THURSDAY, Nov. 6 (HealthDay News) -- A free online service that provides clinical trial information for women diagnosed or at risk for breast cancer was launched this week by the University of California, San Francisco, Center of Excellence for Breast Cancer Care.

BreastCancerTrials.org includes information about clinical trials taking place at more than 1,100 medical facilities across the United States.

"BreastCancerTrials.org is an exciting, win-win development for the breast cancer community," Dr. Laura Esserman, director of the UCSF Center of Excellence for Breast Cancer Care and the UCSF Carol Franc Buck Breast Care Center, said in a university news release.

"Every advance in our understanding and treatment of breast cancer has come from clinical trial results. The more we can empower our patients to find out about and participate in trials, the faster we will be able to complete trials, and the sooner this new knowledge will translate into better care and outcomes for all patients," she said.

It's hoped that many more women will consider taking part in clinical trials if they're encouraged to do so, and it's easy for them to find and evaluate clinical trials for which they may be eligible.

Web site users enter a detailed health history and are then matched to trials specific to their personal health situation. The site provides additional criteria for enrollment in a trial, along with details on how to get more information. Women can use BreastCancerTrials.org once or store their health history on secure servers for continual matching to newly listed trials. Users' health information is never sold or shared with external parties.

It can be a challenge for researchers to recruit patients for clinical trials, because very few patients know that they may be eligible to participate in research studies, according to the Clinical Research Roundtable at the Institute of Medicine.

More information

The U.S. National Cancer Institute has more about clinical trials.

WEDNESDAY, Nov. 5 (HealthDay News) -- Eleven genetic variations believed to be predictors of esophageal cancer have been identified by U.S. researchers.

The University of Texas M. D. Anderson Cancer Center team pinpointed 11 single-nucleotide polymorphisms (SNPs) in microRNA-related genes that showed an association with esophageal cancer.

Each of these unfavorable genotypes was linked with an increased risk of cancer. People with more than four of the 11 genotypes had a more than threefold increased risk of esophageal cancer, according to the study, published in the November issue of Cancer Prevention Research.

"Our ultimate goal is to construct a quantitative cancer risk prediction model based on an individual's epidemiological profile, environment exposure and genetic makeup. This risk prediction model can evaluate each person's relative risk and absolute risk of developing esophageal cancer within a certain time period," study author Dr. Xifeng Wu, a professor in the department of epidemiology, said in an American Association for Cancer Research news release.

Esophageal cancer is the fastest growing cancer in the United States, and the majority of patients are diagnosed at an advanced stage. Being able to identify people at high risk for the disease may improve screening, monitoring and prevention.

"Considering the dramatic increase in incidence, difficulty of early diagnosis, the poor survival rate for esophageal cancer, and the limited knowledge of the natural history of the tumor, we need a greater understanding of the etiology of esophageal cancer for improvement of diagnosis and hopefully a better prognosis," Wu said.

Along with genetics, other risk factors for esophageal cancer include obesity, smoking and gastrointestinal reflux disease.

More information

The U.S. National Cancer Institute has more about esophageal cancer.

SATURDAY, Nov. 1 (HealthDay News) -- Personalized treatment of kidney cancer patients can increase survival, according to a UCLA study of almost 1,500 patients that identified subsets of kidney cancer that behave differently and need to be treated accordingly.

The UCLA team said their findings indicate the traditional one-size-fits-all treatment approach needs to be changed.

"We have shown that not all kidney cancer patients are the same, not all localized kidney cancers are the same, and not all metastatic kidney cancers are the same," study senior author Dr. Arie Belldegrun, a professor of urology and a researcher at UCLA's Jonsson Comprehensive Cancer Center, said in a UCLA news release.

Patients with localized kidney cancer can have either low-, intermediate-, or high-risk cancers based on the chance for recurrence, the researchers found. Patients with kidney cancer that's spread (metastatic cancer) can also be categorized into similar subsets.

"Now we can base treatment decisions based on that," Belldegrun said.

Patients with localized, low-risk kidney cancer have a projected five-year survival rate of 97 percent and a 10-year survival rate of 92 percent, compared to 81 percent and 61 percent for patients with localized, intermediate-risk cancer, and 62 percent and 41 percent for patients with localized, high-risk cancer.

"All these patients with cancers that have not spread present to their doctors with presumably localized disease, and in the past, they may have been treated the same way. They need to be treated individually, according to their risk levels," Belldegrun said.

For example, the UCLA team showed that surgery alone can produce excellent outcomes in patients with localized, low-risk, kidney cancer, meaning they could be spared the harsh side effects associated with radiation or immunotherapy. But surgery alone isn't sufficient for patients with localized, high-risk kidney cancer.

Patients with metastatic, low-risk cancer should get very aggressive treatment, because there's a good chance the therapy will benefit them. But patients with metastatic, high-risk cancer may choose to decline treatment, because they'll get little or no benefit from it.

"Our paper identifies, very precisely, which patients should get which therapies," Belldegrun said.

The study was published in the Nov. 1 issue of Cancer.

More information

The American Urological Association has more about kidney cancer  .

FRIDAY, Oct. 31 (HealthDay News) -- The outlook for cancer patients, in some ways, has never been better, with breakthroughs leading to earlier diagnoses of certain malignancies, new treatments, and improved survival rates.

But that string of successes could be threatened. By the year 2020, the United States could face a shortage of as many as 4,080 cancer doctors, according to a recent report issued by the American Society for Clinical Oncology.

"As of 2007, we were in equilibrium," said Dr. Dean Bajorin, an oncologist at Memorial Sloan-Kettering Cancer Center in New York City and co-chairman of the society's Workforce Implementation Working Group, which developed the report. "It looks like the demand for services appears comparable to provision of services."

"But," he added, "we think it won't get better than that. The shortage will be gradual over time."

The report cites a number of factors likely to lead to the shortfall. They include the aging of the U.S. population, with the number of Americans 65 and older expected to double from 2000 to 2030. Cancer is more common among older adults.

Also, many oncologists are expected to be retiring soon, Bajorin said.

A third factor is the growing number of female oncologists, Bajorin said. While the medical profession applauds the fact that there is more gender balance among oncologists, studies have found women cancer specialists tend to see fewer patients than do male oncologists, he said.

Exactly why isn't known, Bajorin said. "Some may work fewer hours because of family obligations," he said. "Or it may be more complicated than that. They may spend more time with their patients than do the men."

One question being asked by oncologists in anticipation of the expected shortage is whether cancer patients need to be cared for continually by cancer specialists.

One remedy to the shortage might be to train other doctors, or nurse practitioners, to take over some aspects of cancer care, Bajorin said. For instance, they might be trained in "survivorship care," caring for patients once their cancer has gone into remission or has been eliminated.

Or the solution might require an attitude shift on the part of both oncologists and patients, Bajorin said, from a primary cancer doctor providing care to an entire team providing care, with different health care professionals tending to patients at different stages.

Whether the shortage materializes exactly as predicted or not, learning to communicate with your cancer doctor and others on your team is crucial, according to the experts at CancerCare, a New York-based nonprofit organization providing support services to those affected by cancer. Among its tips for communicating with your doctor and other health-care team members:

• Remember that you are a consumer of health care. And with that in mind, the best way to begin making difficult decisions about health care is to educate yourself.
• When you have an appointment, bring someone with you. Doing so lends support, in addition to providing a "second set of ears," and another person to think of questions.
• Write out a list of questions before an appointment; this list will help you remember important questions. Be sure to make the questions specific and brief because your doctor has limited time. And ask your most important questions first.
• Write down the answers and instructions the doctor gives you. Even better, bring a tape recorder to the appointment -- as long as the doctor says it's OK.
• When asking questions, use "I" statements. For example, the phrase "I don't understand..." is much more effective than "You're being unclear about..."
• If you're confused by something your doctor says, repeat it back by saying something like, "So you mean I should...?" And if you're someone who understands better with the use of visuals, ask to see X-rays or slides, or ask your doctor to draw a diagram.

More information

To learn more, visit CancerCare.