Breakthroughs

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Robert S. DiPaola, the senior author of a study recently published in the New England Journal of Medicine about the possible benefits of multiple therapies to combat prostate cancer, is the director of Rutgers Cancer Institute of New Jersey.

Photography: 

Nick Romanenko

Fighting a Scourge
A new prostate cancer therapy could lead to better treatments.

More than 200,000 men in the United States are diagnosed each year with prostate cancer, with nearly 30,000 dying from the disease. For survivors, surgery or radiation along with hormonal treatment has been effective. For more than 60 years, the standard of care for patients with prostate cancer fueled by androgen hormones that has spread to other parts of the body has been androgen deprivation therapy (ADT). Although the success rate is high, some patients become resistant to ADT, at which point chemotherapy is typically administered. Now, findings by the ECOG-ACRIN Cancer Research Group hold the promise of new hope for patients.

If the chemotherapy drug docetaxel is administered at the start of ADT, according to the study, patients survived on average 13.6 months longer than if they were treated with only ADT. For patients who had more extensive evidence of the disease, the benefit was even greater: a survival difference of 17 months. “The benefit was dramatic,” says Robert S. DiPaola, the senior author of the study, which was published recently in the New England Journal of Medicine. “Any improvement in survival ... offers additional opportunities for additional therapies or new clinical trial options.”

DiPaola, who is also the director of Rutgers Cancer Institute of New Jersey, helped lead the design of the protocol a decade ago when he was the national chair of the ECOG Genitourinary Committee, which comprised cancer researchers at numerous institutions who hypothesized that introducing chemotherapy earlier in the patient’s care, and in combination with hormonal therapy, would benefit patients. The new findings are strong enough to support changing that 60-year-old standard of care, according to the study.

No Harm Done
Statins not likely suspect in short-term memory loss.

Contrary to earlier assertions, cholesterol-lowering statin drugs  most likely do not cause short-term memory loss, according to a study conducted by Rutgers and the University of Pennsylvania that evaluated nearly one million patients. Limited studies  and some statin-drug takers had anecdotally reported memory lapses  after taking popular lipid-lowering drugs called statins, according to Brian L. Strom, chancellor of Rutgers Biomedical and Health Sciences and lead author of the study. Thus, some people have stopped taking their statins, inappropriately, he says.

About 610,000 people die each year of heart disease in the United States, accounting for one in every four deaths, according to the Centers for Disease Control and Prevention. One in four Americans over age 45 take statins, drugs that inhibit a liver enzyme that controls the synthesis of cholesterol and lowers LDL, commonly known as “bad cholesterol.” Statins have proven very effective at lowering high cholesterol, one of the major risk factors for heart disease, and preventing heart attacks and deaths. — Dory Devlin

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The chemical in chili peppers that causes the burning pain—capsaicin—has become a popular pain reliever in over-the-counter and prescription medications. Tibor Rohacs, an associate professor in the Department of Pharmacology and Physiology at New Jersey Medical School, is researching just how capsaicin works to calm painful nerves, muscles, and joints.

The Red-Hot Chili Peppers
From burning to pain relief.

Anyone who has unsuspectingly bitten into a hot chili pepper may have thought they were dying. But the truth is, those little devils are actually good for your heath. As philosopher Friedrich Nietzsche once said: “That which does not kill us makes us stronger.”

The very chemical that causes the burning pain—capsaicin—has become a popular pain reliever for over-the-counter and prescription medications. The calming effects of hot chili peppers are old news for Tibor Rohacs, an associate professor in the Department of Pharmacology and Physiology at New Jersey Medical School. What is new, gleaned from his research, is how capsaicin works to calm painful nerves, muscles, and joints.

Rohacs and his research team discovered that capsaicin activates a nerve mechanism that blocks pain signals. They have been studying ion channels found in sensory nerve terminals that respond to heat and other stimuli, focusing in particular on an ion channel known as TRPV1, which is the capsaicin receptor.

“The idea is basically that this pain-causing, heat-sensor ion channel does something to the nerves that in the long run sort of silences them or desensitizes them,” says Rohacs, who published the findings in Science Signaling. “The desensitizing effect, I believe, has a number of different components and different timescales.”

Rohacs says the jury is still out on the practical application of capsaicin as a pain medication, already available in the form of creams and patches. A high-concentration capsaicin remedy has to be injected—along with a local analgesic that numbs the burning sensations until the remedy can begin desensitizing the nerves. — Rick Remington

Food and Love
Why a partner in  a same-sex union may overeat.

Social relationships have an impact on adults’ ability to maintain a good diet, but little attention has been given to the influence of romantic relationships, says Charlotte Markey, a professor of psychology at Rutgers University–Camden. Moreover, research hadn’t addressed the role of those relationships among same-sex couples—until Markey teamed up with Villanova researcher Patrick Markey, Rutgers–Camden faculty researchers Kristin August and Christopher Nave, and Lindzee Bailey GSC’12, who initiated the project as part of her thesis.

A common eating disorder is known as “restrained eating,” a process during which a person deliberately restricts his or her food intake in order to lose or avoid gaining weight. But the behavior is also characterized by alternating episodes of unreasonable food abstention and binge eating, say the researchers in their study published in the Journal of Health Psychology. The study, based on a survey of participants in monogamous same-sex relationships, revealed significant evidence that men and women who were relatively heavier than their partners were at particular risk for engaging in all facets of restrained eating. The explanation? There is a need for people in both same-sex and heterosexual relationships to conform to body ideals of “close reference groups,” in this case, their romantic partners. This tendency can be heightened, the researchers say, when the partner is the same gender.

“The relationships that any individual maintains, regardless of sexual orientation, may be critical in determining their eating behaviors,” Markey says. “Therapeutic interventions may not only improve their relationships, but also their eating habits and even their overall well-being.”

A Grave Oversight
Overweight women treated for cancer need more chemo.

Women who are overweight and being treated for ovarian cancer might not be receiving enough chemotherapy, reducing their chances of survival. The proper amount of chemotherapy should be based in part on a patient’s weight. But a study of doses, led by Elisa Bandera, an  epidemiologist at the Rutgers Cancer Institute of New Jersey, found that many physicians failed to give these patients larger doses. That decision may well have an impact on a patient’s long-term survival, Bandera claims. 

Although treatment guidelines developed by the American Society of Clinical Oncology recommend the full dose, many oncologists are wary of giving heavy patients large amounts because, in their view, the treatment could end up being toxic: chemotherapy affects other parts of the body, not just cancer cells. Too much of a chemotherapy drug, for instance, can drop a patient’s white blood cell count dangerously low or cause nerve damage. Because of her study, Bandera believes, reluctant physicians are now armed with the evidence they need: the higher doses are essential to successful treatment.

Hey, Good Lookin’
Investors prefer to give money to attractive advisers.

Psychological research long ago revealed that most folks think  better-looking people are more trustworthy than others. Now there  is research demonstrating that investors consider better-looking fund managers to be more trustworthy than those who are not as physically attractive. The research, conducted by assistant professor Ankur Pareek at Rutgers Business School–Newark and New Brunswick, and Roy Zuckerman at Tel-Aviv University, confirms that looks are a major factor in how we measure trustworthiness. Not surprisingly, there is no correlation between fund managers’ personal appearance and their performance. In fact, the research finds that those managers rated as more trustworthy by virtue of their looks actually produced worse returns. And, they were more likely to get a break when their investments performed poorly.

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Researchers at Rutgers, the University of Pennsylvania, and Nemours A.I. duPont Hospital for Children have found that children who were prescribed antibiotics have twice the risk of developing juvenile arthritis compared with children the same age who were not prescribed antibiotics.

Childhood Arthritis
Antibiotics seen as a culprit.

Researchers at Rutgers, the University of Pennsylvania, and Nemours A.I. duPont Hospital for Children found that children who were prescribed antibiotics had twice the risk of developing juvenile arthritis compared with children the same age who were not prescribed antibiotics. The more courses of antibiotics  prescribed, the higher the associated risk, according to Daniel Horton, the lead author of the study published in Pediatrics. The risk was strongest  within one year of receiving antibiotics.

According to the Centers for Disease Control and Prevention, between 4,300 and 9,700 children under the age of 16 are diagnosed each year with juvenile arthritis, which causes chronic inflammation of the joints and eyes that can lead to pain, vision loss, and disability. Genetics account for only one quarter of cases in children; environmental triggers may also play an important role.

Studies have indicated that about a quarter of antibiotics prescribed to children—and half of antibiotics prescribed for acute respiratory infections—are probably unnecessary. This is “another possible reason to avoid antibiotic overuse for infections that would otherwise get better on their own,” says Horton, a postdoctoral research fellow in the Department of Pediatrics at Robert Wood Johnson Medical School and a biomedical informatics master’s degree candidate at the School of Health Related Professions. — Dory Devlin

Parental Discretion
Tough times mean more money for daughters.

When times are tight, parents are more financially generous with their grown daughters than with their sons. That’s the conclusion of Kristina Durante, an associate professor of marketing at Rutgers Business School–Newark and New Brunswick, who conducted a  study published in the Journal of Consumer Research. And even though parents expressed equal love for daughters and sons, survey results revealed that they unconsciously believed daughters were more apt to produce a grandchild. (Indeed, participants in the study, also unknowingly, were more inclined to favor those daughters who were nearing childbearing age, when grandparenthood started to feel like a reality.) 

The facts bear out the parental intuition: daughters are more likely to produce grandchildren than sons; indeed, far more men than women go through life without procreating. And in trying economic times, the number of men who fail to find a mate increases. So favoring the daughter becomes a safer bet for parents that they will get at least one grandchild.

“These are subtle things that are happening when people are exposed to information about scarcity,” says Durante, pointing out that daughters and sons received the same amount of financial help from participants in the study if there was the perception of a healthy economy. “And even though we have relative abundance now, there hasn’t been enough time to remove those biases. Something primal happens in tough economic times.” — Rob Forman