Way to go Wake Forest University scientists -- for adding to the body of evidence connecting stress to illness and for reporting before anyone else that the stress hormone epinephrine causes changes in prostate and breast cancer cells that may make them resistant to death.

Emotional stress contributes not only to the development of cancer, says lead researcher George Kulik, D.V.M., Ph.D, but it also reduces the effectiveness of cancer treatments.

Previous research shows levels of epinephrine, produced by the adrenal glands, are sharply increased during stressful situations and can stay elevated during long-term stress and depression.

During this study, published in the on-line Journal of Biological Chemistry, Kulik and colleagues found that a protein called BAD -- the cause of cell death -- becomes inactive when cancer cells are exposed to epinephrine.

This is huge for patients and researchers.

"It may be important for patients who have increased responses to stress to learn to manage the effects," said Kulik. "And, the results point to the possibility of developing an intervention to block the effects of epinephrine."

Results of two studies, sponsored by the Adjuvant Breast Cancer (ABC) Trials Collaborative Group, conclude that adding chemotherapy to the estrogen-blocking drug tamoxifen improves survival for those with early-stage breast cancer. The same studies reveal preventing the secretion of estrogen from the ovaries does not offer much benefit for most women.

Researchers studied 1991 patients, ages 28 to 81. All had received five years worth of treatment with tamoxifen therapy with or without standard chemotherapy. Some premenopausal women were also treated with ovarian removal (ablation) or suppression, a technique used to stop the glands from secreting hormones.

While early results, appearing in the Journal of the National Cancer Institute, fell short of statistical significance, chemotherapy still reduced the overall risk of death by 17 percent, mostly for women younger than 50 and especially for premenopausal women not treated with ovarian ablation or suppression.

At the end of November, EarthLink CEO Garry Betty took a medical leave of absence from his job to fight adrenocortical cancer, a serious form of cancer characterized by a tumor that occurs in the adrenal glands above the kidneys. On Tuesday, Betty died at his Atlanta home from complications of the disease. He was 49.

Betty joined the internet service provider EarthLink in 1996 and helped the regional company grow from a provider with 500,000 subscribers into a national powerhouse with more than five million subscribers.

"Garry was instrumental in building EarthLink into the company it is today," EarthLink Chairman Robert M. Kavner said in a recent statement.

EarthLink was just one of Betty's successful ventures. He began his career at IBM Corp. and won the IBM President's Excellence Award in 1982 for his work on the company's personal computer. He also served as CEO of Digital Communications Associates Inc. and at the time became the youngest CEO of a company listed on the New York Stock Exchange.

Betty, who graduated from the Georgia Institute of Technology in 1979 with a degree in chemical engineering, was responsible for 2,200 EarthLink employees. And in support of his team, he attended the company's 2006 Christmas party just three weeks after receiving his diagnosis.

"He put on a tux and came out for a night to make all of us feel better," said Mike Lunsford, interim EarthLink CEO. "And he succeeded."

Betty is survived by his wife, Kathy.

I'm coming up on my last year on tamoxifen. I often wonder if it would be beneficial to me to begin taking an aromatase inhibitor following my five years of tamoxifen. According to an article published in the journal Cancer, premenopausal women with breast cancer that has spread to at least four lymph nodes received the most benefit from aromatase inhibitors following treatment with tamoxifen. Postmenopausal women with cancer that has spread to three or less nodes only seem to get a 1-2 percent benefit from the addition of an aromatase inhibitor following tamoxifen.

I don't seem to fit in either category since I had premenopausal breast cancer with less than four lymph nodes positive. I also thought that if you are premenopausal that aromatase inhibitors were not beneficial at all and only postmenopausal women were able to take these drugs.

Aromatase inhibitors work by reducing the amount of estrogen your body makes. Your adrenal glands produce a substance called androstenedione, which gets converted into estrogen in tissues such as fat and muscle. The conversion requires the enzyme called aromatase. Aromatase inhibitors stop the conversion of androstenedione to estrogen. However, if your ovaries are still functioning then the body still will have estrogen that can help cancer to grow and the aromatase inhibitors will not stop the estrogen production of the ovaries.

The study that was done concluded - it appears that women who are premenopausal and those whose cancer has spread to four or more lymph nodes would derive greater benefit from the addition of aromatase agents following tamoxifen.

I am assuming that they mean if these premenopausal women are then put into a postmenopausal state, either happening by chemotherapy or shutting down the ovaries by injection or oophorectomy.

This is a confusing article that doesn't seem to make sense. Any insights?