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Other highlights in the April 4 JNCI

Journal of the National Cancer Institute

Testicular Cancer Survivors Have Increased Risk of Noncancer Deaths

Testicular cancer survivors have a slightly higher risk of dying of noncancer causes than the general population. Men who received chemotherapy after 1974 are at particularly high risk.

Although survival rates for men with testicular cancer have greatly improved, some physicians worry that the treatments for testicular cancer could increase patients' risk for other health problems, such as second cancers, heart disease, and infertility.

Sophie Fosså, M.D., Ph.D., of the University of Oslo in Norway, and colleagues examined the risk of noncancer deaths in 38,907 testicular cancer patients who had survived for at least one year post-diagnosis. After a median follow-up of 10 years, 2,942 patients had died from noncancer causes, an increase of six percent relative to the noncancer deaths in the general population. Patients treated with chemotherapy in 1975 or later had higher risks of dying from all noncancer causes, infections, circulatory diseases and respiratory diseases. Men who were diagnosed before age 35, regardless of treatments, were also at higher risk of death from all causes, infections, and circulatory diseases.

"Additional long-term follow-up studies of testicular cancer patients that include detailed information on treatment and comorbid conditions will be required to adequately assess the incidence of the [secondary complications] of testicular cancer and its treatments...In the interim, clinicians and patients should be aware of recently published strategies for the long-term medical care of testicular cancer survivors," the authors write.

Contact: Sophie Fosså,,

Celecoxib Does Not Prevent Cancer in Barrett's Esophagus Patients

Celecoxib, a nonsteroidal anti-inflammatory drug (NSAID), did not prevent cancer in patients with Barrett's esophagus in a placebo-controlled study.

The incidence of Barrett's esophagus--a precancerous change in the lining of the esophagus that increases the risk of developing esophageal cancer--is on the rise in the United States. Previous studies have suggested that aspirin and other NSAIDs might decrease the risk of esophageal cancer.

In a randomized controlled phase II trial, Elisabeth I. Health, M.D., of the Barbara Ann Karmanos Cancer Institute in Detroit, and colleagues randomly assigned 100 Barrett's esophagus patients to take 200 mg of celecoxib or a placebo twice a day. After 48 weeks of treatment, there was no difference in the progression to esophageal cancer between the two groups.

"The lack of secondary chemoprevention with celecoxib in patients with Barrett's [esophagus] was disappointing. However, [the trial] is one of the few prospective chemoprevention trials in patient's with Barrett's [esophagus], and through it, we have gained valuable information about the disease process and the challenges of conducting such a study," the authors write.

Contact: Elisabeth I. Heath,, (313) 576-8717

Bladder Cancer Linked to Androgens and Androgen Receptor in Mice

Male sex hormones and their receptors may be involved in the development and progression of bladder cancer, according to a study in mice.

Men have a considerably higher incidence of bladder cancer than women, though the reasons remain a mystery. Bladder cancer has been linked to exposure to cigarette smoke and industrial chemicals, but it was not previously considered to be influenced by male sex hormones, called androgens.

Chawnshang Chang, Ph.D., of the University of Rochester Medical Center in Rochester, N.Y., used a chemical carcinogen to induce bladder cancer in normal male and female mice and in mice lacking functional androgen receptors. They also treated human bladder cancer cell lines to reduce androgen levels or androgen receptor activity. Some of these cell lines were injected into mice.

None of the androgen receptor-free mice developed bladder cancer when treated with the carcinogen, whereas more than 92 percent of the normal male mice and 42 percent of the normal female mice did. Human bladder cancer cells with reduced androgen levels or androgen receptor activity grew more slowly in culture and in mice then cells with normal androgen and androgen receptor levels.

"The results presented here have the potential to provide the basis for the development of new preventive or therapeutic approaches for bladder cancer, via targeting androgens and the [androgen receptor]," the authors write.

Contact: Tom Rickey, senior science editor, University of Rochester Medical Center,, (585) 275-3676



Also in the February 21 JNCI:

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