Are you at risk for 'Shingles'? Should you get the vaccine?

When Mr. Maven presented at the ER with the horrible pain in his shoulder this week, once the cardiac possibilities had been ruled out, the doc thought “hmmmm, could be the onset of shingles”. Yikes.

Shingles is a really nasty disease - that we can all get if we have had the chicken pox as a child. The virus lays dormant in the nerves throughout the body for decades, and can spring up again, usually after the age of 50 -  but that’s not carved in stone. Even children, in rare cases, have had shingles. My sister-in-law really suffered for nearly two years with it when she lived in Minnesota, and she was in her 50’s then.

Actually, I got thinking about taking the vaccine earlier this year when Mr. Maven and I were getting all our vacinations for going to Western Africa, but somehow didn’t follow up. Then when I got my flu shot a month ago - yes, I’ve already got mine - I asked about it and balked at the $325 price tag. Ouch.

But this most recent event really got me thinking about it - damn the cost if it hurts that much. After asking my doctor about my risk and how it might relate to my status as a cancer survivor, it’s clear that I absolutely should have it, and Mr. Maven too. My doctor said that I should absolutely positively get the vaccine.

You see, anything that could affect my arm on the side where I had my mastectomy - and three levels (21) of lymph nodes removed - could be really, really bad in that it could cause lymphedema that might not be treatable. And that’s not the half of shingles. The complications can be serious.

That said, Mr. Maven and I are both on the waiting list for the vaccination at the end of December when it becomes available.

The first signs of shingles can be unexplained intense pain, followed a few days later by a bad rash similar to those of chicken pox and weeping/oozing blisters. Whoa. That’s sounds harsh.

From the Mayo Clinic:

Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. Anyone who’s had chickenpox may develop shingles. After you recover from chickenpox, the virus can enter your nervous system and lie hidden for years. Eventually, it may reactivate and travel along nerve pathways to your skin — producing shingles.

Shingles is characterized by pain or a tingling sensation in a limited area on one side of the face or torso, followed by a red rash with small, fluid-filled blisters.

The reason for the encore is unclear. But it may be due to lowered immunity to infections as you grow older. Shingles is more common in older adults and in people who have weak immune systems.

Varicella-zoster is part of a group of viruses called herpes viruses, which includes the viruses that cause cold sores and genital herpes. Because of this, shingles is also known as herpes zoster. But the virus that causes chickenpox and shingles is not the same virus responsible for cold sores or genital herpes, a sexually transmitted disease.

Having had chickenpox
Anyone who has ever had chickenpox can develop shingles. Most adults in the United States had chickenpox when they were children, before the advent of the routine childhood vaccination that now protects against chickenpox.

Age
Shingles is most common in people over the age of 50. The risk increases with age. Some experts estimate that half the people who live to the age of 85 will experience shingles at some point in their lives.

Weakened immune systems
People with weakened immune systems are at higher risk for developing shingles. A weakened immune system can be caused by:

• HIV/AIDS
• Cancer or cancer treatments, such as radiation and chemotherapy
• Prolonged use of steroids, such as prednisone
• Drugs designed to prevent rejection of transplanted organs

Complications from shingles can range from a mild to severe, ranging from minor skin infections to postherpetic neuralgia.

Postherpetic neuralgia
For some people, shingles pain continues long after the blisters have cleared. This condition is known as postherpetic neuralgia, and it occurs when damaged nerve fibers send confused and exaggerated messages of pain from your skin to your brain. Pain medication, antidepressants or anticonvulsant medications may help provide relief until the pain subsides.

Vision loss
Shingles in or around an eye (ophthalmic shingles) can cause painful eye infections that may result in vision loss.

Neurological problems
Depending upon which nerves are affected, shingles can cause:

• Encephalitis, an inflammation of the brain
• Hearing or balance problems
• Facial paralysis

Skin infections
If shingles blisters aren’t properly treated, bacterial skin infections may develop.

A breast cancer vaccine on the horizon? Could be. Could be huge!

This is the holy grail for millions of women - both who have not had breast cancer, and those like me who have and live in daily fear that it will return.

Maven in 2002, at the University of Texas, M. D. Anderson Cancer Center, receiving chemotherapy for Stage IIIa breast cancer.

The very idea that I could be vaccinated against a recurrence would change my life as profoundly as the initial diagnosis of Stage IIIa breast cancer did. I could get back to living my life completely - without that sneaky part of my brain that worries every little pain (metastasis to the bones?), rumbling cough (metastasis to the lungs?), and every little tummy ache (metastasis to the liver?) into something sinister.

My only regret about this news? That it didn’t come first from M. D. Anderson. Oh, well.

Here is the information direct from the Cleveland Clinic:

Research Could Lead to First Vaccine to Prevent Breast Cancer Formation in Women over Age 40 and Women at High Risk

A first-of-its-kind vaccine to prevent breast cancer has shown overwhelmingly favorable results in animal models, according to a study by researchers at Cleveland Clinic’s Lerner Research Institute.

The researchers found that a single vaccination with the antigen α-lactalbumin prevents breast cancer tumors from forming in mice, while also inhibiting the growth of already existing tumors. Human trials could begin within the next year. If successful, it would be the first vaccine to prevent breast cancer.

The research will be published online May 30 at http://www.nature.com/naturemedicine/ and in the June 10 issue of Nature Medicine.

“We believe that this vaccine will someday be used to prevent breast cancer in adult women in the same way that vaccines prevent polio and measles in children,” said Vincent Tuohy, Ph.D., the study’s principal investigator and an immunologist in Cleveland Clinic’s Lerner Research Institute Department of Immunology. “If it works in humans the way it works in mice, this will be monumental. We could eliminate breast cancer.”

In the study, genetically cancer-prone mice were vaccinated — half with a vaccine containing α-lactalbumin and half with a vaccine that did not contain the antigen.

None of the mice vaccinated with α-lactalbumin developed breast cancer, while all of the other mice did.

The U.S. Food and Drug Administration has approved two cancer-prevention vaccines, one against cervical cancer and one against liver cancer. However, these vaccines target viruses — the human papillomavirus (HPV) and the Hepatitis B virus (HBV) — not cancer formation.

In terms of developing a preventive vaccine, cancer presents a quandary not posed by viruses. While viruses are recognized as foreign invaders by the immune system, cancer is not. Rather, cancer is an over-development of the body’s own cells. Trying to vaccinate against this cell over-growth would effectively be vaccinating against the recipient’s own body, destroying healthy tissue.

The key, Dr. Tuohy said, is to find a target within the tumor that is not typically found in a healthy person. In the case of breast cancer, Dr. Tuohy and his research team targeted α-lactalbumin — a protein that is found in the majority of breast cancers, but is not found in healthy women, except during lactation. Therefore, the vaccine can rev up a woman’s immune system to target α-lactalbumin — thus stopping tumor formation — without damaging healthy breast tissue.

The strategy would be to vaccinate women over 40 — when breast cancer risk begins to increase and pregnancy becomes less likely. (If a woman would become pregnant after being vaccinated, she would experience breast soreness and would likely have to choose not to breast feed.) For younger women with a heightened risk of breast cancer, the vaccine may be an option to consider instead of prophylactic radical mastectomy.

“Most attempts at cancer vaccines have targeted viruses, or cancers that have already developed,” said Joseph Crowe, M.D., Director of the Breast Center at Cleveland Clinic. “Dr. Tuohy is not a breast cancer researcher, he’s an immunologist, so his approach is completely different — attacking the tumor before it can develop. It’s a simple concept, yet one that has not been explored until now.”

Dr. Tuohy believes that the findings of this study go beyond breast cancer, providing insight into the development of vaccines to prevent other types of cancer. The results show that the antigen used in a cancer vaccine must meet several criteria: it must be over-expressed in the majority of targeted tumors; and it must not be found in normal tissue, except under specific, avoidable conditions (such as lactation).

Update on Thursday, June 10, 2010 at 14:23 by mavenandmeddler

Here is a followup from the Cleveland Clinic regarding any clinical trials on the horizon - there are none, yet. They are in desparate need of donations, however, toward funding any clinical trials - so if you happen to have some spare dollars laying around ….

Their reply:

Thank you for contacting the Cleveland Clinic through our site on the Web.  

The vaccine is currently not in clinical use. Funding is needed to take this discovery to the next step and to be able to bring it to healthy women for prevention of breast cancer. 

It will take several years of clinical trials before the vaccine is readily available to breast-cancer-free women for prevention. The highest priority is the safety of the participants in the trials.  First we will evaluate safety, then we will evaluate dosage.

Initial trials will be done in patients with established disease. We are not soliciting names for inclusion in the clinical trials. We do not yet have the “go-ahead” from the FDA. Financial support is what is needed now so we can continue the processes involved in moving this from the lab to the research venue to the patient. We hope our findings will benefit women who are now ages 30 and up. Early trials will be in a limited population of well defined patients.

This vaccination is different from what has been done in other vaccines for cancer.  Other vaccines served as “treatment” vaccines, but this is for prevention. We are encouraged because this approach is novel, and offers true breakthroughs with respect to vaccine approach to cancer 

 Any contacts interested in donating towards Dr. Tuohy’s breast cancer vaccination project and clinical trials should contact Susan Sasvari, Director of Fund Development at LRI; Tel: 216-444-1821; E-mail: sasvars@ccf.org

Any contacts requesting general info about breast cancer, the Cleveland Clinic, or the vaccine research, call The Cancer Answer line 1-866-223-8100 or 216-444-7923.

For more information, you may read the paper, entitled “A prophylactic, autoimmune-mediated vaccination strategy for breast cancer” and is published in Nature Medicine June 2010.             http://www.nature.com/nm/index.html

To learn more about the services in the Breast Center, please visit our Website at:

http://www.clevelandclinic.org/breastcenter

I hope this information has been of help to you.  Please contact us again if you need additional information.  Best of luck to you!

Sincerely,

Charmaine Jones

The Cleveland Clinic

Cleveland, OH

www.clevelandclinic.org

Vaccine and autism link: it's over, or should be

Anybody who has been paying attention should have already guessed that this would be the finding of the court, that there is no link between the childhood vaccines and autism. Unfortunately, there are still enough distraught parents of autistic children out there who will continue to look for a link where none exists, and perhaps miss the real causes.

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