Parkinson’s could raise risk of prostate cancer
Evidence discovered by a U research team found that those with Parkinson's disease—and their relatives—might have an increased chance of developing prostate cancer.Parkinson's is a neurodegenerative disorder affecting the central nervous system, and causes movement-related symptoms such as shaking and hindering of the ability to walk easily.Stefan Pulst, professor and chairman of the neurology department, and Lisa Albright, professor of genetic epidemiology, teamed up to combine their knowledge to study the possible links between certain cancers and Parkinson's.Pulst and Albright discussed possibilities to investigate the association between Parkinson's disease and cancer in the Utah Population Database. Albright has been using the UPDB for 30 years to provide answers for these possible connections."The UPDB is a computerized genealogy of the Utah pioneers and their descendants, which has additional population statistics and medical data. It was created in the 1970s by Mark Skolnick and is still used today for genetics research," Albright said.By using the UPDB, which contains information for more than 2 million people, Albright and Pulst were able to discard any preconceptions relating to the origin of the disease. They were able to study the cancer risk in certain individuals who had Parkinson's disease and determine if it was similar for their close and distant relatives."The clinical implications of this is that both oncologists and neurologists should gather family data for the associated disease— Parkinson's for cancer patients and vice versa—in their patients, and that early screening could lower mortality," Albright said.To validate their research, the team also studied whether patients who suffered from prostate cancer also had increased chances of developing Parkinson's. The relationship between the two was positive. The researchers said they hope to study some of the high-risk cases to identify the genetic predisposition of genes."Prostate cancer is often caused without obvious symptoms and discovered through an antigen test," said Susan Beck, professor of nursing. "I am researching the improvement of symptoms caused by it, such as pain and fatigue, usually treated via surgery, radiation therapy or watchful waiting."m.lenihanclarke@chronicle.utah.edu
Evidence discovered by a U research team found that those with Parkinson's disease—and their relatives—might have an increased chance of developing prostate cancer.
Parkinson's is a neurodegenerative disorder affecting the central nervous system, and causes movement-related symptoms such as shaking and hindering of the ability to walk easily.
Stefan Pulst, professor and chairman of the neurology department, and Lisa Albright, professor of genetic epidemiology, teamed up to combine their knowledge to study the possible links between certain cancers and Parkinson's.
Pulst and Albright discussed possibilities to investigate the association between Parkinson's disease and cancer in the Utah Population Database. Albright has been using the UPDB for 30 years to provide answers for these possible connections.
"The UPDB is a computerized genealogy of the Utah pioneers and their descendants, which has additional population statistics and medical data. It was created in the 1970s by Mark Skolnick and is still used today for genetics research," Albright said.
By using the UPDB, which contains information for more than 2 million people, Albright and Pulst were able to discard any preconceptions relating to the origin of the disease. They were able to study the cancer risk in certain individuals who had Parkinson's disease and determine if it was similar for their close and distant relatives.
"The clinical implications of this is that both oncologists and neurologists should gather family data for the associated disease— Parkinson's for cancer patients and vice versa—in their patients, and that early screening could lower mortality," Albright said.
To validate their research, the team also studied whether patients who suffered from prostate cancer also had increased chances of developing Parkinson's. The relationship between the two was positive. The researchers said they hope to study some of the high-risk cases to identify the genetic predisposition of genes.
"Prostate cancer is often caused without obvious symptoms and discovered through an antigen test," said Susan Beck, professor of nursing. "I am researching the improvement of symptoms caused by it, such as pain and fatigue, usually treated via surgery, radiation therapy or watchful waiting."
m.lenihanclarke@chronicle.utah.edu
Gene Therapy for Parkinson's Advances
Improves movement for some
By Nathan Seppa, Science News
Using brain surgery to insert replacement genes, doctors can alleviate some movement problems in people with Parkinson’s disease. While not all of the gene therapy recipients in a new study improved, the group on average registered tangible gains after getting a gene that revs up production of a much-needed neurotransmitter, researchers report in an upcoming issue ofLancet Neurology.
Notably, none of the patients had significant side effects attributable to the therapy.
“The pendulum on gene therapy has really swung back and forth,” says study coauthor Matthew During, a physician and neuroscientist at Ohio State University in Columbus. “It was enormously hyped at first.” But the death of a patient in Philadelphia in 1999 and the appearance of leukemia in children in France getting gene therapy for an immune disorder—leading to a temporary suspension of trials in 2003—stalled the research. “The field languished for a while,” During says.
But he and his colleagues have continued to pursue the technology, using a disabled, nonpathogenic virus as the delivery vehicle for potentially useful genes. To treat Parkinson’s disease, the team has targeted a troublesome part of the brain where signaling gets obstructed in patients with the neurological disorder.
In the new study, the researchers randomly assigned 16 patients with advanced Parkinson’s to undergo an operation to install gene replacements; 21 similar patients got sham surgery and received no genes. Neither group was told which operation they were getting.
Doctors measured each patient’s physical movement before surgery, using a standard scoring formula for Parkinson’s patients. Six months after surgery, the patients given gene therapy showed an average improvement of 23.1 percent in their scores, compared with a 12.7 percent improvement among the sham surgery group. The formula measures problems such as freezing up, tremors and uncontrolled movements.
“This experiment was extremely well constructed and well designed,” says Michael Hutchinson, a neurologist at New York University who wasn’t involved in the trial. “This seems to be a positive effect, but not a clinically big effect.” Even so, he says, it clears the way for a larger study with more patients and possibly larger doses of the gene therapy.
The therapy zeroes in on a brain region called the subthalamic nucleus. While its normal role is poorly understood, this region becomes overactive in Parkinson’s patients, blocking signals that regulate muscle movement. Parkinson’s patients lack a brain-signaling molecule called dopamine, and that shortage results in the loss of another neurotransmitter called GABA in the subthalamic nucleus, triggering overactivity there.
The experimental therapy delivers a gene encoding an enzyme that boosts GABA production in the subthalamic nucleus. When it works, the gene therapy calms this region and smooths the flow of messages in the brain by allowing signals governing muscle movement to be shuttled through the nearby thalamus, Hutchinson says.
Another Parkinson’s treatment, called deep brain stimulation, uses an implanted electrode to quiet the subthalamic nucleus (SN: 1/31/09, p. 13).
The placebo effect seen in the people getting sham surgery is a curiosity not uncommon in Parkinson’s treatment, During says. Just getting the operation, in which “burr holes” are drilled into both sides of the skull under light sedation, stimulates optimism in the patient and results in a rise in dopamine production, alleviating some symptoms, he surmises.
During, who teamed with study coauthor and neurosurgeon Michael Kaplitt of Weill Cornell Medical College in New York City and others on the study, says a larger trial is planned. Meanwhile, people who got the sham surgery in this trial are now being offered the gene therapy.
Some patients from an earlier safety trial of this gene therapy are still showing sustained improvement; one is now seven years post-surgery. “It appears the clinical benefit persists,” says During, and that the transferred genes continue to help calm the overactive subthalamic nucleus. He and Kaplitt are cofounders of Neurologix, a biotechnology company based in Fort Lee, N.J., that financed this trial and makes portions of NLX-P101, the gene therapy medication.
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Follow U.S. News Science on Twitter.Parkinson’s Disease and Divorce
How do you know when it is time to leave a marriage (if you have PD)?
You won’t. At least not with any certainty. Exiting a marriage (for a person) with PD is no different than exiting a marriage (for) a person who has no neurological challenges.
Divorce is, always was, and always will be a messy, uncertain process rather than an event
Ultimately everyone who leaves a marriage does so because there is nothing left to sustain the relationship.
Strains including falling out of love, financial stress, child-rearing conflicts, lack of communication or commitment, personality differences, sexual incompatibility, conflicts with in-laws and parents, differences in life goals, physical or emotional abuse, infidelity, different levels of emotional maturity, and/or disagreement on gender roles
. All can be present in any marriage, including one with Parkinson’s.
If the marriage was already marked by hostility between the partners before the onset of PD, what follows might be even more corrosive to everyone in the family.
Staying together solely for the sake of (children or) Parkinson’s disease is unfair to both partners. A person who feels trapped but obligated is going to experience chronic stress with subsequent negative impact on health and general well-being. The person with PD is going to be left with the maddening, chronic uncertainty of whether their spouse’s anger will cause them to leave after all. They will feel ever more dependent and beholding to their spouse, a situation that is one of the most common topics in therapy. As lonely as it can feel, at least when a bad marriage ends, the person with PD can make some concrete plans for the future.
Whether or not to end a marriage is a complex issue for which there is no one-size-fits all answer. However, I do not think Parkinson’s disease should ever be a deciding factor in whether two people stay together. It should be one of many things a couple should consider. Two people can grow and mature with the adversity PD brings. They can also slip into unremitting daily misery.
When is it time to turn out the lights on a marriage?
When the music’s over.
Dr. Paul
The Parkinson’s Coach
The Parkinson’s Coach
Fear, Divorce, and Parkinson's
“My marriage is hell but it is better than being on my own. What will I do if I need someone to look after me when my PD gets worse?”
It is a question I am asked a lot by men and women with early PD. The answer, of course, is that I don’t have an answer. However, it is a question that is important to explore.
In my previous blog,
When the Music’s Over- Parkinson’s Disease and Divorce, I explored when it might be time to end a marriage. In that piece, I looked at how PD sometimes keeps people together through guilt. Now, it is time to look at how fear can work the same kind of black magic.
When the Music’s Over- Parkinson’s Disease and Divorce, I explored when it might be time to end a marriage. In that piece, I looked at how PD sometimes keeps people together through guilt. Now, it is time to look at how fear can work the same kind of black magic.
Fear is in play when anyone says he or she is willing to put up with a relationship they know to be bad because the future with PD is bleak. There is an unstated assumption here: the disease will get worse and I will be in bad enough shape I will not be able to remain independent. This assumption naturally leads to fear because it not only presumes that a dire future is inevitable but it predicts the final outcome, as well.
I once heard someone say that predicting the future by looking at the past is like trying to drive by looking only at the rearview mirror. The intervening years between now and the future are never going to be constant.
How might this apply to the fear expressed in our question? First, it is impossible to predict with any degree of reliability what any individual’s PD will be like in 10, 20, or 30 years. It is always going to be different for each person. Second, present PD treatment is unlikely to be the state of the art in the coming decades. Our understanding of PD is growing exponentially, producing not only new treatments but better treatment strategies. Although many people with the disease are focused on a cure, improved effectiveness for management of symptoms may eventually render this target less critical. Look to what happened with HIV, a condition that once had a very bleak prognosis. There is still no cure but highly target treatment has certainly reduced viral loads and progression to full immune deficiency. This example suggests it is not inevitable that any or even most individuals with PD are facing a future with the same limitations and worries that exist today.
There is another fear-inducing assumption embedded in our question, that there will be no one to look after us when we are vulnerable. This assumption is not limited to people with PD, by the way. Everyone faces decline with aging and faces the challenge of dependency and issues of care. There are no easy answers here but there is one certainty, being in a marriage does not guarantee that there will be someone there in your time of need. The simple fact of life is this- one member of a couple will become incapacitated first. Although having PD may make it appear that one will be the first of the couple to require assistance, there are no guarantees this will be the case. PD or no PD, each of us faces uncertainty about dependence and care needs.
Planning for future contingencies is important but remaining married is not necessarily the only viable response. In fact, remaining in a bad marriage for the sake of having some chimeric assurance of a safety net may not be a winning long-term response.
I believe in marriage and spend a lot of my professional life working to help families with PD live as successfully as possible. However, I also recognize that for the mental health of each spouse, there are times when the best course of action is to end a bad marriage and move forward.
However, fear of a future extrapolated from present circumstances can cause a couple to remain together, even when it is not in either person’s best interest. It can be like driving with just the rear view mirror.
Regards,
Dr. Paul
The Parkinson’s Coach
The Parkinson’s Coach
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Drug Stops Progression of Parkinson'sSource: http://www.investors.com/NewsAndAnalysis/Article/565466/201103091847/Parkinsons-drug-is-promising.htm
A drug undergoing research and testing, has demonstrated the ability to prevent progression of Parkinson's disease during tests on mice. Researchers at the Univ. of Colo. say the drug turns on a protective gene in the brain, called DJ-1, that reduces the debilitating effects of excess oxygen in brain cells. Mice genetically programmed to get Parkinson's were given the drug. They were able to move normally, with no decline in mental function, and their brains did not accumulate the protein that causes Parkinson's, the scientists said. The drug is now being tested on humans.
Sounds like this drug has potential, Wonder what the side effects are?
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