sheets to form the linings of the ducts in breasts, lungs and other organs, they change into mobile, more sickle-shaped cells that can form bones and blood. Researchers have long theorized that cancer cells may co-opt the program for that transformation, using it to gain mobility and roll out from a primary tumor to seed others elsewhere. What Mani and his colleagues found fits into that theory and goes a step further: By exploring genes and proteins involved in metastasis, they found that when a cancer cell undergoes that square-to-sickle transformation, it also gains properties of stem cells, which can spawn vast numbers of new cells. In particular, they found that by turning on any one of three genes, called Twist, Snail and FOXC2, they could make a cancer cell in a petri dish undergo the square-to-sickle shift. And unexpectedly, these sickle-shaped cells became far more capable of generating new tumors. Mani hopes to prove that the same thing happens in metastasis.

Their work fits into the burgeoning field of cancer stem cells, the increasingly accepted idea that tumors host a few cancer "super-cells," which are capable of forming new tumors despite extensive cancer treatment. But it went beyond cancer. Weinberg pushed Mani to test a seemingly logical hypothesis: Could inducing the square-to-sickle shift in normal cells turn them into normal stem cells? Mani tested the idea in normal human breast cells left over from breast-reduction surgery. And indeed, he found that by inducing the square-to-sickle shift, those normal cells also started to resemble stem cells, becoming able to generate great numbers of copies. Their method, if it pans out, could be easier and safer than other methods to make stem cells now in development because it would involve manipulating a cell's biochemical environment to turn on existing genes rather than changing genes, Weinberg said. The work suggests that it may be possible, with relatively modest manipulation, to "get what looks like a more mature cell to revert back to a stem-cell-like state," said Dr. David Scadden, co-director of the Harvard Stem Cell Institute, who was not involved in Weinberg's and Mani's work. "This is fantastic," he said, because it indicates "that maybe cells don't live on a one-way street." For all his excitement, Weinberg readily acknowledged that Mani's line of investigation has yet to produce a "gold-standard proof" that the stem-like cells are actually stem cells. If their thinking is correct, he said, it should be possible to induce the key metamorphosis in some breast cells of one mouse, place them in another mouse's chest and develop a breast.

The experiment worked once, he said, but his lab has been unable to replicate it and ended up publishing its work in the leading biology journal Cell this May without that crowning proof. "I'm not discouraged by that lack of success, though it would be nicer if it had succeeded," Weinberg said. Such experiments take time and present technical challenges, he said. Already, Mani, who left Cambridge in December to become an assistant professor at the M.D. Anderson Cancer Center in Houston, and researchers still in Weinberg's lab are racing ahead to apply their findings. It may be possible, Mani said, to develop a new test for whether a tumor has the potential for metastasis. And if such a detection method for metastasis can be found, he said, it could possibly be used to identify bad cells and destroy them with drugs. Weinberg said he was more optimistic about eventual applications in stem cells than in cancer. "We're not yet there," he said, "but I don't think it's hype to say this has illuminated a clear and obvious path by which one could one day make stem cells."

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Crystalline Compound Found in Asian Medicine, Cuisine Shown to be Cancer Chemopreventive (Newswise)

A collaborative team of scientists from the Uniformed Services University of the Health Sciences (USU) will have a study of the effects of curcumin in prostate cancer cells published in the September 2008 issue of Cancer Biology and Therapy. Curcumin (diferuloylmethane), a crystalline compound, is the major active component of turmeric (Curcuma longa Linn), which has been traditionally used in medicine and cuisine in Asian countries. Curcumin has shown to be cancer chemopreventive in several different model tumor bioassay systems including colon, duodenal, stomach, prostate and breast carcinogenesis both in-vitro and in-vivo. Dr. Radha Maheshwari, professor of Pathology, USU; Dr. Rajesh Thangapazham, graduate student of Birla Institute of Technology and Science, Pilani; Dr. Rajesh Thangapazham, at the Department of Pathology in collaboration with Drs. Shiv Srivastava, Albert Dobi and colleagues at the Center for Prostate Disease Research, Department of Surgery, USU, performed a temporal gene expression analysis of the Curcumin-Gene Expression Response using hormone-responsive and non responsive human prostate cancer cell line, LNCaP and C4-2B respectively. Hierarchical clustering methods and functional classification showed temporal co-regulation of genes involved in specific biochemical pathways involved in the cellular stress response pathways. Androgen Receptor (AR) regulated genes which play critical roles in normal growth and differentiation of prostate gland, as well as in prostate cancer, were also a part of the observed gene expression alteration. NKX3.1, TMPRSS2 and PMEPA1 were downregulated by curcumin. Of note curcumin down-regulated androgen upregulated transcript encoded by the potentially causal TMPRSS2-ERG gene fusion, a common oncogenic alteration noted in 50-70% of prostate cancer patients. This report established novel features of curcumin in prostate cancer cells of varying tumorigenic phenotypes and provides potentially novel read-outs for assessing effectiveness of curcumin in prostate cancer and likely in other cancers. Specifically known as well as new gene-networks identified here further delineate molecular targets of curcumin in prostate cancer cells.

The current study was supported by grants from the US Military Cancer Institute, Uniformed Services University of the Health Sciences and US-INDIA Foreign Currency Fund from the US Department of State. The Uniformed Services University is located on the grounds of Bethesda’s National Naval Medical Center and across from the National Institutes of Health. The university is the nation’s federal school of medicine and graduate school of nursing. It educates health care professionals dedicated to career service in the Department of Defense and the U.S. Public Health Service. Students are active-duty uniformed officers in the Army, Navy, Air Force and Public Health Service, who are being educated to deal with wartime casualties, national disasters, emerging infectious diseases, and other public health emergencies. Of the university’s more than 4,200 physician alumni, the vast majority serve on active duty and are supporting operations in Iraq, Afghanistan, and elsewhere, offering their leadership and expertise.

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Asian Health Ministers Pledge to Prevent Tobacco Use (Yahoo News-12/09/2008)

Asia is one of the largest tobacco markets in the world, but this week health officials meeting in New Delhi, India promised to do more to prevent tobacco use, according to the World Health Organization (WHO). The Voice of America reported Sept. 11 that WHO officials stressed that tobacco companies are aggressively marketing to half a billion Asian potential new smokers between the ages of 10 and 24. Many smokers in the region get addicted at a young age, sometimes even before their 10th birthday. "We have ... good political support from all countries in the region, they are committed to tobacco control, despite the fact that even in the government, there is some opposition, but as a whole government is committed to tobacco control," said Khalil Rahman, the WHO's regional coordinator for tobacco control. India plans to ban smoking in indoor public spaces, and the WHO would like to see other Asian countries follow suit. The international health body also is calling for a total ban on tobacco advertising and higher taxes on tobacco products. Bangladesh, Burma and Thailand have already raised their tobacco taxes significantly. "If you increase tax, you can earn more revenue from tobacco industry, and at the same time you can reduce consumption, and if consumption is reduced, you get less diseases and you spend less to treat those diseases," said Rahman.

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Tobacco companies using legal loopholes to target kids in outdoor ads (Yahoo News-30/07/2008)

Tobacco companies have failed to keep a promise they made a decade ago to eliminate ads for alcohol and tobacco within 500 feet of schools, playgrounds and churches, say researchers. In 1998, tobacco industry moguls like Philip Morris, R.J. Reynolds, Brown & Williamson, Lorillard and Liggett had agreed to support the Tobacco Master Settlement Agreement as a part of anti-smoking efforts, and stop targeting children with glossy ads featuring cartoon characters and removing tobacco billboards and bus bench ads. However, Rand Corporation researchers have found that kids still remain a part of the industry's advertising strategy. The researchers evaluated compliance by observing outdoor advertisements for one year during 2004 and 2005, in 106 census tracts in pre-Katrina New Orleans, as well as 114 census tracts in Los Angeles County. They found that in Los Angeles, 25 percent of tobacco ads and 37 percent of alcohol ads were located within 500 feet of a school, playground or church. About 20 percent of tobacco and alcohol ads in Louisiana were within 500 feet, where, 26 percent of tract residents were underage. In Los Angeles County tracts, 28 percent were minors. "You have these small media, posted multiple times in multiple locations," said Molly Scott, lead study author and a Rand Corporation researcher. "These are not huge billboards, so they [tobacco companies] are complying. But in the big sense of things, not so much." The tobacco ads were also not complying with the terms of their size and frequency.

Of 130 alcohol ads observed in Los Angeles, more than half were either extra-large billboards (14 feet by 48 feet) or average size (12 feet by 24 feet). In Louisiana, 61 percent of the alcohol ads were average size (12 feet by 24 feet). Of 81 tobacco billboards observed in Los Angeles, 99 percent were posters, banners or fliers, and 27 percent of those appeared two to four times in the same location. In Louisiana, 25 percent of 154 tobacco ads were small billboards, while 71 percent were posters, fliers or banners. About 66 percent appeared two to four times in the same location. "Maybe one of the unintended consequences of the MSA [the master settlement agreement] is more local targeting," Scott added. Stephen Freitas, chief marketing officer for the Outdoor Advertising Association of America said that store-owners could place some small advertisements - without brand name attachments - announcing that cigarettes are on sale. He added that the organization does not specifically consider banners and posters outdoor advertising. As far as the advertising industry's efforts, "We're not aware of members deliberately or aggressively violating the voluntary pledge," said Freitas.

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Ramadoss to push for smoke free Delhi University (Yahoo News-21/07/2008)

Health Minister Anbumani Ramadoss will join the Delhi University Student Union (DUSU) Tuesday to campaign against tobacco and push for a smoke free campus. The health ministry Monday said the July 22 function assumes significance in the context of the minister's announcement of complete ban on smoking in public places from Oct 2. Ramadoss along with DUSU functionaries will exhort all students especially freshers not to smoke in public places and also tell their peers to do the same. Government has launched the National Tobacco Control Programme (NTCP) in the 11th five-year plan to implement anti-tobacco laws. India is one of the pioneer signatories of the WHO framework convention on tobacco control (FCTC). Delhi University is one of the largest varsities in the country with over 40,000 students.

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Orissa ranks second in tobacco consumption, next to mizoram (Yahoo News-22/06/2008)

Killer habit: Women in urban Orissa falling prey to smoking.Women in Orissa are lighting up the cancer stick or chewing tobacco more often than their counterparts in other states. In a recent survey, the state stood second when it came to tobacco consumption among women, next only to Mizoram. The percentage of girls (from 15 years and above) who chewed some form of tobacco in 1998 was 34.9 per cent. Now, according to National Family Health Survey, the percentage has risen to 50 per cent and more. Similarly, the percentage of women smokers has increased from mere 0.9 per cent to 6 per cent. More than 50 per cent of the women in the state, who are into tobacco consumption, are mainly from tobacco growing rural pockets where women use paan with zarda, gudakhu, gutkha, khaini, snuff, acorn nut, dhuan patra and gundi. A growing number of rural women are now into smoking bidis or cigarettes, too, though when compared to the rest of India their numbers are still the lowest in the country. But the habit is growing in parts of rural areas in the tobacco pockets in the state. Smoking in urban Orissa has gone up by five to seven percent, says Kavita Dash, programme associate of the Voluntary Health Association of India which is planning a detailed survey on Orissa’s habit soon. “Girls who work for multinational companies, airlines or in mass media are taking up the habit faster. College girls, too, are succumbing to peer pressure and taking up the cancer stick. The number of girls who prefer to chew tobacco has also risen. Gutka and mouth fresheners are the more sought-after products among the college going groups between ages 20 and 25,” Dash explained.

In recent years women have been identified as a priority group for tobacco control efforts, she added. “More people dying due to tobacco consumption is not setting off panic bells as it should. The longer incubation period of tobacco-related diseases has hindered people’s recognition of the threat,” said Mira Aghi, a behavioural scientist. Lung cancer is fast overtaking breast cancer as the commonest malignancy among women in this part of the world. Those who chew chuttas and tobaccos end up suffering the cancer of the mouth, pharynx, larynx or oesophagus, besides research confirms that babies born to women who smoke beedi during pregnancy are 200gm lighter in weight on an average. “Young girls who smoke often suffer from problems in their reproductive system and tend to be more depressed,” said Aghi.

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