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6 - The Role of Metastasis Suppressor Genes in Metastasis
- from GENES
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- By Brunilde Gril, National Cancer Institute, United States, Russell Szmulewitz, The University of Chicago, Committee on Cancer Biology and Pritzker School of Medicine, United States, Joshua Collins, National Cancer Institute, United States, Jennifer Taylor, The University of Chicago, Committee on Cancer Biology and Pritzker School of Medicine, United States, Carrie Rinker-Schaeffer, The University of Chicago, Committee on Cancer Biology and Pritzker School of Medicine, United States, Patricia Steeg, National Cancer Institute, United States, Jean-Claude Marshall, National Cancer Institute, United States
- Edited by David Lyden, Danny R. Welch, Bethan Psaila
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- Book:
- Cancer Metastasis
- Published online:
- 05 June 2012
- Print publication:
- 25 April 2011, pp 64-76
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Summary
In the 1970s and 1980s, clever scientific insight and innovation rapidly advanced our understanding of the molecular mechanisms of cancer biology. The discoveries of oncogenes and tumor suppressors, and the elucidation of their functions, greatly aided in studies aimed at a molecular understanding of the etiology of primary tumors. Despite this, cancer biologists had little understanding of the molecular aspects of metastasis. Considering the devastating consequences, scientists were anxious for a breakthrough. The first clue would come from the study of tumor suppressors.
Tumor suppressor genes were identified when it was discovered that their loss of function was critical to tumorigenesis. Prior to their discovery, researchers were of the mindset that the oncogenic phenotype was always dominant. In other words, a mutation need happen on only a single allele for a normal cell to be transformed into a tumor cell. However, not all disease incidence data seemed to fit neatly into this hypothesis. By studying retinoblastoma case histories, a “two-hit” hypothesis emerged, predicting that for at least some cancers, two mutations must occur (one on each allele) to successfully transform a cell [1]. Indeed, the retinoblastoma gene, or Rb, would become known as the first described tumor suppressor. We now know that the “two hits” need not come in the form of distinct somatic mutations but may be the result of any combination of germinal and/or somatic mutations, mitotic recombinations, gene conversions, and functional inactivation of genes owing to promoter hypermethylation.
An exploration of the utility of hypnosis in pain management among rural pain patients
- THOMAS THORNBERRY, JENNIFER SCHAEFFER, PETER D. WRIGHT, MINDI C. HALEY, KENNETH L. KIRSH
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- Journal:
- Palliative & Supportive Care / Volume 5 / Issue 2 / June 2007
- Published online by Cambridge University Press:
- 22 May 2007, pp. 147-152
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- Article
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Objective: Hypnosis is an adjunctive, noninvasive treatment with few side effects that can be useful in the management of chronic pain. However, it has fallen into disfavor in recent years and is often perceived by physicians as simple charlatanism. We evaluated the efficacy of this treatment as used clinically in a large, mostly rural, pain management center.
Methods: We conducted a chart review of 300 pain patients from the Pain Treatment Center of the Bluegrass who had undergone hypnosis for their pain concerns. A chart audit tool was developed consisting of basic demographics, pre- and posthypnosis pain ratings, a rating of relaxation achieved posthypnosis, and scores on the Beck Depression Inventory, Perceived Disability Scale, and the Pain Anxiety Symptom Scale.
Results: The sample consisted of 79 men (26.3%) and 221 women (73.7%) with a mean age of 46.3 years (SD = 9.9, range = 19–78). Pain levels recorded pre- and posthypnosis revealed significant improvement as a result of the intervention (mean difference = 2.5, t(1,298) = 25.9, p < .001). Patients reported an average of 49.8% improvement in relaxation level posthypnosis (SD = 24.2%) and had a mean score of 19.0 on the Beck Depression Inventory (SD = 9.9), indicating moderate levels of depression. Also, patients saw themselves as severely disabled regarding their ability to engage in physical (8.3/10) or job-related (7.7/10) activities. Attempts to identify predictors of hypnosis success were not fruitful with one exception. “Poor” responders to hypnosis reported greater levels of perceived dysfunction in their sexual functioning compared to the “good” responders, F(1,187) = 7.2, p < .01.
Significance of results: Hypnosis appears to be a viable adjunct for pain management patients, including those from rural and relatively disadvantaged backgrounds. Prospective trials are needed to examine the utility of this modality in end-of-life and palliative care patients.