Online support communities for high survival rate cancers contain a greater amount of emotional support content than online support communities for cancers with low survival rates, according to a new study from the U-M Health System (UMHS) and the VA Ann Arbor Healthcare System.
The researchers also found that support communities for low survival rate cancers contain a greater amount of informational support content than online support communities for high survival rate cancers.
“Online communities have become an important resource for individuals seeking emotional and informational social support related to cancer,” says senior author Dr. Caroline Richardson, assistant professor in the Department of Family Medicine at UMHS.
The study — led by Lorraine Buis, a postdoctoral research fellow at the VA Ann Arbor Healthcare System — assessed differences in emotional and informational social support content in online communities for cancers with high and low survival rates.
The researchers also found that, overall, emotional support was more prevalent than informational support across all communities and all types of cancers.
Both emotional and informational support widely is available within online communities for cancer, but not all of these sites are created equally, Buis says.
“When primary care providers refer individuals to online communities for support, they should be aware that there might be differing amounts of support based on the survival rare of a particular cancer,” she says. Buis also explains that not only are such online communities for patients, “but they help family and friends cope with the struggles that cancer presents.”
Until Richardson’s and Buis’s most recent study, there had been no previous research on the influence of patients’ cancer survival rates on social support content within online support communities for cancer.
Participants in this study all were reviewed under the same time period, were online community members who participated in online support communities for four different types of cancer — lung cancer, pancreatic cancer, thyroid cancer and melanoma — and participated in eight different online communities in the investigation.
The study was presented last week at the annual meeting of the North American Primary Care Research Group. In addition to Buis and Richardson, Pamela Whitten of Michigan State University also was an author of the study.
Joyce told me about this puppy cam, and I just have to share! They’re so darned cute. I don’t know how I’ll get any work done!
Note: The puppy cam was discontinued at some point. :( I just want to keep this post here, because my friend Joyce told me about it. Joyce and I were the “Myeloma Twins” until MM took her life.
Gene Variants Can Predict Early or Late Mortality in Multiple Myeloma
Elsevier Global Medical News. 2008 Nov 11, MG Sullivan
Genetic variants in the DNA of patients with multiple myeloma appear to strongly influence survival, a groundbreaking new genomic study has concluded.
In this first pass at identifying genetic markers for survival, treatment response, and complications in the disease, a group of 3,400 variants predicted early or late mortality 76% of the time, Dr. Brian Van Ness said in an interview about the initial report (BMC Medicine 2008 Sept. 8 [doi: 10.1186/1741-7015-6-26]).
“Clearly, inherited genetics influenced survival,” said Dr. Van Ness
of the University of Minnesota, Minneapolis. “What we have not yet done is identify which specific variants are responsible for these differences. Our hypothesis is that it won’t be a single variant driving response or survival, but a complex interaction of many.”
After narrowing down the initial 3,404 candidate single nucleotide polymorphisms (SNPs), Dr. Van Ness and his colleagues are now focusing on 1,000 SNPs found to be most strongly associated with the outcome
measures. More studies are on the way using this genetic panel, he said.
Indeed, just 2 weeks after the first study appeared, a coinvestigator, Dr. Gareth Morgan of London’s Royal Marsden Hospital, published findings on the association between certain SNPs and the incidence of
treatment-associated venous thromboembolism (VTE). The analysis showed that some of the variants associated with thalidomide-related VTE occurred in pathways important in drug transport and metabolism.
“The effects of the SNPs associated with thalidomide-related VTE may be functional at the level of the tumor cell, the tumor-related microenvironment, and the endothelium,” Dr. Morgan and his colleagues wrote (Blood 2008 Sept. 19 [Epub ahead of print]).
“Another study, currently submitted, has identified an association between some of the variants and the development of severe myeloma bone disease,” Dr. Van Ness said.
The initial investigation used a genetic screen developed from two DNA data sets: cells from the Coriell Institute for Medical Research, and samples obtained from multiple myeloma patients enrolled in two
randomized drug trials, as well as some unaffected spouses. The samples came from white, black, Hispanic, and Asian patients from North America and Europe. The candidate SNPs, occurring on 983 genes, were chosen based on the most recent genetic research and included on a myeloma-specific gene-testing chip.
The investigators chose extremes of survival as the first test of the panel, because this comparison was most likely to show the effects of any genetic variant. “We took the worst outcomes – people who died in
the first year of their disease – and the best outcomes – those who survived at least 3 years without progression,” Dr. Van Ness said. After repeatedly running the screen on both data sets, the team concluded that, as a whole, it discriminated the survival groups correctly 76% of the time.
Further drilling down identified several SNPs of particular interest, including some associated with drug metabolism, transport, and export; a variant that induces myeloma apoptosis; one associated with cellular
migration and angiogenesis; and several linked to proliferative responses.
Although not designed to detect racial differences, the initial screen did identify some interesting variations: 401 of the SNP variants occurred only in black patients. In whites, there was no difference in these SNPs between cases and controls.
“We know that African Americans have a two- to threefold increase in the incidence of myeloma, but we don’t yet know why,” Dr. Van Ness said. “We’ll be trying to identify those genetic variants that might uniquely increase the risk for one race to develop myeloma over another.”
Neither this initial analysis nor subsequent ones will examine the possible interplay of environment with genetics. But, Dr. Van Ness said, such studies may be forthcoming. The International Myeloma Foundation of North Hollywood, Calif., is conducting a patient survey to begin assessing what role – if any – environmental exposure plays in disease development. The 36-page survey asks patients to detail their environmental, dietary, and geographical exposures. The National Cancer Institute will collaborate with the group in evaluating the data.
The International Myeloma Foundation is also the curator of the DNA samples used in the analysis through its Bank on a Cure program. “Bank on a Cure was developed by an international group of physicians and scientists to deal with a disease that’s difficult to deal with,” Dr. Van Ness said. “It’s not a high-incidence cancer, so it’s not easy to research.”
The Bank on a Cure group developed cooperative agreements with national and international clinical trial groups, and the studies were funded by the International Myeloma Foundation. While exploration of genetic variants relevant to multiple myeloma is in its infancy, Dr. Van Ness predicted the effect could be profound.
On the mailing list we had a discussion about bone disease in MM. Here’s what Nancy said about it. I hadn’t realized before that IgA patients are less prone to bone disease. One of my doctors did tell me we’re more likely to have kidney involvement though.
Some people never have bone disease…that’s just the way their myeloma is; just as some people never have kidney problems. The names given to the variations of myeloma are not different. Patients with IgA myeloma are less likely to have bone disease than those with IgG myeloma…and those with IgG myeloma are less like than those with IgA myeloma (or Bence Jones myeloma) to have kidney problems.
Perhaps by “classic myeloma” they are referring to myeloma that is in the bone marrow…as opposed to extramedullary myeloma which is outside the bone marrow….rather than affecting the bones. However, about 80% of patients do have bone involvement, so it is the most common symptom of myeloma.
I had a chance to see Jupiter Saturday night! The Forsyth Astronomical Society (FAS) had a public observation event at Pilot Mountain State Park. I looked at the moon quite a bit, too. To be able to see those objects in such great detail is amazing. When I was in college I got to view Saturn one night, but I had forgotten how incredible it is. The FAS holds four public viewings a year. I plan on being at the next one!
The FAS members were extremely friendly and eager to share their knowledge.
Dallas attorney, Fred Baron, lost his battle with multiple myeloma on Thursday. He was 61 years old. Mr. Baron made the news when he tried to get the Biogen drug Tsyabri to treat the myeloma that was taking his life. There aren’t any reports about whether or not Mr. Baron actually was treated with the drug.
I had never heard of Mr. Baron before a few weeks ago even though he was a supporter of and fundraiser for John Edwards. Edwards was a democratic candidate for president this year and vice president in 2004. He was a North Carolina senator whose affair with a woman who produced videos for his campaign probably ruined his future in politics. According to the Dallas News, Mr. Baron was the friend who got Mr. Edwards’s mistress out of Dodge when it was feared knowledge of the affair would go public.
Elizabeth Edwards, wife of John Edwards, has breast cancer with bone metastasis. It was discovered during his presidential campaign after she fractured a rib while moving some furniture, according to the News and Observer.
