Doctor, What Should I Do?
September 27, 2006 – Marc Silver
Web Exclusive: Corporations Unite Against Cancer
September 27, 2006 – Elizabeth Whittington
Web Exclusive: What Parents Can Do
September 27, 2006 – Elizabeth Whittington
Web Exclusive: A Lion in the House
September 27, 2006 – Marc Silver
Multiple Myeloma & Leukemia
September 27, 2006 – Elizabeth Whittington
Coping
September 27, 2006 – Christopher Schultz
Legal Rights as a Survivor
September 27, 2006
Bookshelf
September 27, 2006 – Kathy LaTour
House Call
September 27, 2006 – Aman Buzdar
Mitigating Litigation
September 27, 2006 – Elizabeth Whittington
Cancer with a Known Cause
September 27, 2006 – Elizabeth Whittington
Cure Becomes Less Risky
September 27, 2006 – Alice McCarthy
Classifying & Clarifying MDS
September 27, 2006 – Elizabeth Whittington
When the Choice Is Not Cure
September 27, 2006 – Marc Silver
The Scoring System
September 27, 2006
Do Women Under 50 Need Mammograms?
September 27, 2006 – Beverly A. Caley
Watch It or Treat It?
September 27, 2006 – Beverly A. Caley
Sisterhood
September 27, 2006 – Jo Cavallo
Creating a Dragon Boat Team
September 27, 2006 – Elizabeth Whittington
Arms in Motion
September 27, 2006 – Elizabeth Whittington
Job-Searching Hints for Survivors
September 27, 2006 – Elizabeth Whittington
Working Through Caregiver Grief
September 27, 2006 – Elizabeth Whittington
Fatal Fibers
September 27, 2006 – Katy Human
People & Places
September 27, 2006 – Elizabeth Whittington
Back in Action After DCIS
September 27, 2006 – Nancy Reuben Greenfield
Getting the Care You Deserve
September 27, 2006 – Stacy Beller Stryer
Treatment Boost for MDS
September 27, 2006 – Alice McCarthy
Power to the Patient
September 27, 2006 – Marc Silver
In Situ Breast Cancer: Is It Really Cancer?
September 27, 2006 – Beverly A. Caley
The Shadow Survivors
September 27, 2006 – Jo Cavallo
Taming the Dragon
September 27, 2006 – Elizabeth Whittington
The Choice to Work
September 27, 2006 – Elizabeth Whittington
A Waste of Taste
September 27, 2006 – Elizabeth Whittington
A Cunning Predator
September 27, 2006 – Katy Human
Lessons Learned
September 27, 2006 – Cole A. Giller, MD PhD
Letters from Our Readers
September 27, 2006
A Worry-Free Way to Support Nonprofits?
September 27, 2006 – Emma Johnson
Message from the Editor
September 27, 2006
Doctor, What Should I Do?
September 27, 2006 – Marc Silver
Web Exclusive: Corporations Unite Against Cancer
September 27, 2006 – Elizabeth Whittington
Web Exclusive: What Parents Can Do
September 27, 2006 – Elizabeth Whittington
Web Exclusive: A Lion in the House
September 27, 2006 – Marc Silver
Multiple Myeloma & Leukemia
September 27, 2006 – Elizabeth Whittington
Coping
September 27, 2006 – Christopher Schultz
Legal Rights as a Survivor
September 27, 2006
Bookshelf
September 27, 2006 – Kathy LaTour
House Call
September 27, 2006 – Aman Buzdar
Mitigating Litigation
September 27, 2006 – Elizabeth Whittington
Currently Viewing
Cancer with a Known Cause
September 27, 2006 – Elizabeth Whittington
Classifying & Clarifying MDS
September 27, 2006 – Elizabeth Whittington
When the Choice Is Not Cure
September 27, 2006 – Marc Silver
The Scoring System
September 27, 2006
Do Women Under 50 Need Mammograms?
September 27, 2006 – Beverly A. Caley
Watch It or Treat It?
September 27, 2006 – Beverly A. Caley
Sisterhood
September 27, 2006 – Jo Cavallo
Creating a Dragon Boat Team
September 27, 2006 – Elizabeth Whittington
Arms in Motion
September 27, 2006 – Elizabeth Whittington
Job-Searching Hints for Survivors
September 27, 2006 – Elizabeth Whittington
Working Through Caregiver Grief
September 27, 2006 – Elizabeth Whittington
Fatal Fibers
September 27, 2006 – Katy Human
People & Places
September 27, 2006 – Elizabeth Whittington
Back in Action After DCIS
September 27, 2006 – Nancy Reuben Greenfield
Getting the Care You Deserve
September 27, 2006 – Stacy Beller Stryer
Treatment Boost for MDS
September 27, 2006 – Alice McCarthy
Power to the Patient
September 27, 2006 – Marc Silver
In Situ Breast Cancer: Is It Really Cancer?
September 27, 2006 – Beverly A. Caley
The Shadow Survivors
September 27, 2006 – Jo Cavallo
Taming the Dragon
September 27, 2006 – Elizabeth Whittington
The Choice to Work
September 27, 2006 – Elizabeth Whittington
A Waste of Taste
September 27, 2006 – Elizabeth Whittington
A Cunning Predator
September 27, 2006 – Katy Human
Lessons Learned
September 27, 2006 – Cole A. Giller, MD PhD
Letters from Our Readers
September 27, 2006
A Worry-Free Way to Support Nonprofits?
September 27, 2006 – Emma Johnson
Message from the Editor
September 27, 2006

Cancer with a Known Cause

About 20 percent of patients develop secondary MDS—when the disease is caused by chemotherapy, such as alkylating agents, or radiation used to treat a previous cancer—and current research is focused on finding genetic alterations that will provide better treatment options for these patients.

BY Elizabeth Whittington
PUBLISHED September 27, 2006

 Although most cases of MDS have an unclear cause, called primary or de novo MDS, about 20 percent of patients develop secondary MDS—when the disease is caused by chemotherapy or radiation used to treat a previous cancer. Chemical exposure from benzene and other toxic chemicals have also been known to cause secondary MDS. Unfortunately, patients with this form of MDS usually do not respond as well to treatment and have a worse prognosis than patients with primary MDS. There is also no standard therapy for patients with secondary MDS.

Secondary MDS is mostly found in patients treated for lymphoma or leukemia with chemotherapy combinations, but survivors of breast cancer, prostate cancer and colon cancer, among others, can also be affected. Alkylating agents, such as Cytoxan (cyclophosphamide), Alkeran (melphalan) and Myleran (busulfan), as well as VePesid® (etoposide), Vumon (teniposide) and topoisomerase inhibitors are the most well-known chemotherapy culprits.

Current research is hoping to find genetic alterations that will help provide better treatment options for patients with secondary MDS since studies have shown that up to 90 percent of secondary MDS patients have chromosomal mutations in their DNA. Chromosomal abnormalities caused by alkylating agents usually appear in chromosomes 5 and 7 and can develop into MDS over several years, while MDS caused by topoisomerase inhibitor exposure appears sooner as mutations in chromosome 11.

Currently, there is no way to identify patients who have a high risk of secondary MDS. Studies have shown that different mutations confer prognostic information, which may help patients decide between treatment options. In the future, these specific alterations could be used as biomarkers to determine risk of the disease and detect additional cancer cells after treatment.

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