Eric Shanteau says the support of teammates has been important as he fights testicular cancer.

August 11, 2008, BEIJING, China (CNN) — He’s certainly not the star of the team or even a medal favorite, but Eric Shanteau has earned as much respect as any of the U.S. swimmers at the Olympic Games.

Shanteau, 24, of Lilburn, Georgia, was diagnosed with testicular cancer June 19, a week before he left for the U.S. swim trials. But he put off the decision to have surgery until after the Summer Games, his first and last Olympics.

“I can’t believe what he is going through,” said teammate Dara Torres, “but he still has that drive to be here and to do his best. It is an amazing thing to watch.”

It will be even more amazing if Shanteau can medal in the 200-meter breaststroke, which begins with preliminaries Tuesday night (Tuesday morning in the United States). He has the ninth fastest time in the world this year, but he’s confident he can surprise people. After all, swimming is the easy part.

Cancer is on his mind constantly, he said. He worries about himself and his father, Rick, who has lung cancer. It reminds him that while reaching the Olympics was his dream, there are other things he should treasure.

Shanteau, an Auburn University graduate, admits that he has some down times because of the disease, but constantly reminds himself: “I have cancer; cancer doesn’t have me.”

And there is the support of his 40 teammates. He broke the news to them at a training camp. They had suspected something was wrong after Shanteau barely celebrated making the team. Aaron Piersol, who is a club teammate of Shanteau’s, wondered why his friend had been keeping to himself and had been showing up late for practice a lot.

Eric Shanteau was diagnosed with cancer a week before leaving for the U.S. swim trials in June.

Since the announcement, Shanteau has received e-mails, cards and letters from all over the world, but he points to his fellow swimmers as a huge support group.

“I’m very thankful they’ve taken me under all their wings,” he said Wednesday at a news conference before the swimming competition began. “They are all behind me, willing to support me in the fight I am going through.”

He also has the support of his girlfriend, Jeri Moss, who played the key role in discovering the cancer. She was the one who prodded him to go to the doctor one weekend. One of those kick in the butt moments that may have prevented a more serious issue.

Testicular cancer is an extremely treatable disease, especially when caught early. More than 95 percent of cases are cured, according to the National Cancer Institute’s Web site.

In Shanteau’s case, it was discovered extremely early and doctors determined it was slow-moving. He decided to live “week to week” in hopes that the cancer wouldn’t quickly spread or grow.

Shanteau’s decision to wait is common for people who have constant doctors’ care.

“It is not unusual for someone to delay getting treatment for several weeks or several months,” Dr. Otis Brawley of the American Cancer Society told CNN in July. “I’m not advocating that everybody wait a period of three or four weeks. If they do it under medical supervision, it can be very safe.”

Asked about how he kept his focus after deciding to compete with cancer, Shanteau said it wasn’t difficult.

“A lot of times when you get to an event like the Olympic Games, you can put too much pressure on yourself,” he said. “I’ve kind of got an out with cancer.”

It is unlikely that when Shanteau boards a plane to head back to the United States that he will have a medal to take with him. He disagrees. He said he believes he will finish in the top three “if I show up and swim the race I am capable of.”

And then the man with cancer will turn supporter, cheering on the teammates who look to him for inspiration.

“To know I will be cured and I will beat this is inspiring,” he said. “It’s not going to get in the way of my life.”

According to a report published in Psychosomatic Medicine (2008;70:653-660), a study was performed to examine the association between adiposity and the magnitude of cardiovascular reactions to acute psychological stress. For the study, blood pressure and heart rate (HR) were measured at rest and in response to a brief time-pressured mental arithmetic stress in 1647 adults. At the same session and 5 years later, height, weight, waist and hip circumference were measured and body mass index (BMI) and waist-hip ratio were computed. Obesity was defined as a body mass index of 30kg/m2. Contrary to expectations, the most robust and consistent results to emerge from cross-sectional analyses were negative associations between all three measures of adiposity and HR reactivity; i.e. those with greater BMI and waist-hip ratios and those categorized as obese displayed smaller HR reactions to stress. In prospective analyses, high HR reactivity was associated with a reduced likelihood of becoming obese in the subsequent 5 years. According to the authors, the analysis suggests that it is low, not high, HR reactivity that is related to adiposity, and that low HR reactivity, probably by reflecting generally blunted sympathetic nervous system reactions to challenge, may be a risk marker for developing obesity.

Researchers at the Salk Institute for Biological Studies may have found a way around the sweat and pain of exercise. They identified two signaling pathways that are activated in response to exercise and converge to dramatically increase 1) ___. The report, which appeared in the July 31 advance online edition of the journal Cell, showed that by simultaneously triggering both pathways with oral drugs, laboratory mice were turned into long-distance runners and conferred many of exercise’s other benefits. In addition to their allure for endurance athletes, drugs that mimic the effects of exercise have therapeutic potential in treating certain 2) ___ diseases, such as wasting and frailty, hospital patients unable to exercise, veterans and others with disabilities as well as obesity where exercise is known to be beneficial. Previous work with genetically engineered mice had revealed that permanently activating a genetic switch known as PPAR delta turned mice into indefatigable marathon runners. In addition to their super-endurance, the altered mice were resistant to 3) ___ gain, even when fed a high-fat diet that caused obesity in ordinary mice. On top of their lean and mean physique, their response to insulin improved, lowering levels of circulating 4) ___. The research team wanted to know whether a drug specific for PPAR delta would have the same beneficial effects. An investigational 5) ___, identified only as GW1516 seems to have fit the bill. When this substance was given to laboratory mice over a period of 4 weeks, the mice got the expected benefits in lowering fatty 6) ___ and blood glucose levels but no effect on exercise performance. Undeterred, they put mice treated with GW1516 on a regular exercise regimen and every day had them run up to 50 minutes on a treadmill. Now the exact same drug that had shown no effect in 7) ___ animals improved endurance by 77% over exercise alone and increased the portion of “non-fatiguing” or “slow twitch” muscle fibers by 38%. The result, while very dramatic, gave rise to a vexing question: Why is exercise so important? First and foremost, exercise depletes muscles’ energy store, a chemical known as ATP. In times of high demand, ATP releases all its 8) ___ and forms AMP. Rising AMP levels alert AMPK, a metabolic master 9) ___, which increases the production of ATP. That led the team, to consider whether AMPK activation was the critical trigger that allowed PPAR delta to work. Usually, AMPK can be found in the cytoplasm, the compartment that surrounds the nucleus, but the Salk researchers’ experiment revealed that some exercise-activated AMPK molecules slip into the nucleus. There they physically interact with PPAR delta and increase its ability to turn on the genetic network that increases endurance. Then came the ultimate couch potato experiment. The researchers fed untrained mice AICAR, a synthetic AMP analog that directly activates AMPK. After only 4 weeks and without any prior training, these mice got up and ran 44% longer than untreated, untrained mice. “Exercise in a pill” might sound tempting to couch potatoes and Olympic contenders alike, but the dreams of the latter might be cut short. Evans developed a test that can readily detect GW1516 and its 10) ___ as well as AICAR in blood and urine and is already working with officials at the World Anti-Doping Association, who are racing to have a test in place in time for this year’s Summer Olympics.

ANSWERS: 1) endurance; 2) muscle; 3) weight; 4) glucose; 5) drug; 6) acids; 7) sedentary; 8) energy; 9) regulator; 10) metabolites

Recent clinical research contracts include:

1. Medical imaging (phase 2)
2. HIV (IND)
3. Emergency care (pre-IND)
4. Women’s health (2 INDs)
5. EDC (3 global studies, 1 diagnostic study)
6. Target Document® was licensed by a global CRO.

Software development programs include:

1. Target e*CRF® – Standard EDC plus:
* Target Pharmacovigilance – generate Form 3500A directly from the clinical trial database
* Target Batch Edit Checks™ – all validation checks managed through the Target e*CRF query system
2. Target Encoder® – Version 1 released – MedDRA and WHO DRUG
3. Target Document® – Version 1.2 released – Paperless TMF
4. Target e*CTMS™ – Release September 30, 2008, beta release operational
5. Target Newsletter™ – Version 1 released – Fully integrates with Target e*CRF®
6. Target e*CTR™ (clinical trial record) – provides eSource records for clinical trials. Eliminates the paper – Q4 release – THIS IS A PARADIGM SHIFT IN THE WAY WE WILL DO CLINICAL RESEARCH

For more information about Target Health or any of our software tools for clinical research, please contact Dr. Jules T. Mitchel or Ms. Joyce Hays. Our software tools are designed to partner with both CROs and Sponsors.