May 19, 19 10:29 AM
Air-pollution is detroying our hibitat
May 12, 19 03:34 PM
Mednews announcements of latest treatments, medicines and discoveries
Apr 28, 19 05:19 PM
obesity is a growing problem worldwide.
Study provides insight into severe form of cancer
Glioblastoma, also known as GBM, is the most aggressive cancer that begins within the brain. It is one of the deadliest form of cancer because of the limited treatment options. A team of scientists “reverse engineered” GBM cells derived from patients to uncover multiple potential targets for this hard-to-treat cancer.
The research, published today in the journal of Cell Reports, is the result of a collaboration between University of Toronto – Leslie Dan Faculty of Pharmacy, University of Calgary and The Hospital for the Sick Chiildren (SickKids). It is a record-breaking research, being the first published study to systematically profile a large panel of patient-derived brain tumour cells that have stem cell properties.
“We think that, in one big experiment, we have uncovered many new targets for glioblastoma, some of which were surprising,” Dr. Peter Dirks said. “These glioblastoma stem cells are also resistant to treatment, which is one reason that these tumours are so hard to cure. We need new ways to disrupt these cells specifically if we are going to give people a better chance of survival."
Dirks is a professor of Neurosurgery the University of Toronto, senior scientist at the Research Institute, staff neurosurgeon at The Hospital for the Sick Children, and one of the primary investigators of the study. He was also the first to discover the existence of cancer stem cells in brain tumours.
The research findings revealed that GBM is actually linked to the same genes that are important for brain development in infancy and early childhood. "This really emphasises how much research needs to be done to understand the developing human brain," Dirks said.
Unravelling New Ways To Treat Cancer
Before this study on GBM, researchers were focused on the genomic sequencing of cancer tumours that cost thousands of dollars. Such studies have provided an idea about the possible mutations present in GBM and other cancers, but it has not led to any significant advancement for the treatment of glioblastoma.
"This shows that just knowing about genetic mutations is not enough," Graham MacLeod said. "That is a static picture of cancer. We are learning that we need to better understand the blueprint of how this cancer functions and what specific genes fuel tumour growth in order to attack it." Macleod is one of the primary authors of the study, titled “The functional genomic circuitry of human glioblastoma stem cells,” and a post-doctoral fellow at Angers lab.
The Success of CRISPR-Cas9 and Gene Editing Tools
Gene editing is a type of technological application that gives researchers the ability to change an organism’s DNA. This technique allows genetic material to be added, removed or altered at particular locations. Several approaches to gene editing have been developed, one of which is the recently developed CRISPR-Cas9. It is short for clustered regularly interspaced short palindromic repeats and CRISPR-associated protein 9.
CRISPR-cas9 technology has generated a lot of excitement in the scientific community because it is faster, cheaper, more accurate and more efficient than other existing gene-editing methods. Dr. Stéphane Angers, co-principal investigator of the study on GBM and professor at the University of Toronto, was able to take unique patient-derived GBM stem cell cultures collected by Dirks’ research team.
"Cancer stem cells fuel the growth of tumours and progression of the disease," Angers said. "In order to effectively target these cells, having a comprehensive view of the genes controlling the growth programs is critical. If you know which genes are necessary for these cells to survive and proliferate, you can then look at ways to attack or block these genes and stop tumour growth in its tracks."
Angers’ team found multiple genetic weaknesses and rich data that can be furthermined to identify possible drug targets for GBM. "This is one of the first studies of its kind, where CRISPR screens are performed directly in multiple freshly isolated patient cells in parallel. This study has provided a massive amount of new information that the research community can now interrogate to help design new treatment strategies," he said.
DOT1L is one of the genes identified in the study. It was found to be important for the persistence of brain cancer tumours among 10 GBM patients. In collaboration with Dr. Samuel Weiss at the University of Calgary - Cumming School of Medicine, his team used preclinical models to determine the effectiveness of a drug currently used to treat leukemia against the DOT1L gene expression in GBM.
"We found that blocking this specific protein in this particular form of brain cancer reduced tumour growth and resulted in longer survival in the preclinical model," Angers said. "This is promising because it uncovered a biological process, not previously suspected to be implicated in glioblastoma, for which a small molecule drug already exists."
April 6th 2019
Everything you need to know about colon cancer
The family of supermodel Pat Cleveland has revealed she is battling colon cancer after she was diagnosed in March - a diagnosis that came after months of digestive issues.
The 68-year-old American model underwent emergency surgery after a scan found a cancerous tumour blocking her colon.
Colon cancer, often grouped with rectal cancer due to the similarities, is the third most common cancer diagnosed in men and women in the United States, according to the American Cancer Society.
In 2019, there have been an estimated 101,420 new cases of colon cancer.
This is everything you need to know about colon cancer, the symptoms and treatment.
What is colon cancer?
Colon cancer is cancer of a portion of the large intestine (large bowel).
The colon, a five-foot-long muscular tube that is part of the digestive system and responsible for absorbing water and salt from food matter, is split into four parts - the ascending colon, the transverse colon, the descending colon and the sigmoid colon.
Cancer of the colon frequently starts as growths, called polyps, on the inner lining of the colon.
However, not all polyps become cancerous and the likelihood of the polyp turning into cancer is dependent on the type of polyp it is.
There are two main types of polyps, according to the American Cancer Society, Adenomatous polyps (adenomas), which sometimes morph into cancer, and Hyperplastic and inflammatory polyps, which are more common and generally do not cause cancer.
According to the American Cancer Society, other factors that increase the risk of a polyp becoming cancerous include if a polyp is larger than 1cm, if there are more than two polyps found, or if dysplasia, a pre-cancerous condition, is found in the polyp after it is removed.
Adenocarcinomas, a type of tumour that makes up 96 per cent of colorectal cancers, starts in cells that make mucus (the mucosa) to lubricate the inside of either the colon or the rectum.
After starting in the inner-most layer, the cancer can then grow into the walls of the colon.
If the cancer cells reach the wall, they can grow into blood vessels or lymph vessels - increasing the likelihood of the cancer spreading to other parts of the body.
The stages of colon cancer are diagnosed by how deeply the cancer has spread into the wall of the colon.
What are the symptoms of colon cancer?
Because polyps are typically small and rarely produce symptoms, doctors recommend regular screenings for polyps and colon cancer.
If a polyp has turned into cancer, symptoms are usually more noticeable.
Symptoms of colon cancer include changes in bowel habits, such as diarrhoea or constipation, or a change in consistency of stool that lasts for more than four weeks, rectal bleeding or blood in stool, persistent abdominal discomfort, feeling as if your bowel doesn’t completely empty, weakness or fatigue or unexplained weight loss, according to the Mayo Clinic.
However, many people do not experience symptoms, so screenings are important.
According to the Mayo Clinic, screenings typically begin at age 50, but your doctor may recommend earlier screenings if there is a family history of colon cancer.
How many people does it affect and what is the treatment for colon cancer
In the US, nearly 50,000 men and 50,000 women have been diagnosed with colon cancer this year.
The disease, which is the third leading cause of cancer death in men and women, mainly affects older adults.
Currently, the overall five-year survival rate for colon cancer is 64 per cent, according to the American Society of Clinical Oncology (ASCO), but the death rate for the disease is declining as treatment has improved.
The three primary treatment options for colon cancer are surgery, chemotherapy and radiation, depending on the stage of the cancer, according to the Mayo Clinic.
If the cancer is in an early stage, a minimally invasive surgical option is often used to remove polyps, either during a colonoscopy or through laparoscopic surgery.
For more invasive colon cancer, doctors may recommend a partial colectomy, where a portion of the colon is removed.
If it is impossible to reconnect the colon, an ostomy may also be required - which involves creating an opening in the wall of your abdomen for the elimination of stool.
In addition to the surgical options, chemotherapy drugs to destroy the cancer cells may be used.
Chemotherapy is occasionally used before surgery to shrink the cancer, but is more common in rectal cancer than colon cancer.
Radiation may also be used as a method of shrinking the cancer before surgery.
Less common treatments may include immunotherapy or proton beam therapy.
What risk factors increase the chance of colon cancer?
Old age, African-American race, family history, having an inflammatory intestinal conditions such as ulcerative colitis, a low fibre high-fat diet, a sedentary lifestyle, diabetes, obesity, smoking and alcohol all may increase the risk of developing colon cancer, according to the Mayo Clinic.
A CLEVER NEW STRATEGY FOR TREATING CANCER, THANKS TO DARWIN
IN OCTOBER 1854, a government entomologist was inspecting some farmland outside the town of Ottawa, in northern Illinois, when he came upon a disturbing scene in a cabbage patch.
THE LARGE OUTER leaves of the vegetables were “literally riddled with holes, more than half their substance being eaten away.” With each step he took around the ravaged cabbages, tiny swarms of little ash-gray moths rose from the ground and flitted away. This was, it appears, the first record in the United States of the diamondback moth, an invasive pest that in its larval form shows a fondness for cruciferous vegetables. By the late 1800s the moths were chewing through the leaves of cabbages, brussels sprouts, collards, and kale from Florida to Colorado.
To fight this invasion, farmers started bombarding their fields with primitive pesticides. This worked. Or seemed to. It killed most of the moths, but those that survived the poison reproduced, and the population bounced back stronger than ever. For decades, one pesticide after another failed as the moths evolved to withstand it. Even the grievously toxic DDT was no match for the diamondback. Beginning in the late 1950s, agriculture experts started to abandon the idea of eradication and adopted a new strategy. Farmers would leave the moths alone until their numbers exceeded a certain threshold, and only then would they deploy pesticides. Remarkably, this helped. The moths did not die out, but the pest could be managed and crop damage held in check.
When Robert Gatenby heard this history of the diamondback moth in 2008, he immediately latched onto it. Gatenby is not a farmer nor an agronomist nor a fan of cruciferous vegetables—in fact, he deeply loathes brussels sprouts. He is a radiologist by training and heads the radiology department at the H. Lee Moffitt Cancer Center in Tampa, Florida. But unlike your typical doctor, he is also obsessed with the evolutionary principles put forth more than 150 years ago by Charles Darwin. The story of the diamondback moth appealed to Gatenby as a useful metaphor for his own project—one concerned not with crops but with cancer.
Like the diamondback moth, cancer cells develop resistance to the powerful chemicals deployed to destroy them. Even if cancer therapies kill most of the cells they target, a small subset can survive, largely thanks to genetic changes that render them resistant. In advanced-stage cancer, it’s generally a matter of when, not if, the pugnacious surviving cells will become an unstoppable force. Gatenby thought this deadly outcome might be prevented. His idea was to expose a tumor to medication intermittently, rather than in a constant assault, thereby reducing the pressure on its cells to evolve resistance.
Just as ecologists allow for a manageable population of diamondback moths to exist, Gatenby’s method would permit cancer to remain in the body as long as it doesn’t spread further. To test this idea, Gatenby got permission in 2014 to run a trial on advanced-stage prostate cancer patients at Moffitt. The patients had cancer that no longer responded to treatment; their drug-resistant cells were winning an evolutionary battle within the body, surviving an onslaught of toxic drugs where weaker cancerous cells had succumbed. The hope was that, by using a precise drug-dosing scheme developed using evolutionary principles, they could slow the rise of the mutations that would endow some cancer cells with the fitness to survive. Gatenby's name for the approach was adaptive therapy.
One of the patients in the trial was Robert Butler, a British oil-exploration engineer who had retired in Tampa. In 2007 he was diagnosed with prostate cancer, and seven years later, after taking the drug Lupron and getting blasts of radiation, his prostate tumor had progressed to stage 4, advanced cancer. Butler did not give up, though. He tried a newly approved immunotherapy treatment—one that involved having cells from his blood sent by courier to a facility outside Atlanta, where they were mixed with a molecule that activates immune cells, and then shipped back to Florida to be injected back into him. The treatment was expensive—its sticker price can be as high as $120,000—but the threat that the cancer would progress remained.
When Butler and his wife showed up at his oncologist’s office at the Moffitt Cancer Center in August 2014, they braced for what would come next; they had heard about invasive treatments, like radioactive seed implants. So they were intrigued when the doctor told them about Gatenby’s trial and asked if Butler wanted to participate. He would take a powerful and exceedingly expensive drug called Zytiga, but not in the scorched-earth, kill-all-the-cells fashion that is standard. Instead he would receive only as much Zytiga as was necessary to stop the cancer from growing. The idea was radical and counterintuitive. His last best shot at escaping death from his cancer was to give up on curing it.
Knowing the modified Zytiga regimen wasn’t designed to rid him of cancer left Butler, the engineer, with a question about how the doctors would measure the success of their new treatment approach. He asked, “How do we know this stuff is working?” And one of his doctors replied, “Well, you won’t be dead.”
IN THE UNITED States we use military metaphors when we talk about cancer. We battle and we fight, and if we survive, we’re victorious. The attitude traces back in part to 1969, when the Citizens Committee for the Conquest of Cancer ran an ad in The Washington Post and The New York Timesimploring the president with the words “Mr. Nixon: You can cure cancer.” The call to action helped trigger the country’s “war on cancer” with a determination that, using enough medical weaponry, the malignant foe could be obliterated.
By the mid-1970s, however, signs were beginning to emerge that certain strategies aimed at total eradication were liable to backfire. Against this backdrop, a cancer researcher named Peter Nowell published a seminal paper in Science in 1976. Nowell conjectured that evolutionary forces drive certain cell populations in tumors to become progressively more malignant over time. The cells inside a tumor are in competition, not only with nearby healthy cells, Nowell argued, but also with each other. Nowell suggested—and later research confirmed—that certain DNA alterations grant cancer cells resistance against chemotherapy or other treatments, causing them to edge out drug-sensitive cells through a process of natural selection.
Nowell conveyed his ideas to his students at the University of Pennsylvania School of Medicine, sometimes smoking a cigarette as he lectured. His theories were respected but slow to catch on. He emphasized that tumors may become deadlier as they accumulate more genetic errors. It was an idea ahead of its time. Scientists back then didn’t have the technical capability to measure all the changes in the vast genomes of tumor cells. Instead, they could sequence only little tidbits of DNA at a time, and most scientists viewed cancers as the fruit of just a few genetic mutations.
One of the medical students listening to Nowell lecture in the late 1970s happened to be a young Bob Gatenby. But Nowell’s ideas didn’t make a strong impression on him, Gatenby says; instead, what inspired him was what he witnessed in his first years as a practicing radiologist on the bloody front lines of the war on cancer.
“I couldn’t understand why you would treat someone with a fatal disease and kill them with your therapy. It just didn’t feel right to me.”
By the mid-1980s, Gatenby had secured a job at the Fox Chase Cancer Center in Philadelphia. At that hospital and others around the country, clinical trials were putting breast cancer patients through an extreme treatment: a combination of a potentially lethal dose of chemotherapy followed by a bone marrow transplant. The treatment was harrowing. The women had diarrhea and nausea, and some had so much lung damage they had difficulty breathing. Others experienced liver damage and weakened immune systems that left them vulnerable to serious infections. As a radiologist, Gatenby’s job was to interpret x-rays and other scans of the patients, and he saw the treatment failing. Out of more than 30,000 women with breast cancer in the US who underwent the procedure between 1985 and 1998, as many as 15 percent died from the treatment itself. “What happened was these women suffered horribly, and they weren’t cured,” Gatenby says.
Around the same time as the breast cancer trials, the father of a colleague of Gatenby’s came to the hospital to receive an initial, aggressive round of chemotherapy for lung cancer. According to the colleague, her father arrived on a Friday with no apparent symptoms and was dead by Monday. “That event to me was very traumatizing,” Gatenby recalls, and the cause to him seemed obvious. “I couldn’t understand why you would treat someone with a fatal disease and kill them with your therapy. It just didn’t feel right to me.” During this fraught period, Gatenby’s own father died from esophageal cancer.
Gatenby felt there must be a better way to treat cancer—to outsmart it rather than carpet-bomb it. He had studied physics in college and believed that biologists could leverage equations to capture the forces driving cancer the same way physicists use math to describe phenomena like gravity. Whereas Nowell had put forth general theories about how cancers followed evolutionary principles, Gatenby was taking a further leap: He wanted to figure out a way to describe the evolution of cancers with mathematical formulas.
BY 1989, BOB Gatenby was preoccupied with modeling the evolution of cancers. During the day he would scrutinize the x-rays of cancer patients, and at night, after he and his wife had put their young kids to bed, he would sit at the kitchen table in their suburban Philadelphia home and pore over medical journals. The patterns he started seeing in the literature led him to a question: What if cancer cells outcompete normal, healthy cells in the body in the same way an animal species edges out its competitors in nature?
Gatenby recalled that ecologists had come up with equations to describe the balance between predators and prey. As an undergraduate at Princeton University, he had learned the classic example of the math that plotted how growing populations of snowshoe hares fuel the rise of the lynx that feed on them. He began dusting off old books and buying new ones to educate himself on species interactions.
For a year Gatenby read and mulled. Then, in 1990, on a family trip to the Atlantic coast of Georgia, he found himself stuck in a hotel room one afternoon with his two napping children. Out of nowhere, an idea presented itself. He grabbed a pad of hotel stationery and a pen and began scribbling down some key formulas from population ecology. Those formulas, called Lotka-Volterra equations, have been used since the 1920s to model predator-prey interactions and, later, competition dynamics between species, and were among the ones he had recently brushed up on at home. Gatenby thought this set of formulas could also describe how tumor cells compete with healthy cells for energy resources such as the glucose that fuels them.
When he returned to Philadelphia, he spent what time he could at a typewriter composing a paper that laid out this theoretical model. As soon as he finished, he showed it to some colleagues. He didn’t get the response he had hoped for: They thought it was ridiculous to try to use ecological equations to model cancer. “To say that they hated it would not do justice to how negative they were about it,” he says. His peers thought that a brief set of formulas couldn’t capture cancer’s seemingly infinite complexities.
Louis Weiner, who worked alongside Gatenby at the time, recalls that their colleagues viewed Gatenby’s ideas as offbeat. “Treatment orthodoxy at that time favored high-intensity, dose-dense treatments aiming to eradicate every last tumor cell in a cancer patient,” says Weiner, who is now director of the Georgetown Lombardi Comprehensive Cancer Center in Washington, DC. “Bob’s perspective was antithetical to those beliefs.”
But Gatenby pressed on and succeeded in getting the paper, chock-full of Lotka-Volterra equations, accepted in the prominent journal Cancer Research in 1991.
Despite the publication of his theory, he still couldn’t convince oncologists that his idea had practical merit. “I think that they felt intimidated,” Gatenby says. “Most physicians are mathematically illiterate.” He found that the medical establishment was reluctant to publish much of his follow-up work.
In the years afterward, Gatenby moved up the ladder to lead the department of diagnostic imaging at Fox Chase Cancer Center. He was later appointed head of the department of radiology at the University of Arizona College of Medicine in Tucson, and he continued to garner recognition for his skilled interpretation of scans and to receive federal grants to study cancer.
Then, in 2007, the Moffitt Cancer Center offered Gatenby a job as chair of the radiology department. He had a condition: He would come if the hospital created a division where he could pursue in earnest the link between Darwin’s principles and cancer. The Integrated Mathematical Oncology Department, born from this negotiation, is the first math department in a cancer hospital, he says. Finally, Gatenby had a place where he could put his ideas to the test.
GATENBY ARRIVES AT his corner office at Moffitt most days by 7 am. He’s 67 now, and his hair is gray at the temples, but his eyebrows are still brown. His children—the ones who were napping in that hotel room when he jotted down his Darwinian inspiration—now have children of their own, and he has the “I ♥ Grandpa” coffee mug to prove it. A hospital lanyard around his neck, he rolls up his crisp shirtsleeves and settles down at his desk. Outside his office, roughly 30 scientists and PhD students spend their days researching patterns of cancer growth using equations like those describing population dynamics.
To Gatenby's knowledge, no one had endeavored to exploit evolution against cancer in a clinical trial until he developed his prostate cancer experiment. He picked prostate cancer to test this approach partly because, unlike other cancers, a routine blood draw for a molecule called prostate-specific antigen (PSA) can offer an immediate proxy for the cancer’s progression.
To design a clinical trial, Gatenby and his Moffitt collaborators first needed to account for their idea that tumor cells vie against each other for resources. They turned to game theory to plot this dynamic and plugged the numbers into the Lotka-Volterra equations. The computer simulations they ran with these equations estimated how quickly drug-resistant cells would outcompete other tumor cells when exposed to the continuous dosage of Zytiga typically given to advanced-stage prostate cancer patients.
In the simulations, the typical administration of the drug led to drug-resistant cancer cells rapidly running rampant. The treatment would ultimately fail each time. That bleak outcome matched up with the results seen in hospital records. In contrast, the computer simulations suggested that if Zytiga were administered only when the tumor seemed to be growing, then the drug-resistant cells would take much longer to gain enough advantage to overrun the cancer.
In 2014 the Moffitt team managed to get the first small study to test this adaptive therapy approach off the ground, recruiting Robert Butler and a small group of other men with advanced prostate cancer. Butler’s oncologist explained to him how it would work. He would remain on the Lupron he’d taken for years, and each month he would go to the hospital to get his PSA level tested, to judge whether his prostate tumor was growing. Every three months, he would get a CT scan and a full-body bone scan to watch for disease spread. Whenever his PSA level edged above where it stood when he entered the trial, he would start taking the more powerful Zytiga. But when his PSA level fell to under half of the baseline, he could go without Zytiga. This is appealing because Zytiga and drugs like it can cause side effects like hot flashes, muscle pain, and hypertension.
The Moffitt approach also promised to be far cheaper than taking Zytiga continuously. When purchased wholesale, a one-month supply costs almost $11,000. Butler had health insurance, but even so, his first month’s supply each year would set him back $2,700 in out-of-pocket copayments, and $400 a month thereafter. Going off the drug whenever his PSA level was low would translate to huge cost savings.
“Conceptually it’s a beautifully simple approach. He’s turning cancer into a chronic disease.”
Butler was participating in a so-called pilot trial, which was less rigorous than a large clinical trial, because it didn’t randomly assign patients to receive the experimental or standard treatments. Rather, the study relied on a group of patients treated outside the trial as well as results from a 2013 paper on Zytiga to come up with a benchmark for how patients typically fare when receiving continuous dosing of the drug.
When the early results of their new trial trickled in, the Moffitt scientists were gratified and relieved. Ahead of the trial, “we were, to be honest, terrified,” Gatenby says. The benefit of adaptive therapy appeared to be huge. Of the 11 men in the study, one left the trial after his disease spread, but most were living longer than expected without their cancer progressing. Men getting continuous dosing of Zytiga go a median of 16.5 months before the cancer becomes resistant to the drug and spreads. In comparison, the median time to progression for the men receiving adaptive therapy was at least 27 months. Moreover, they were on average using less than half of the standard amount of Zytiga. Joel Brown, an evolutionary ecologist and one of Gatenby's collaborators, said the team felt a moral obligation to get the word out: “The effect was so big that it would be unethical not to report it immediately,” he says.
They published a report in 2017, far earlier than anticipated, to a generally positive reaction from prostate experts—particularly because it suggested a way that people with cancer might live longer with less medication. “If you can reduce side effects, I think that’s fantastic,” says Peter Nelson, an oncologist who studies prostate cancer at the Fred Hutchinson Cancer Research Center in Seattle. “Conceptually it’s a beautifully simple approach.” Jason Somarelli, a biologist at the Duke Cancer Institute, calls Gatenby a pioneer: “He’s turning cancer into a chronic disease.”
Butler, who is 75, has gone for long periods off Zytiga—with stretches lasting as long as five months. “I’m now the poster boy, they say,” Butler says. He’s one of the best responders in the study.
Some doctors are already trying adaptive therapy on patients outside of clinical trials. In 2017 a doctor in Oregon, inspired by Gatenby’s pilot study, started a prostate cancer patient on a modified version of the approach when he refused the standard continuous dosing. She has since started treating a second man using adaptive therapy. Other oncologists might be doing the same. It’s nearly impossible to know for sure, because adaptive therapy doesn’t require government approval. The protocol uses already-approved medications, and the US Food and Drug Administrationdoesn’t police specific dosing schedules.
Experts urge caution, however. The prostate cancer study was very small, and without a randomly assigned control group the results aren’t truly reliable. While the majority of the men in the trial remain stable, four more saw their cancer progress since the paper came out. “This is an approach that now needs to be carefully studied in prospective clinical trials before it is adopted into clinical practice,” says Richard L. Schilsky, chief medical officer for the American Society of Clinical Oncology. Years could pass before a large-scale test of adaptive therapy takes place. Len Lichtenfeld, interim chief medical officer of the American Cancer Society, echoes Schilsky’s concerns. “Is it intriguing? Yes,” Lichtenfeld says. “But there is still a long way to go.”
Gatenby agrees that adaptive therapy needs rigorous testing. He conveys a kind of humility you don’t see very often in the upper reaches of medical science. He told me multiple times that he is not an interesting subject to write about, and more than once I heard close colleagues mangle the pronunciation of his name (which is pronounced GATE-en-bee); apparently he had never corrected them. But when he believes in something, he doesn’t relent. And he believes in adaptive therapy. “He’s like a teddy bear, but underneath that soft exterior he’s made of steel,” says Athena Aktipis, who studies theoretical and cancer biology at Arizona State University and has collaborated with Gatenby.
Late last year, Gatenby presented his work at a meeting of prostate cancer specialists. In the question and answer session afterward, an attendee shared his surprise at the results. “I guess what you’re saying is that we’ve been doing it wrong all these years,” the man mused, according to Gatenby. “I was literally speechless for a few moments,” Gatenby admits, “and then I said, ‘Well, yeah, I guess that’s what I’m saying.’” He is still dwelling on the exchange and wishes he could somehow find the man and apologize. He’s not taking back what he said; he does think the profession can do better. But, he says, “I should have been more diplomatic.”
IN 2016, A couple dozen researchers gathered in a conference room at an ultramodern genetic sequencing center along the banks of the River Cam, 9 miles outside of Cambridge, England. The gathering brought together experts to discuss how principles of ecology might apply to cancer. When they took a break, their idea of fun was to play a round of “Game of Clones,” in which a small group of scientists pretended to be cancer cells trying to persuade the maximal number of other researchers bouncing around the room to be their malignant clones.
During this meeting, one overarching theme kept popping up: Evolution doesn’t operate the same way within all cancers. It’s not even clear that Darwinian natural selection always determines the genetic mutations that abound within a tumor. A study of colon cancer samples conducted by one of the conference attendees, Andrea Sottoriva of the Institute of Cancer Research in London, and Christina Curtis, a computational biologist at Stanford University, suggested a different pattern.
When colorectal tumors begin to form, there seems to be a “big bang” of mutations. This initial explosion of cellular diversity in these colon cancers seems to be followed by a period in which random genetic changes arise and become more prevalent out of pure happenstance rather than because the mutations confer some sort of competitive advantage. It’s still unclear whether adaptive therapy, which operates on the assumption that there’s Darwinian competition between tumor cells, would work well for cancers where the mutations arise continuously by chance.
Still, a kind of consensus emerged, and a year after the Cambridge meeting, the organizers published a statement outlining how cancers might be better classified. Twenty-two researchers—some of the biggest names in the field of evolutionary oncology, including Gatenby—coauthored the document.
One important factor in the group’s suggested classification scheme is a measure of how swiftly a cancer is mutating. In the past decade, faster DNA sequencing tools have shown that Nowell—Gatenby’s old professor, the cigarette-smoking pioneer in applying evolutionary thinking to cancer—was prescient: Individual tumors often bristle with rapid-fire genetic changes. Rather than two or three initial errors setting off a chain of uncontrolled growth, many tumors are the result of several series of mutations. A significant experiment published in 2012 found at least 128 different DNA mutations in various kidney tumor samples from one patient, for instance. There's some evidence that the more mutations there are, the more aggressive a cancer tends to be, suggesting a higher chance that one of these DNA changes will confer tumor cells with the potential to be drug-resistant. Given technological advances, it’s not too far-fetched to think that within the coming decade, doctors will routinely measure the amount of mutations in their patients’ tumors.
Today most cancers are assessed using a system that dates back to the 1940s. Doctors typically evaluate factors such as whether a cancer has spread to lymph nodes or beyond and on the basis of these attributes determine its “stage.” On one end of the spectrum are stage 1 cancers, which are relatively confined, while at the other end are stage 4 cancers, which have spread extensively. Crucially, this system of assigning cancer a stage doesn’t formally take a cancer’s genetic mutations into account.
The suggested categorization system that grew out of the Cambridge meeting would look at cancer in a completely new way. Rather than four stages of cancer, the authors of the 2017 consensus statement propose no less than 16 different categories—for example, tumors that have slow cell turnover and a low rate of accumulating mutations, or tumors that are a hotbed of genetic diversity with quickly replicating cells competing for resources. This latter type of tumor might be the most likely to evolve a way to outcompete drug-sensitive cells in the body and thereby could, in some cases, be the most dangerous. A fast-moving cancer of this kind might also be the best candidate for adaptive therapy.
Around the time the consensus statement came out, Gatenby and his collaborators in Tampa were hard at work running cell experiments in a lab down the hall from his office. The goal was to prove a key tenet of adaptive therapy. Gatenby’s approach assumes that when treatment is removed, drug-resistant cancer cells will replicate more slowly than drug-sensitive cells. The theory rests on the assumption that those resistant cells need lots of energy to maintain their armor against the medication meant to kill them. During treatment breaks, the thinking goes, the fuel-hungry resistant cells are outcompeted by drug-sensitive cells, which need fewer resources to thrive.
To gather evidence for this idea, Gatenby’s research team placed human breast cancer cells with resistance to the drug doxorubicin in a petri dish alongside an equal-size population of doxorubicin-sensitive breast cancer cells and watched the two groups fight for resources. By day 10 the resistant cells made up only 20 percent of the cells in the dish and continued to slowly decline from there. At the end of the experiment, published last year, these resistant cells had dropped to around 10 percent of the total population.
Granted, this experiment happened in a petri dish, not a human body—or even the body of a lab rat. Some leading cancer specialists agree with Gatenby that drug-resistant cells are likely outcompeted by other cells when cancer medication is withdrawn. But, say others, what if Gatenby is wrong? What if resistant cells actually thrive during the period when the patient is taken off drugs? The risks are high. No one wants to hasten death.
RETHINKING CANCER AS a chronic illness requires a mental shift—a shift that other changes in cancer therapy might be easing. There’s a practice of letting cancer patients take doctor-supervised “drug holidays” from their medications, for instance. And we’ve adapted our thinking when it comes to medicine before. Doctors once thought that stress was the primary culprit behind ulcers, but biologists uncovered a bacterium as the main cause. More recently we’ve gotten used to the weird idea that trillions of bacteria live in our gut microbiome.
Perhaps, then, it isn’t a huge stretch to think we might tolerate coexisting with cancer cells as long as we can prevent them from growing unchecked. Whereas Darwin put forth ideas about what has become known as macroevolution—the rise and fall of species, whether they be beetles or bald eagles—this new view of cancer could be an example of what we might call “endo-evolution”: natural selection playing out within an organism’s own tissues.
The American Cancer Society acknowledges that some cancers are already managed as chronic illnesses. In certain cases, doctors simply try to keep the malignancies from spreading with new rounds of medication. Gatenby’s adaptive therapy aims to take the guesswork out of the treatment. More trials at Moffitt are in the planning stages or underway for cancers affecting the breast, skin and thyroid, in addition to a new, bigger trial in prostate cancer patients. Across the country, in Arizona, Athena Aktipis and her husband and scientific collaborator, Carlo Maley, have secured a grant to begin a breast cancer trial using adaptive therapy in conjunction with a local branch of the Mayo Clinic.
It isn’t a huge stretch to think we might tolerate coexisting with cancer cells as long as we can prevent them from growing unchecked.
But the idea of cancer as an implacable enemy that needs to be annihilated runs deep. Even Gatenby feels it, particularly when it comes to children. When his daughter was a teenager, one of her classmates died from a form of cancer called rhabdomyosarcoma. He never met his daughter’s friend but heard about his decline. Then, last year, a pediatric oncologist at Moffitt approached him to see if therapy inspired by evolutionary theory might work to fully weed out cancer from children newly diagnosed with that same disease. In the highest-risk group, that cancer kills as many as 80 percent of patients within five years.
In October, they met to begin designing a study. This trial will use a more sophisticated evolutionary model to cycle patients on and off of several drugs. The hope is to deploy the additional drugs to kick the cancer while it’s down, and thereby drive it to extinction. It’s an ambitious goal.
For now, Gatenby is most focused on managing advanced cancers in adults, and doing so as a chronic disease. In that sense, he’s challenging the words emblazoned on the outside wall of the Moffitt Cancer Center: “To contribute to the prevention and cure of cancer.” Robert Butler has pondered these words too, which he passes when walking into the building for checkups and treatments. “Certainly, in my case there’s no intention of cure. What we’re doing is control. So that’s not really the correct logo anymore, is it?” he says. Butler tells me about a time when he and some of the Moffitt researchers brainstormed alternative slogans. “We finally came up with ‘Our aim is to make you die of something else’—which I thought was lovely,” he adds. “It’s more true.”
Old but interesting
The 10 Deadliest Cancers and Why There's No Cure
The dread and fear that can come with a cancer diagnosis have their roots in its killer nature: It's the No. 2 cause of death in Americans, second only to heart disease, according to the Centers for Disease Control and Prevention. Even when diagnosed early and attacked with the latest treatments, it still has the power to kill.
To help raise money to find cures and treatments for cancer patients, the "Stand Up to Cancer" telethon will air on ABC, NBC and CBS and other networks and cable stations starting at 8 p.m. ET tonight. The telethon will feature a host of celebrity guests, including George Clooney, Denzel Washington, Renee Zellweger and Will Smith.
"'Stand Up To Cancer' represents collaborative efforts" to provide funding for cancer research, Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, told MyHealthNewsDaily.
"We would not be where we are if basic and clinical science wasn't funded," Lichtenfeld said. "Basic science teaches us about mechanisms, about how drugs may be effective, and we take that info and put it into a clinic to find out whether or not those new ideas work in cancer treatment."
While there are many successful treatments today that didn't exist just a couple decades ago, a wholesale "cure for cancer" remains elusive for many reasons. There are more than 100 types of cancer, characterized by abnormal cell growth. There are many different causes, ranging from radiation to chemicals to viruses; an individual has varying degrees of control over exposure to cancer-causing agents.
Cancer cells, and how they grow, remain unpredictable and in some cases mysterious. Even after seemingly effective treatments, crafty cancer cells are able to hide out in some patients and resurface.
About $200 billion has been spent on cancer research since the early 1970s, and the five-year survival rate for all people diagnosed with cancer in the U.S. has risen from about 50 percent in the 1970s to 65 percent today.
Here's a look at the 10 cancers that killed the most people in the United States between 2003 and 2007, the most recent data available, according to the National Cancer Institute (NCI).
1. Lung and bronchial cancer: 792,495 lives
Lung and bronchial cancer is the top killer cancer in the United States. Smoking and use of tobacco products are the major causes of it, and it strikes most often between the ages of 55 and 65, according to the NCI. There are two major types: non-small cell lung cancer, which is the most common, and small cell lung cancer, which spreads more quickly. More than 157,000 people are expected to die of lung and bronchial cancer in 2010.
2. Colon and rectal cancer:268,783 lives
Colon cancer grows in the tissues of the colon, whereas rectal cancer grows in the last few inches of the large intestine near the anus, according to the National Cancer Institute. Most cases begin as clumps of small, benign cells called polyps that over time become cancerous. Screening is recommended to find the polyps before they become cancerous, according to the Mayo Clinic. Colorectal cancer is expected to kill more than 51,000 people in 2010.
3. Breast cancer: 206,983 lives
Breast cancer is the second most common cancer in women in the United States, after skin cancer, according to the Mayo Clinic. It can also occur in men – there were nearly 2,000 male cases between 2003 and 2008. The cancer usually forms in the ducts that carry milk to the nipple or the glands that produce the milk in women. Nearly 40,000 people are expected to die from breast cancer in 2010, according to the NCI.
4. Pancreatic cancer: 162,878 lives
Pancreatic cancer begins in the tissues of the pancreas, which aids digestion and metabolism regulation. Detection and early intervention are difficult because it often progressives stealthily and rapidly, according to the Mayo Clinic. Pancreatic cancer is expected to claim nearly 37,000 lives in 2010, according to the NCI.
5. Prostate cancer: 144,926 lives
This cancer is the second-leading cause of cancer deaths in men, after lung and bronchial cancer, according to the NCI. Prostate cancer usually starts to grow slowly in the prostate gland, which produces the seminal fluid to transport sperm. Some types remain confined to the gland, and are easier to treat, but others are more aggressive and spread quickly, according to the Mayo Clinic. Prostate cancer is expected to kill about 32,000 men in 2010, according to the NCI.
6. Leukemia: 108,740 lives
There are many types of leukemia, but all affect the blood-forming tissues of the body, such as the bone marrow and the lymphatic system, and result in an overproduction of abnormal white blood cells, according to the NCI. Leukemia types are classified by how fast they progress and which cells they affect; a type called acute myelogenous leukemia killed the most people – 41,714 – between 2003 and 2007. Nearly 22,000 people are expected to die from leukemia in 2010.
7. Non-Hodgkin lymphoma: 104,407 lives
This cancer affects the lymphocytes, a type of white blood cell, and is characterized by larger lymph nodes, fever and weight loss. There are several types of non-Hodgkin lymphoma, and they are categorized by whether the cancer is fast- or slow-growing and which type of lymphocytes are affected, according to the NCI. Non-Hodgkin lymphoma is deadlier than Hodgkin lymphoma, and is expected to kill more than 20,000 people in 2010.
8. Liver and intrahepatic bile duct cancer: 79,773 lives
Liver cancer is one of the most common forms of cancer around the world, but is uncommon in the United States, according to the Mayo Clinic. However, its rates in America are rising. Most liver cancer that occurs in the U.S. begins elsewhere and then spreads to the liver. A closely related cancer is intrahepatic bile duct cancer, which occurs in the duct that carries bile from the liver to the small intestine. Nearly 19,000 Americans are expected to die from liver and intrahepatic bile duct cancer in 2010, according to the NCI.
9. Ovarian cancer: 73,638 lives
Ovarian cancer was the No. 4 cause of cancer death in women between 2003 and 2007, according to the NCI. The median age of women diagnosed with it is 63. The cancer is easier to treat but harder to detect in its early stages, but recent research has brought light to early symptoms that may aid in diagnosis, according to the Mayo Clinic. Those symptoms include abdominal discomfort, urgency to urinate and pelvic pain. Nearly 14,000 women are expected to die of ovarian cancer in 2010, according to the NCI.
10. Esophageal cancer: 66,659 lives
This cancer starts in the cells that line the esophagus (the tube that carries food from the throat to the stomach) and usually occurs in the lower part of the esophagus, according to the Mayo Clinic. More men than women died from esophageal cancer between 2003 and 2007, according to the NCI. It is expected to kill 14,500 people in 2010.
Old but interesting
How to spot the early signs of 'silent killer' cervical cancer
Early precautions and regular tests are both crucial to defending against this deadly disease which killed Julie O'Connor
If caught early, the outlook is good — and despite the failures with Julie’s case, smear tests are crucial.
Yet those attending routine screening appointments has hit a 20-year low.
Public Health England estimates that eight in ten of the deaths could be prevented if all eligible women were screened and abnormal cells spotted early.
Being vaccinated against HPV — an extremely common virus passed on during any kind of sexual contact — at school also reduces your risk, as almost all cases are linked to it.
But it is also vital to be alert to early warning signs, such as abnormal bleeding and lower back pain.
The disease affects the cervix– the gateway to your womb from the vagina — and some women do not experience symptoms in the early stages.
But there are a number of easy-to-spot abnormalities that could mean the difference between quick, life-saving treatment and needing a hysterectomy, chemotherapy or something worse.
Kate Sanger, of Jo’s Cervical Cancer Trust, said: “These signs can be associated with lots of other things that are not cancer, and the chances are they are nothing to worry about.
“The key thing is to be aware of what they are and get them checked, not brush them off.
“Changes to cervical health are much harder for you to see than in another body part, like your eyes.
“Gynaecological problems can feel embarrassing but doctors and nurses have seen it all before and early detection and treatment of cervical cancer has really positive outcomes.”
Five signs you should act on, even if you recently had a normal smear test:
1. Abnormal bleeding. This means between periods or during or after sex.
Vaginal discharge that is unusual in terms of smell,
colour or amount.
3. Increased menstrual bleeding or post-menopausal bleeding.
4. Lower back pain.
5. Pain during intercourse.
As cervical cancer develops, it can cause further symptoms. These may include:
· Going for a wee more often.
· Blood in your urine.
· Bleeding from the bottom.
· Lower limb swelling.
For more information and support, contact Jo's Cervical Cancer Trust by visiting jostrust.org.uk or on 0808 802 8000.
My patient swapped chemotherapy for essential oils. Arguing is a fool’s errand
I wish that as an oncologist I could see off quackery through good communication. Unfortunately that doesn’t work
‘Bottles of unknown and frequently adulterated or plainly toxic substances cost hundreds of dollars, not to mention every consultation that pretends to read the eyes and sense the energy to cure cancer.’ Photograph: Seksak Kerdkanno/Getty Images/EyeEm
“Tell me why I should have your chemotherapy when I can be healed naturally!”
His face is set, his arms defensively squared. His friend carries a pamphlet that features a suspiciously healthy woman with glamorous hair and a glowing complexion. This is the urgent appointment of the day, for whom other patients were hastily shuffled to make room.
I know I shouldn’t take the bait but, like an addict, I have the urge to say:
Go ahead then, be healed. And I will almost certainly see you again, emaciated, ruined, lamenting the fact that it’s too late.
Thankfully, the code of conduct glides in. I imagine his dread. I remember my position. And I say: “Tell me more.”
I hear about the man who uses waves, the woman who boosts immunity and the seller of pure herbs. They are the healers – 100% convincing, 100% certified by a gaggle of secret Facebook users.
He asks: “What’s the guarantee of your chemo, anyway?”
I have perfected my retort during sleepless nights.
In life there are no guarantees but you have a curable cancer. Yes, there will be side effects but we can manage them. No, I can’t guarantee a cure, but I’d recommend evidence-based treatment any day over the magnet that purportedly draws out cancer cells. And while we are there, it’s not my chemotherapy. Your taxes fund my job but I don’t profit from giving you chemo.
But how many times have I heard that if oncologists hectored a little less and listened a little more, we might win more hearts?
So I bite my tongue again, thinking of the alarmed nurse who begged me to change his mind. As I talk him through his various options from least to most intensive, I remember the patient who swapped chemotherapy for essential oils, the one who chose to “burn” the tumour out and the one who suggested I become a sales representative for a life-saving juice.
In an era where fake news abounds, why should cancer medicine be immune?
“You don’t convince me.”
“You have the facts, you get to decide,” I reply.
I used to think that these second opinions were illuminating for patients and nudged them towards change. But what I have learnt in the last few years is that cancer patients in search of alternative cures are more deeply entrenched than ever in their beliefs. Thanks to the rise of social media, the ability to filter out conflicting viewpoints and a bevy of supporters for every outrageous idea, these people arrive convinced about their theories. Arguing with them is a fool’s errand.
Despite the longest consultations, carried out by disadvantaging other needy patients, these patients are often the most dissatisfied because oncologists like me speak our truths with less conviction than the quacks who promise the world but deliver nothing except a lonely death in an unfamiliar emergency room in front of a bewildered family.
In an era where fake news abounds, why should cancer medicine be immune?
A survey commissioned by the American Society of Clinical Oncology spoke to more than 4,000 American adults, a quarter of whom were current or former cancer patients. Nearly 40% of those surveyed “somewhat” or “strongly” agreed that cancer can be cured via oxygen, diet and herbs alone. This is despite the fact that patients who solely choose alternative therapies have a greater than twofold risk of mortality, and those with early-stage cancers such as those of the breast and bowel face a four to sixfold increase in mortality compared with those who have standard therapy.
It is tempting to think that modern patients with access to multiple vetted channels of information and, equally, many sources of health warnings, will use them to their advantage. Today’s youth are thought to be especially savvy and discerning. Alas, the survey found that nearly half of those under the age of 53 thought that cancer can be cured by alternative therapies alone. Even among people directly affected by cancer, a quarter believed in alternative therapy over standard treatments. If anyone was relying on family to help them see the light, more than a third of caregivers for cancer patients shared the misguided belief in alternative cures.
Enzymes, waves and magnets do not cure cancer, and they cost the patient every step of the way. Small bottles of unknown and frequently adulterated or plainly toxic substances cost hundreds of dollars, not to mention every consultation that pretends to read the eyes and sense the energy to cure cancer, even as the patient worsens. How do I know? Because dying patients relate these stories in a last attempt to prevent their fellow patients being duped.
It has been received wisdom that oncologists can see off quackery through good communication but I’m afraid that isn’t so.
Oncologists have been properly entangled in a web of fake news. Their authority has been undermined and their expertise ridiculed by a determined, global and hard-to-track battalion of quacks and their acolytes. Greater vigilance, stronger regulation and improved health literacy might help, but the pull of alternative cures is strong.
Make no mistake. With so much misinformation fuelling the use of increasingly bizarre alternative therapies, patients will be ultimately robbed and disappointed, and their doctors will be relegated to the sidelines. To paraphrase an old joke, oncologists will no longer be giving chemotherapy until the grave, but the quacks will be laughing all the way to the bank.
• Ranjana Srivastava is is an oncologist and Guardian Australia columnist
World Cancer Day: Signs and risk factors
Around 360,000 people in the UK are diagnosed with cancer every year, cancer charity Macmillan states.
The number of cancer diagnoses is expected to rise by two per cent between 2014 and 2035, charity Cancer Research UK estimates.
According to the organisation, the reason for this rise is due to longer life expectancy, as two thirds of people with the disease are aged over 65.
On 4 February, World Cancer Day is observed to raise awareness of cancer and to encourage the global population to check for potential signs and take preventative measures.
This year marks the beginning of a new three-year campaign titled “I Am and I Will”, which calls for people to make a “personal commitment” to combatting cancer.
What is cancer?
Our bodies are made up of millions of cells. When changes occur in one cell or in a small group of cells, this can lead to the development of cancer, Cancer Research UK outlines.
When changes to the genes occur in the body, this can cause cells to grow and multiply at a rapid rate, causing them to become cancerous.
This can then lead to the growth of a tumour.
When cells become cancerous in one area of the body, they can sometimes spread into other bodily tissues.
There are more than 200 different types of cancer, the most common forms being breast, prostate, lung and bowel cancer.
What is lifetime risk of cancer?
L ifetime risk of cancer is the calculation of whether a person is likely to be diagnosed with cancer at some point during their life.
The estimated lifetime risk of men being diagnosed with cancer is one in two, or 50 per cent, Cancer Research UK states.
The estimated lifetime risk is for women is also one in two, or 45 per cent.
This means that one in two people in the UK have a strong chance of being diagnosed with cancer during their lifetime.
However a large range of genetic and lifestyle factors mean the risk for each person is different.
Why is age a big risk factor?
Cancer can develop at any age. However, the majority of cases – nine out of 10 – occur among people aged 50 or older.
Over time, the cells in our body can become damaged.
This may happen for a number of reasons, such as being exposed to the sun for an excessive amount of time or from being a smoker.
This damage to the cells can build up over the years, causing the cells to grow and multiple at a faster rate than usual and thus increasing likelihood of developing cancer.
Can lifestyle affect risk of developing cancer?
It’s believed that eating certain foods can increase your chances of being diagnosed with cancer later on in life.
The NHS explains that reducing your intake of red meat can in turn reduce your risk of developing bowel cancer.
Obesity has also been linked to increased risk of developing cancer. A recent study found that the number of obesity-linked cancers is rising faster in young adults than individuals aged over 45.
People who use sunbeds or sunbathe irresponsibly could be at risk of developing skin cancer.
According to the NHS, the UV rays emitted by sunbeds can be far stronger than the sun during the hottest part of the day.
What treatments are available for cancer?
Treatments for cancer include surgery, radiotherapy, chemotherapy, hormone therapy, biological therapies, bisphosphonates and bone marrow and stem cell transplants.
What are the signs of cancer for both men and women?
Signs for cancer can include unusual lumps or swelling anywhere on the body, changes in appearance of a mole, ulcers lasting longer than three weeks, a persistent cough or croaky voice lasting longer than three weeks, blood in the urine or faeces, unexplained weight loss or heavy night sweats.
Breast cancer or cervical cancer signs include an unusual breast change, bleeding from the vagina after the menopause or between periods, and persistent bloating.
According to a recent study conducted by Bupa and HCA Healthcare UK, one in four women in the UK don’t check their breasts for signs of breast cancer.
Can cancer be prevented?
Experts estimate that more than four in 10 cancer cases could be prevented by undertaking certain lifestyle changes.
These changes include not smoking, keeping a healthy body weight, cutting back on alcohol, eating a healthy balanced diet, keeping active, avoiding certain infections (like HPV), avoidance of radiation and staying safe in the sun.
Breast cancer could be detected early through self-examination and smear tests can spot abnormal cells that could lead to cervical cancer.
'Shocking' rise in obesity-related cancers among young adults
Rates of obesity-fuelled cancers are now rising in successively younger age groups, a landmark study shows.
Experts said "shocking" levels of disease linked to growing waistlines across the globe threaten to reverse decades of progress in the war on cancer.
The Lancet study shows that rates of obesity-related cancers are rising faster in adults aged 25 to 49 than in older generations - despite the fact cancer is seen as a disease of old age.
The research, which examined 12 types of cancer linked to obesity, divided patients into five-year age groups from 25-29 to 80-84 years old.
In six of the main cancers - including bowel, pancreatic and kidney disease - it was found that the younger the age group, the greater the increase in incidence.
The major research used data covering more than half the population of the United States.
But British experts warned that trends in this country - where obesity rates are rising faster than the US - means there is a similar threat to Britain’s population.
The study, led by the American Cancer Society, considered 30 of the most common cancer types, and tracked trends among those diagnosed between 1995 and 2014.
They included 12 cancers linked to obesity, as well as 18 other types of disease where no such association has been found.
While rates of most of the obesity-related cancers saw a sharp rise in younger generations - outpacing the rise in older generations, in six types of disease - no such trend was seen in the other types of cancer, where rates either remained stable or fell.
Cancer patients could triple survival rates by taking painkillers, study suggests
People with head and neck cancers could more than triple their chances of survival simply by taking everyday painkillers, a new study suggests.
Common and cheap painkillers such as ibuprofen and aspirin were found to boost survival rates from 25 per cent to 78 per cent if the cancer contained one specific gene, found in about one-third of head and neck cancers.
Head and neck cancers are diagnosed in about 12,000 people in Britain – and kill a further 4,000 – each year.
Researchers at University of California San Francisco examined the survival rates for patients five years after diagnosis.
They found regular use of non-steroidal anti-inflammatory drugs (NSAIDs) had a dramatic impact for about a third of cancer sufferers.
Everyone in the study, published in the Journal of Experimental Medicine, who saw this marked increase in survival rates had the mutated gene PIK3CA.
For those whose gene had not been altered in the tumour, taking painkillers had no effect.
NSAIDs are a class of drugs which not only reduce pain but also can reduce inflammation. Aspirin and ibuprofen are the most common varieties; the other popular painkiller, paracetamol, works by a different process and is not classified as an NSAID.
Dr Jennifer Grandis, a professor of head and neck surgery, and senior author of the paper, said: “Our results suggest that the use of NSAIDs could significantly improve outcomes for not only head and neck cancer patients, but also patients with other cancers that contained the PIK3CA mutation.
“The magnitude of the apparent advantage is strong, and could potentially have a positive impact on human health.”
The researchers looked at 266 patients from the University of Pittsburgh Medical Centre
whose tumours were surgically removed.
Among the patients who regularly used NSAIDs, 93 per cent used aspirin at some point. Most of the regular users only began regularly taking the drug after their cancer was diagnosed.
Professor Justin Stebbing, NIHR Research Professor of Cancer Medicine and Medical Oncology at Imperial College London, said: “We know that inflammation is really important in cancer and can be used as part of the processes by which cancer cells spread and grow.
“Studies in colon, breast and other tumours have shown that anti-inflammatories may be helpful in patients with cancers that have certain mutations in them.
“This study in head and neck cancer takes that knowledge further with anti-inflammatories acting on two enzymes: the COX and PI3K proteins.”
Prof Stebbing said more work was needed to understand whether doctors should start telling cancer patients to take NSAIDs, and how often and in what dose.
A clinical trial to attempt to replicate the findings of the study is currently being designed.
Schoolboy with rare brain cancer among first to have NHS proton beam therapy in UK
15-year-old boy has spoken of his excitement at being among the first to have NHS proton beam therapy in the UK.
Mason Kettley, who suffers from a rare brain tumour, began treatment on Tuesday - five years after the parents of Ashya King sparked an international manhunt when they took him abroad in search of treatment.
Until last month, NHS patients were sent as far away as the US for treatment, if specialist doctors said it was required.
Now the Christie Hospital in Manchester has begun offering the highly targeted treatment, with Mason the fourth case to undergo it, and the first to speak publicly about it.
The schoolboy, who was diagnosed with a rare brain tumour in October, said his experiences at the hospital had convinced him that he wanted to train as a doctor.
The lack of proton therapy in the UK became the subject of public debate in 2014, when the parents of Ashya King, then aged five, fled the country in search of proton beam therapy because they believed the standard radiotherapy he was due to have in Southampton would harm his brain.
The child ended up receiving proton therapy in Prague, and has since been cleared of cancer.
Mason was diagnosed with the inoperable tumour after suffering headaches and failing to put on weight.
Doctors found that the tumour was growing in a critical part of his brain but could not operate due to the risk of causing blindness and damage to vital brain tissue.
Following a biopsy and an operation to insert a shunt, doctors referred Mason's case to a national panel of experts.
They decided his tumour - known as a benign pilomyxoid astrocytoma - made him a suitable candidate for proton beam therapy.
Mason, who lives with his mother Cally, step father Ryan, and four siblings - Taylor, 20, Logan, 10, Scarlett, seven, and Elijah, four - said he feels apprehensive about the treatment.
He said: "I'm a bit nervous because the machine is intimidating because of its size.
"It's a bit nerve-wracking but this is a better choice than chemo because it's more effective.
"Because of my age, (doctors) thought radiation would be a better choice.
"Their goal is to stabilise the tumour. It may shrink, but they are aiming to stabilise it."
Mason, who likes to spend his spare time on social media and watching movies, is planning on going to McDonald's once his six weeks of treatment has finished.
"I'm a fussy eater but I'll be having large fries," he said.
Because of its precision, proton beam therapy is beneficial for patients with difficult-to-treat tumours in critical areas, such as in the brain or spinal cord, and for young people whose tissues are still developing.
Consultant clinical oncologist Gillian Whitfield, who is leading Mason's care at the Christie, said: "With proton beam therapy, compared to conventional radiotherapy, there is less dose to surrounding normal tissues and less risk of permanent long-term effects of treatment.
"This is particularly important for children and teenagers with curable tumours, who will survive decades after treatment and are at much greater risk of serious long-term effects of treatment than adults.
"Mason's tumour is a low grade (slow growing) tumour with a high chance of cure.
"For Mason, in comparison to conventional radiotherapy, proton beam therapy should carry a lower risk of some important long-term side effects of treatment, particularly effects on short-term memory and learning ability and the risk over the next eight decades of the radiation causing other tumours."
Two new proton beam therapy centres have now been built at the Christie and University College London Hospital (UCLH) with £250m of Government money.
Professor Stephen Powis, medical director for the NHS in England, said: "This is a hugely exciting development for the NHS and we are delighted that we are able to provide this life-changing treatment for patients like Mason."
Cervical Cancer Prevention Week: Why men need to talk about cervical cancer
At the start of Cervical Cancer Prevention Week, sports broadcaster Ali Maxwell speaks out about the part men need to play in eliminating this life-shattering disease.
Ali was six years old when he lost his mother.
The dimming fog of time and trauma has consumed many of his memories of her, but he knows she left an extraordinary legacy, and he knows what it’s like to grow up without a mum.
Jo Maxwell, Ali’s mother, gave her final months and name to fighting cervical cancer. She and her husband James set up her eponymous charity Jo’s Cervical Cancer Trust in 1999 to support people suffering from what was then a lesser-known illness. Jo’s Trust is now a major British charity and the only one of its kind in the UK.
Cervical cancer develops in a woman's cervix, which is the entrance to the womb from the vagina. However, it’s not just women who bear the burden of this disease. For every victim there are countless loved ones whose lives are torn apart.
Jo was 40 when she died, leaving behind a daughter, two sons and a doting husband. Ali, now 26, doesn’t want other children to go through what he did.
Speaking exclusively to the Standard, Ali said: “As a man, I’ve often felt as though I don’t have the right to talk about this because it’s a cancer that’s so intimate and specific to women.
“But now I realise that’s precisely why men need to talk about it. I know first-hand what it’s like to lose a woman you love. I also know that the number of women attending their smear tests is at a 20-year low. And I know too many men shy away from the problem, either through embarrassment, ignorance or both, because this is one cancer they can’t contract themselves.”
Over 3,000 women are diagnosed with cervical cancer in the UK each year and almost 900 die of the disease.
It’s the most common cancer in women aged 35 and under, despite being one of the only ones that can be prevented through early screenings.
Cervical screening – commonly known as a smear test – can stop 75 per cent of cervical cancer cases from developing, yet screening attendance rates in the UK have dropped to their lowest level since records began in 1995.
“It’s our duty, as sons, brothers, partners and friends, to understand how important these tests are and to encourage the women we love to get theirs done,” said Ali.
“We need to reinforce that they’re nothing to be nervous or embarrassed about. Women need to feel relaxed about discussing them. It’s terrible that there are women who wouldn’t miss work to go to an appointment because they’d find it too uncomfortable to tell their boss or colleagues.”
New research released by Jo’s Trust today reveals that 81 per cent of young women in Britain find smear tests embarrassing.
Of the 2,005 women interviewed, aged 25-35, three quarters (72 per cent) admitted to putting off a test because of this embarrassment, while 71 per cent said they felt scared at the prospect of going. Additional barriers included worries about making a fuss (27 per cent), thinking their concerns were too silly or small (16 per cent), or fear of being judged (18 per cent).
Almost half of respondents said they regularly delayed or didn’t take up their screening appointments at all, despite being the age group most at risk of developing the cancer.
Today marks the start of Cervical Cancer Prevention Week 2019 – an annual programme spearheaded by Jo’s Trust to promote awareness of the disease and encourage take-up of the life-saving tests.
Over the course of this week, the charity will hold events and encourage communities across the country to fundraise or simply spread the word. This includes the relaunch of its #SmearForSmear campaign, for which supporters are asked to post a selfie with lipstick smeared across their face, along with a tip or word of support.
“Your post might be the reminder or encouragement someone needs to book their test, it could literally save their life,” the charity states on its website.
#SmearForSmear has seen high levels of female engagement since it was first launched in 2014 – with celebrities like singer Rita Ora, model Georgia May Jagger and the presenters of Loose Women all posting photos – but Jo’s Trust CEO, Robert Music, would like to see more men involved in the campaign.
“During #SmearForSmear I put my lipstick on and know I look silly but I also want to show support to everyone who gets involved in the campaign and remind people that it has a really serious message – smear tests save lives,” said Robert in an interview with the Standard.
“We all have women in our lives, whether mothers, sisters, friends or partners, and so all have a role to play in reducing the impact of cervical cancer by sharing messages about how it can be prevented,” he added.
When Jo Maxwell fell ill over 20 years ago with what she called an 'unfashionable' cancer, she and her husband James struggled to find any clear information about the disease and had to cope without a support network.
Since then, Jo’s Trust has provided advice and care to millions of women and their families across the UK, yet cervical screening attendance continues to fall.
Ali, Jo’s youngest son, said: “There is still a lot of work to be done. The ultimate goal of Jo’s Trust is to eradicate cervical cancer entirely, and the only way this will happen is by improving everyone’s understanding of the disease and removing any taboos surrounding it.”
“We all need to be part of the conversation. That includes men.”Over 3,000 women are diagnosed with cervical cancer in the UK each year and 220,000 British women are diagnosed with cervical abnormalities.
It is the most common cancer in women aged 35 and under, despite being one of the only cancers that can be prevented through early screenings. Smear tests can stop 75 per cent of cases from developing.What is a smear test?
A smear test – known medically as a cervical screening – involves a sample of cells being taken from the cervix by inserting an instrument called a speculum into the vagina and extracting the cells using a small brush. These cells are then tested for any abnormalities.
The main cause of abnormal cells in the cervix is the human papillomavirus (HPV).What is HPV?
HPV is a common virus transmitted through skin to skin contact in the genital area and around 80 per cent of adults will be infected with some form of it during their lifetime. There are about 200 different strands of the virus, and the immune system can get rid of most of them without the need for medical treatment. HPV rarely produces symptoms, so many people never know they have it.
However, about 13 types of HPV infection are linked to cancer and these don’t display symptoms either. This is why it is important for women to attend their smear tests – the screening can detect a high-risk HPV virus early, before it develops into cancer.How do you arrange an appointment for a smear test?
Cervical screening appointments are currently offered for free to women in England aged 25 to 64. All eligible women who are registered with a GP automatically receive an invitation by mail.
Women aged 25 to 49 receive invitations every 3 years. Women aged 50 to 64 receive invitations every 5 years.What about women who are under 25?
An online petition, organised by cervical cancer victim Natasha Sale, could see the screening age lowered from 25 to 18.
Natasha, a mother from Devon, campaigned to lower the age after she was diagnosed with the cancer in 2016. Her petition had received more than 78,000 signatures by the time she died on January 3 this year, aged just 31. Three days later, on January 6, the petition reached the target of 100,000 signatures, the number needed to be considered for debate in Parliament.
Cervical screening rates are at their lowest since records began in 1995.
Of the 4.46 million women invited to a smear test in the UK between 2017-2018, 3.18 million attended. This means 1.28 million women did not get tested.
A report commissioned by Jo's Trust in 2017 revealed that of the 2,017 British women surveyed, half either delayed or didn’t attend a screening at all.
In the same 2017 report by Jo's Trust, a third of respondents said embarrassment caused them to delay getting a smear test. This figure rises to three quarters (72 per cent) for women aged 25 - 35, according to research released today.
The 2017 survey showed between a third and half of women were too embarrassed to attend allocated appointments because of their body shape or the appearance of their vulva, while 31 per cent said they wouldn't go if they hadn't shaved or waxed their bikini area.
The study also signalled a lack of understanding about the importance of screening, with a quarter of participants saying they didn't think they needed a smear because they were healthy, and more than a third (37 per cent) unaware that the test reduces cancer risk.
Other barriers to attendance include psychological issues for survivors of sexual violence, and a lack of convenient appointments, with 16 per cent saying they would miss their smear test for a gym class and 35 per cent saying they would not take time off work to be tested. Other women admitted that they simply forgot.
Skin cancer is rising because men in particular ignore deadly warning signs
Years ago I remember making a TV documentary on Bondi beach in Australia, in blazing sunshine, asking sunbathers if they were worried about getting melanoma.
The universal answer was NO.
Even though there were information kiosks every few hundred yards, they stood empty as women and men soaked up the harmful rays on a beach.
Research shows that women take more notice of warnings about the link between exposure to the sun and the development of melanoma – a highly aggressive form of skin cancer.
Men, it turns out, aren’t as sensitive to the warnings. But they should be – as the latest stats show that death rates in men for melanoma skin cancer outstrip those for women.
Men are being urged to cover up in the sun to guard against this killer.
A study shows that the death rate among British men has increased by almost 75% since the mid-1980s, but for women it went up less than 10%.
Previous research suggests that men are more reluctant to act on advice to avoid overexposure to ultraviolet radiation from sun and are less likely to report potentially cancerous moles.
Dorothy Yang, of the Royal Free London NHS Foundation Trust, who led this recent study, said: “Evidence suggests men are less likely to protect themselves from the sun or engage with melanoma awareness and prevention campaigns.”
Between 1985 and 1987, the average melanoma death rate for British men was 1.48 per 100,000 of the population. For women, it was 1.45. By 2013-15, the death rate for women had grown to only 1.58 per 100,000, whereas it had risen to 2.57 per 100,000 for men.
Melanoma is the deadliest form of skin cancer because it can spread quickly to other organs.
Rates have increased across the globe, particularly in regions with predominantly fair-skinned populations like us Anglo-Saxons.
The data has been gathered by the World Health Organization over the past 30 years.
Death rates for 2013-15 were highest for men in Australia, at 5.72 per 100,000, and lowest in Japan, at 0.24.
Martin Ledwick, of Cancer Research UK, said that investigation was needed into the causes of male death rates.
He said: “Once we know the answer, researchers may recommend targeting men with information about how to reduce their risk... such as advice on staying safe in the sun and getting any new moles or blemishes, or changes to existing ones, checked out by a doctor.”
Testicular cancer How to check, symptoms and everything you need to know
Around 2,200 men are diagnosed with testicular cancer each year, according to the NHS.
Testicular cancer is a relatively rare type of cancer, accounting for just 1% of all cancers that occur in men.
However, the NHS also reports that the number of cases has roughly doubled in the UK since the mid-1970s, so it's important to know what signs to look for.
Here's everything you need to know about testicular cancer and how to check for symptoms:
Who is at risk?
Around 1 in 213 males will be diagnosed with testicular cancer in their lifetime.
It tends to affect men between 15 and 49 years old and for reasons that are unclear, has a higher chance of affecting white men than men from other ethnic group.
Cancer Research UK says that a person's risk of developing cancer depends on a multitude of factors, including age, genetics and exposure to risk factors such as lifestyle choices.
However, testicular cancer is not clearly linked to any preventable risk factors.
How to check
The best time to check is after a bath or shower, as this is when the scrotal skin will be relaxed.
Hold the scrotum in the palm of your hand and gently roll each testicle between your fingers and thumb to look for any abnormalities.
What are the symptoms?
The early signs of testicular cancer include:
· A hard lump on the front or side of a testicle
· Swelling or enlargement of a testicle
· An increase in firmness of a testicle
· Pain or discomfort in the testicle or scrotum
· An unusual difference between one testicle and the other
If you find any of the above signs, see a doctor.
Scientists have been studying cancers in a strange way for decades
In 1959, an American physician named Harry Eagle mixed up one of the most pivotal cocktails in medical history—a red blend of sugar, salts, vitamins, and amino acids that allowed scientists to efficiently grow the cells of humans and other animals in laboratory beakers. This red elixir, known as Eagle’s minimal essential medium (EMEM), became a bedrock of biological research. Sixty years later, the medium and its variants are still heavily used whenever researchers want to study animal cells, whether to investigate the viruses that infect us, or to work out what goes wrong when cells turn cancerous.
As its name suggests, EMEM was designed to be as simple as possible—it has everything a cell needs to grow and nothing more. And in recent years, scientists have started realising that such pared-down concoctions might be skewing their results, by warping the ways in which cells process nutrients. It’s as if they had spent decades studying the health of people who had only ever been given rations to eat.
Instead of using generic “culture media” like EMEM (or its more concentrated variant, Dulbecco’s Modified Eagle’s Medium, known as DMEM), it might be better to start creating concoctions that more accurately reflect the chemical profiles of our bodies. That’s what Saverio Tardito did in 2012, when he joined the Cancer Research UK Beatson Institute in Glasgow. “Around 90 percent of the papers in cancer research are using the same two or three commercially available media,” he says. “We researchers are aware that the medium you choose at the beginning of the experiment will affect the output, but it’s too easy to open the door of the fridge and use what’s there. I think we have been all been a bit too lazy.”
Over several years, he fine-tuned a mixture called Plasmax, which contains around 60 nutrients and chemicals at the concentrations usually found in human blood. “It was a side project—just a way of obtaining a better tool to do better research,” Tardito says. “But from the beginning, we noticed that the medium was making a difference.”
His colleague Johan Vande Voorde realised that cancer cells, when grown in Plasmax, behave more like they would in actual tumours, without several weird behaviours that are triggered by commercially available media. For example, DMEM contains a substance called pyruvate at 10 times its normal concentration in blood. These abnormal levels force cancer cells to grow as if they were starved of oxygen, even when the gas is abundantly present. In DMEM, the cells act as if they were being choked. In Plasmax, they do not.
Unlike DMEM, Plasmax also contains selenium, an essential mineral. By comparing the two media, Vande Voorde showed that when breast cancer cells are grown at low densities, they die in the absence of selenium, but flourish in its presence. That’s a little worrying. Several researchers have tested selenium supplements as a way of preventing cancer, but despite many studies there’s no strong evidence for a protective effect. Instead, Tardito wonders if such supplements could be risky: If selenium allows cancer cells to survive in sparse populations, it might make it easier for fragments of tumours to spread to other parts of the body. “We’ll need to follow that up in animal studies,” he says.
David Sabatini of the Whitehead Institute for Biomedical Research has also been mixing up his own culture medium that mimics the nutrient levels of human blood. In 2017, he showed that cancer cells grown in this mixture are much less sensitive to a chemotherapy drug called Adrucil.
These results come at an interesting time. In recent years, cancer biologists have been grappling with a possible reproducibility crisis, in which results from several experiments involving lab-grown cells can’t be repeated by other teams. More broadly, researchers have struggled to translate the results of basic experiments involving such cells into new treatments that actually help cancer patients. Although there are many possible reasons for these problems, Tardito wonders whether he and his colleagues might get better results if they grow their cells in more realistic media.
“Could these new media uncover vulnerabilities of cancer cells more robustly than before?” adds Chi Van Dang of the Wistar Institute, who also wants to know how immune cells might react under these more physiological conditions. “Could these media help us to understand immunotherapy better?”
“These studies are absolutely a step in the right direction,” says Gina DeNicola of the Moffitt Cancer Centre. “For this approach to be applied more broadly, these types of media will need to be commercialised. While it’s possible to make these media in a lab, it’s very costly and time-consuming. Commercial media preparations are also more consistent and higher quality, which will help with reproducibility between Labs.” (Indeed, that’s partly why researchers have been so slow to move beyond traditional media like DMEM.)
Commercial preparations would also help Sabatini and Tardito, whose teams have been laboriously making up stocks of their own artisanal media and shipping them to collaborators around the world. “I struggle to keep up with the requests,” Tardito says. Sabatini adds, “We are working with vendors, but it is not easy, as physiological media is more expensive and is likely to have a shorter half-life.”
For researchers looking to understand how cancers gobble up nutrients, “testing one’s finding in a medium such as Plasmax would, without any doubt, add unparalleled rigour, and hopefully become a more widespread practice,” says Natasha Pavlova of the Memorial Sloan Kettering Cancer Centre.
But she notes that such media aren’t perfect. They’re still largely missing many important components of blood, including fats and proteins. They don’t capture the different chemical profiles that exist in other tissues and organs. They don’t reflect the chemical wastelands that exist at the heart of tumours, which grow so quickly that their blood supplies can’t provide them with enough nutrients. Just last month, Alexander Muir of the University of Chicago showed that the fluids inside a tumour, which circulate between its cancerous cells, contain different levels of nutrients to those in blood.
Perhaps most important, Pavlova says, many cancer researchers rely on lineages of tumour cells that were created decades ago. These lines have been grown in conventional media like DMEM ever since, and have likely adapted accordingly. If they were now dunked in Plasmax, would that get researchers closer to real-life biology, or further away? Would researchers have to create entirely new cell lines that are grown in Plasmax from the start?
Tardito acknowledges these issues. “There will never be a perfect medium that mimics the tumor environment beginning to end,” he says. “All we can do is try and minimise those imperfections as much as we can.”
Breakthrough breathalyser test for cancer 'could save thousands'
A breathalyser test that could revolutionise cancer diagnosis is being trialled in the UK.
The Breath Biopsy device is designed to detect cancer hallmarks in molecules exhaled by patients.
Scientists hope it will lead to a simpler, cheaper method of spotting cancers at an early stage, when they are more likely to respond to treatment.
The cancer breathalyser has the potential to save thousands of lives and save millions of pounds in healthcare costs, its developers claim.
The two-year trial, taking place at Addenbrooke’s Hospital in Cambridge, is recruiting 1,500 participants, including healthy individuals as well as cancer patients.
Initially patients with suspected oesophageal and stomach cancers will be asked to try the test. Later the trial will be extended to include prostate, kidney, bladder, liver and pancreatic cancers.
The lead investigator, Professor Rebecca Fitzgerald, from the Cancer Research UK Cambridge Centre, said: “We urgently need to develop new tools, like this breath test, which could help to detect and diagnose cancer earlier, giving patients the best chance of surviving their disease.
“Through this clinical trial we hope to find signatures in breath needed to detect cancers earlier. It’s the crucial next step in developing this technology.”
Participants will be asked to breathe into the cancer breathalyser for 10 minutes.
Airborne molecules called volatile organic compounds (VOCs) collected by the test will then be sent to a laboratory in Cambridge for analysis.
Cells in the body produce a range of VOCs as part of their normal metabolic processes. The molecules find their way into the lungs and emerge in the breath.
The idea behind the test is that cancer can cause recognisable alterations in the pattern of VOCs.
If the technology is shown to be reliable and accurate, cancer breathalysers could become common sight in GP surgeries.
Billy Boyle, who is the co-founder and chief executive of Owlstone Medical, said: “There is increasing potential for breath-based tests to aid diagnosis, sitting alongside blood and urine tests in an effort to help doctors detect and treat disease.
“The concept of providing a whole-body snapshot in a completely non-invasive way is very powerful and could reduce harm by sparing patients from more invasive tests that they don’t need.
“Our technology has proven to be extremely effective at detecting VOCs in the breath, and we are proud to be working with Cancer Research UK as we look to apply it towards the incredibly important area of detecting early-stage disease in a range of cancers in patients.”
Jan 1st 2019
Chemotherapy 'may cause breast cancer to spread'
Chemotherapy may cause breast cancer to spread, alarming research suggests.
The commonly prescribed chemo drugs paclitaxel and doxorubicin cause breast tumours to release proteins that then circulate in the blood until they reach the lungs, triggering the disease's onset in a new part of the body.
When scientists blocked this protein in a lab model, the cancer did not spread. They hope their findings will help make chemotherapy more effective.
The study was carried out by the Swiss Institute for Experimental Cancer Research and led by Professor Michele De Palma, head of the lab.
Chemotherapy is often given to breast-cancer patients before surgery to shrink their tumours and make them easier to remove.
Known as 'neoadjuvant therapy', this also helps to save healthy breast tissue.
In some cases, chemotherapy can even eradicate the tumour entirely, with such patients
being highly likely to remain cancer-free for life.
But the treatment does not always shrink tumours. If the growth resists neoadjuvant therapy, it is more likely to spread to other parts of the body.
Breast cancer affects one in eight women at some point in their lives in both the UK and US, statistics show.
It is unclear how many cases of the disease spread, with the lungs, bones, liver and brain being the most commonly affected secondary areas.
Working with experimental tumour models, the researchers found both paclitaxel - more commonly known by the brand name Taxol - and doxorubicin - or Adriamycin - cause breast cancer tumours to release small fluid-filled sacs called exosomes.
Chemo makes exosomes containing the protein annexin-A6, which is not found in sacs released from untreated tumours.
'It seems that loading of annexin-A6 into exosomes is significantly enhanced in response to chemotherapy,' study author and postdoctoral researcher Professor Ioanna Keklikoglou said.
Once released from tumours, exosomes circulate in the blood until they reach the lungs.
They then give out annexin-A6, which stimulates lung cells to release another protein called CCL2.
CCL2 then attracts immune cells called monocytes, which fight certain infections and help other cells remove dead or damaged tissue.
However, monocytes can also be dangerous, with previous studies showing they fuel the survival and growth of cancerous cells in the lungs.
' In short, our study has identified a new link between chemotherapy and breast cancer metastasis,' Professor De Palma said.
When the researchers neutralised annexin-A6 or blocked the monocytes, the experimental breast tumour no longer spread to the lungs.
They hope this will improve the effectiveness of neoadjuvant therapy.
Various monocyte inhibitors have been developed for clinical use, so they may be tested in combination with neoadjuvant chemotherapy to potentially limit unwanted side effects mediated by exosomes,' Professor De Palma said.
Although the results are concerning, he urges people not to jump too conclusions.
'While this observation supports the significance of our findings, at the moment we don't know if annexin-A6 has any pro-metastatic activity in human breast cancer,' Professor De Palma added.
The authors also stress their findings should not discourage people from receiving neoadjuvant chemo when it is needed.
'It remains an essential and potentially curative treatment for many invasive breast cancers, as shown by multiple clinical trials,' they wrote.
Dec 15th 2018
Increased risk of breast cancer in years immediately following childbirth
Researchers thought being a mum protected against breast cancer. That’s true — but only 20 years after childbirth.
You’ve probably heard that having children and breastfeeding them reduces a woman’s lifetime risk of breast cancer. But according to new research, in the years immediately following childbirth, women are actually at a small, heightened risk of the disease.
That’s the finding of a major new review of 15 studies from three continents on the relationship between breast cancer and childbirth, published in the Annals of Internal Medicine. It’s not the first paper to come to this conclusion, but it’s certainly the biggest — and one that clarifies a little-appreciated breast cancer risk factor.
Globally, breast cancer is the top cancer diagnosis in women of reproductive age. In America, it’s the most common cancer for women after skin cancer, according to the American Cancer Society. One in eight women in the US will develop the disease, and in 2018, approximately 266,000 new cases of invasive breast cancer were diagnosed.
We’ve known for a while that women who smoke as well as women who have the BRCA1 and BRCA2 gene mutations are at a heightened risk. Now women who have recently had a child are in that higher risk group as well, said the study’s lead author, University of North Carolina epidemiologist Hazel Nichols. That risk is highest about five years after childbirth, but it lasts some 20 years.
“This is one example of how risk factors can change over the course of a woman’s life,” she added. Which means that when doctors are trying to assess breast cancer risk, they should take into account when and whether she has had children, along with the other well-known breast cancer risk factors. Together, these risks might inform a woman’s decision to get screened earlier.
Why childbirth can both prevent and promote breast cancer
Researchers have long shown that a woman’s lifetime risk of breast cancer is reduced if she’s had children. Hormones produced during the ovulation cycle can stimulate cell growth, which can help cancerous cells multiply. But women who have been pregnant and breastfed have fewer periods, and therefore produce fewer cancer-inducing hormones. That may be why lifetime breast cancer risk generally declines with every child a woman has.
But those figures account for lifetime risk. This new study pooled the results of other studies, from 1976 to 2012, and looked at how breast cancer risk changes at every stage of life in both mums and women who haven’t had kids. What they found has complicated the thinking around breast cancer and motherhood.
By about 60, when breast cancer is most common, women who have had kids are at a lower risk of the disease. But in the years immediately after childbirth, mums are at a greater risk. That risk peaks five years after childbirth, and then gradually declines until childbearing becomes protective against breast cancer, about 20 years later. You can see that changing lifetime risk in this chart:
One important point: The heightened risk in the years following childbirth, while statistically significant, is not huge. Mums 41 to 50 years old had a 2.2 percent risk of developing cancer, while women that age who didn’t have children had a 1.9 percent risk.
“We’re not arguing with the idea that, overall, breast cancer is beneficial for reducing breast cancer risk,” Nichols said. “But that information came from looking at the majority of breast cancer cases, and the majority are diagnosed later in life. By that time in your life, you are experiencing a benefit of your childbearing history.”
With the new study, she added, “We were able to look more closely at the time period after birth, when breast cancer is overall much less common. And that’s where we saw an elevated risk.”
Dec 8th 2018
Uterine Cancer Killing More US Women, with Black Women Hardest Hit
More women in the U.S. are developing and dying from uterine cancer than they were nearly two decades ago, and black women are "disproportionately" affected, a new report finds.
Uterine cancer is one of the few cancers in the U.S. for which incidence and death rates are on the rise, according to the report, published today (Dec. 6) by the Centers for Disease Control and Prevention (CDC). Live Science reported in July that death rates for liver cancer are also increasing, even as overall cancer death rates (meaning rates for all combined cancers) are falling.
From 1999 to 2015, rates of uterine cancer increased by 12 percent, from around 24 cases per 100,000 women in 1999 to 27 cases per 100,000 women in 2015, the report said. From 1999 to 2016, rates of death from uterine cancer increased by 21 percent, from around 4 deaths per 100,000 women in 1999 to 5 deaths per 100,000 women in 2016. [5 Signs of Gynecological Cancer Ignore]
Incidence rates among black women were particularly notable, the report said. For example, although the rates of uterine cancer were the same for white and black women in 2015, black women saw a 46 percent increase from 1999, compared with a 9 percent increase for white women. Black and white women had higher incidence rates of uterine cancer than Alaskan Indian/Native American, Hispanic and Asian/Pacific Island women.
What's more, the report found that black women were "approximately twice as likely to die from uterine cancer" compared with women in other racial and ethnic groups. One potential explanation for this disparity, the authors noted, is that the odds of surviving uterine cancer are higher when the disease is detected at an early stage, but black women were more likely than other women to be diagnosed at a later stage.
Overall, the rising rates of uterine cancer may be linked to rising rates of obesity among U.S. women, according to the report. Women with overweight or obesity are two to about four times more likely to develop endometrial cancer (the most common type of uterine cancer) than women with normal weight, according to the National Cancer Institute. Other factors that could contribute to the increase include insufficient physical activity, increasing rates of diabetes and the decreasing use of certain hormone therapies.
Because screening tests are not recommended for uterine cancer (a cancer test can spot the disease before symptoms start), the authors stressed the importance of increasing the awareness of early symptoms of this disease. One such symptom is abnormal vaginal bleeding, which occurs in approximately 90 percent of women who have this cancer, the report said. Indeed, if women experience this symptom, they should seek prompt medical attention.
The report is based on data from the CDC's National Program of Cancer Registries and the National Cancer Institute's Surveillance, Epidemiology and End Results program, both of which collect information on cancer incidence. The researchers also used data from the National Vital Statistics System, which contains death certificates from all 50 states and the District of Columbia.
Dec 4th 2018
Scientists develop 10-minute universal cancer test
Inexpensive procedure shows whether patient has cancerous cells in the body, but does not reveal where or how serious it is
Scientists have developed a universal cancer test that can detect traces of the disease in a patient’s bloodstream.
The cheap and simple test uses a colour-changing fluid to reveal the presence of malignant cells anywhere in the body and provides results in less than 10 minutes.
While the test is still in development, it draws on a radical new approach to cancer detection that could make routine screening for the disease a simple procedure for doctors.
“A major advantage of this technique is that it is very cheap and extremely simple to do, so it could be adopted in the clinic quite easily,” said Laura Carrascosa, a researcher at the University of Queensland.
The test has a sensitivity of about 90%, meaning it would detect about 90 in 100 cases of cancer. It would serve as an initial check for cancer, with doctors following up positive results with more focused investigations.
“Our technique could be a screening tool to inform clinicians that a patient may have a cancer, but they would require subsequent tests with other techniques to identify the cancer type and stage,” Carrascosa said.
The test was made possible by the Queensland team’s discovery that cancer DNA and normal DNA stick to metal surfaces in markedly different ways. This allowed them to develop a test that distinguishes between healthy cells and cancerous ones, even from the tiny traces of DNA that find their way into the bloodstream.
Healthy cells ensure they function properly by patterning their DNA with molecules called methyl groups. These work like volume controls, silencing genes that are not needed and turning up others that are. In cancer cells, this patterning is hijacked so that only genes that help the cancer grow are switched on. While the DNA inside normal cells has methyl groups dotted all over it, the DNA inside cancer cells is largely bare, with methyl groups found only in small clusters at specific locations.
Writing in the journal Nature Communications, the Queensland team described a series of tests that confirmed the telltale pattern of methyl groups in breast, prostate and colorectal cancer as well as lymphoma. They then showed that the patterns had a dramatic impact on the DNA’s chemistry, making normal and cancer DNA behave very differently in water. “This is a huge discovery that no one has grasped before,” said Carrascosa.
After a series of experiments, the scientists hit on the new test for cancer. The suspect DNA is added to water containing tiny gold nanoparticles. Though made of gold, the particles turn the water pink. If DNA from cancer cells is then added, it sticks to the nanoparticles in such a way that the water retains its original colour. But if DNA from healthy cells is added, the DNA binds to the particles differently, and turns the water blue. “The test is sensitive enough to detect very low levels of cancer DNA in the sample,” Carrascosa said.
Led by Matt Trau, a professor of chemistry at the University of Queensland, the researchers have run the test on 200 human cancer samples and healthy DNA. “We certainly don’t know yet whether it’s the holy grail for all cancer diagnostics, but it looks really interesting as an incredibly simple universal marker for cancer, and as an accessible and inexpensive technology that doesn’t require complicated lab-based equipment like DNA sequencing,” Trau said.
The scientists are now working towards clinical trials with patients that have a broader range of cancer types than they have tested so far.
To test for cancer today, doctors must collect a tissue biopsy from a patient’s suspected tumour. The procedure is invasive and relies on the patient noticing a lump, or reporting symptoms that their GP recognises as a potential sign of cancer. A less invasive test that has the potential to spot cancer earlier could transform how patients are screened for the disease.
The DNA in cancer cells can be riddled with mutations that drive the growth of a specific tumour, but these mutations tend to differ depending on the type of cancer. A universal cancer test would not be precise enough to pinpoint the location or size of a tumour, but would give doctors a swift answer to the question: does this patient have cancer?
Tests in the lab showed that the scientists could distinguish normal DNA from cancer DNA by looking for a colour change in the gold particle solution that was visible to the naked eye within a few minutes.
“This test could be done in combination with other simple tests, and become a powerful diagnostic tool that could not just say that you have cancer, but also the type and stage,” said Carrascosa.
Ged Brady, of the Cancer Research UK Manchester Institute, said: “This approach represents an exciting step forward in detecting tumour DNA in blood samples and opens up the possibility of a generalised blood-based test to detect cancer. Further clinical studies are required to evaluate the full clinic potential of the method.”
Dec 3rd 2018
Scientists may have found a way to treat cancer without chemotherapy by replicating our body's own self-destruct system
· Every day, millions of our cells "kill" themselves and are quickly removed from our system, helping protect us from potentially harmful cells. · Cancer cells, on the other hand, can protect themselves from self-destruction by ignoring our immune system's cell-death signals. · Scientists from the US recently discovered a genetic "kill code" in our cells that could theoretically be used to treat cancer without chemotherapy.
Every day, millions of cells in our bodies "kill" themselves and are quickly removed.
While the mechanism may sound dramatic, it's for our own good. The process ensures that potentially harmful cells destroy themselves and protects us from diseases.
Cancer cells, however, can protect themselves from self-destruction by ignoring our immune system's cell-death signals — and that's precisely what makes them so dangerous.
As advanced as medicine is today, the incidence of cancer diagnoses continues to rise.
Scientists at the International Agency for Research on Cancerestimate that this year about 18 million people will be diagnosed with cancer and about 10 million people will die of cancer. But researchers all over the world are looking for new therapy options.
Researchers have deciphered the kill code within our RNA
Scientists from Northwestern University recently discovered a kind of genetic "kill code" in cells that could theoretically be used to treat cancer without chemotherapy.
Last year, scientists led by Marcus E. Peter discovered that every cell in the body has a code that can trigger programmed cell death, though the team was unable to decipher the mechanism behind it.
But the researchers recently said in the journal Nature Communications that they've now figured out how this code works. It could be an important step toward making tumor cells vulnerable to attack without the use of chemical substances.
According to the new study, the code is available as information in ribonucleic acid, or RNA, and microRNAs. The small RNA molecules can effectively kill cancer cells, a process that chemotherapy is meant to activate.
The microRNAs can lead affected cells to cell suicide
The researchers found that cancers were unable to develop resistance to the molecules, turning the mechanism into a potentially viable treatment for tumors — especially if the code could be multiplied
Now that we know the kill code, we can trigger the mechanism without having to use chemotherapy and without messing with the genome," Peter said in a news release. MicroRNAs could be used to push the affected cells to cell death.It turns out we already have the deadliest weapon against cancer in every one of our cells
The potential of the approach was already clear to the scientists because the molecules destroy several genes that cancer cells need to survive.
"It's like committing suicide by stabbing yourself, shooting yourself, and jumping off a building all at the same time," Peter said last year, according to the news release. "You cannot survive."
Since chemotherapy has serious side effects, the aim of the study was not to develop a new toxic substance. Peter said he wanted to use a mechanism that had developed naturally — something already inside us that only needed activating.
The next step would be to incorporate this mechanism into a new therapy. Because the method hasn't been tested on animals, let alone humans, that very well could take years, but it may be a revolutionary step in the fight against cancer.
Nov 30th 2018
Immunotherapy may offer ray of hope for triple negative breast cancer patients
Breast cancer is the most common cancer among women worldwide with over two million new cases diagnosed in 2018. There are different types of breast cancers, mainly classified based on the expression of certain proteins like Estrogen Receptor (ER), Progesterone Receptor (PR) and Her2 (human epidermal growth factor receptor 2).
Drugs have been specifically developed to target these proteins on cancer cells. For example, women with ER positive breast cancer are treated with a drug called Tamoxifen which blocks the action of ER and has given hope to millions of women. Some breast cancers, however, do not express any of these three proteins (ER, PR or Her2) and are classified as Triple Negative Breast Cancer (TNBC).
TNBC is a notoriously aggressive form of breast cancer and those suffering from it have slim chance of survival. It is more likely to occur in younger women. This type of breast cancer accounts for approximately 15% of total breast cancer cases. Its incidence in India, however, is higher (27.9%) compared to other regions of the world.
Traditionally, chemotherapy which involves administration of a range of drugs to prevent cancer cells from uncontrolled growth has been the standard of care for TNBC. Despite treatment, TNBC patients show high rates of reappearance of the disease which unfortunately leads to untimely death. Hence there is an urgent need for better therapies in treating TNBC.
Immunotherapy, which boosts the immune system of the body, has shown a great deal of promise in treating certain cancers and is now being recognised as a potential therapeutic approach in TNBC too. It uses the body’s own molecules or synthetically produced substances that enhance or restore immune system.
One recently developed type of immunotherapy uses a class of drugs called checkpoint inhibitors, which exploits key surface molecules on T cells, which are a major weapon of the human body’s immune system. James P Allison and Tasuku Honjo were awarded the 2018 Nobel Prize in Physiology or Medicine for their work that led to the discovery of novel molecules which led to the development of immunotherapy.
A new study published recently in New England Journal of medicine (NEJM) by Dr. Peter Schmid of Barts Cancer Institute, Queen Mary University of London, and his colleagues, has found that combining immunotherapy with chemotherapy could improve the outcome for some advanced triple negative breast cancer patients.
More than 900 patients with untreated metastatic (where the cancer has spread to other parts of the body like the lungs) TNBC were enrolled in a phase III clinical trial and randomly assigned to receive Nab-Paclitaxel, a chemotherapeutic drug used to treat breast cancer either with a placebo (no immunotherapy drug) or in combination with Atezolizumab, a drug belonging to the checkpoint inhibitor class of immunotherapy drugs.
In the body, immune T cells express a surface molecule called PD-1 which can attach with another molecule called PD-L1 present on other cells. This attachment conveys to T cells that the other cell is not to be destroyed and hence prevents them from being attacked by the immune system. Some cancer cells very cleverly exploit this in a Trojan horse-like manner by having more PD-L1 molecules on their surface and hence escape an immune attack. The immunotherapy drug, Atezolizumab, works by blocking PD-L1 molecules on cancer cells and thus prevents them from conveying wrong signals to immune cells.
However, there are significant drawbacks in this study. The combination therapy was found to increase the average survival to 25 months as against 15.5 months. But cancer cells had to have a high level of PD-L1 molecules on their surface which may not be so in all patients. This means there is a need to check the status of PD-L1 receptor in patients before commencing the therapy.
In addition, it must be considered that side effects associated with combination therapy are more severe than for single agent chemotherapy. Also the cost of such personalised immunotherapy could be extremely high with one round of therapy being Rs. 1 lakh to Rs.13 lakh.
Immunotherapy is still evolving in developing nations like India and is now being offered in just a few treatment centres and that too primarily for solid tumours like prostate, breast, renal, colon, hepatocellular carcinoma, colorectal, oral, lung and ovarian. Although this is only the first large clinical trial involving immunotherapy and more studies are required, the positive findings shine a ray of hope for TNBC patients.
Nov 14th 2018
Cervical cancer blunder saw nearly 50,000 women miss results and screening reminders
Almost 50,000 women have not been sent NHS letters about cervical cancer screening - including those containing their results, an investigation has found.
The British Medical Association (BMA) said "appalling" failures by the company to which the task was outsourced have risked lives.
The BMA has written to the chief executive of NHS England expressing "extreme concern"after being made aware that more than 47,000 women were not sent information regarding cervical cancer screening after a system error.
The majority of the correspondence is understood to relate to appointment invitations or reminder letters, but they included more than 4,500 test results.
These included around 180 letters warning women that their results were abnormal.
Health officials said around half of these patients have so far been contacted, and found not to have come to harm.
The errors were made between January and June of this year.
This incident is the latest in a series of failings by Capita, the organisation contracted to provide GP back office services.
In a letter to Simon Stevens, the BMA has urged NHS England to strip Capita of the contract and take support services for GPs back in-house.
Health officials have now written to all women affected and informed their GP practices.
Dr Richard Vautrey, BMA GP committee chairman said: “This is an incredibly serious situation, and it is frankly appalling that patients may now be at risk because of this gross error on the part of Capita.
"Some women will now be left extremely anxious because they have not received important correspondence, particularly letters about abnormal smear test results that need urgent follow up. This has been caused solely by Capita’s incompetence.
"We know that, because of the nature of this procedure, many patients are already reluctant to attend these appointments, and therefore reminder letters are crucial to provide encouragement and reinforce the importance of having a cervical smear test done.
"Incidents like this, therefore, will hardly inspire confidence in the system and risk even fewer women getting checked."
He said the outsourcing of the responsibilities had risked lives. "Since it took responsibility for GP back room functions three years ago, Capita‘s running of these services has been nothing short of shambolic and after repeated warnings from the BMA and government, this is now clear evidence that its failings have put patient safety – and possibly lives – at risk.
"It is ultimately NHS England that bears overall responsibility and it must now take this service back in-house.
"As the body which commissioned Capita to take on this work, despite clear warning signs that it was not up to the job, NHS England must shoulder the blame for this dreadful situation; you cannot outsource responsibility," he said.
Around 4.5 million invitations for breast screening are sent out every year to women
aged 25 to 64.
Those aged 25 to 49 are offered screening every three years, with the older age groups invited every five years.
The news comes just months after it emerged 450,000 women had not been invited for breast cancer screening after mistakes went undetected for years. It is thought up to 75 women may have died as a result.
An NHS England spokesman said: “Capita has alerted NHS England to an administrative failure in its processing of cervical screening, which means some women have not received invitation, reminder and result letters when they should have.
“Every woman’s case is being reviewed, but there is no current evidence that this incident has led to harm to the women involved, and our priority now is to ensure that anyone affected by this incident is contacted, and knows how to get checked if they are due a cervical screen.”
Capita said the risk to women from the incident is low, with no current evidence of harm, but apologised to the NHS and the patients involved.
In a statement, the company said: "We have investigated the precise circumstances around this incident, and it is clear that the correct process for uploading, organising and checking datafiles was not properly followed. When the problem was discovered, it was not immediately escalated to senior leadership, or NHS England, by the individuals responsible. Capita is investigating the managerial handling of the matter and taking appropriate disciplinary action. Additionally, a senior executive responsible for this contract has already left Capita."
An independent audit of the operational systems and processes has now been ordered.
Nov 8th 2018
'Fluorescent marker' could help surgeons remove deadly brain tumours
luorescent marker could be used to boost survival from one of the deadliest form of brain tumours.
Scientists found that using a chemical to highlight cancerous cells meant that they were able to identify the most aggressive types of disease, and to ensure that healthy brain tissue was not harmed.
The study, presented at the National Cancer Research Conference in Glasgow, involved 99 patients suffering from suspected glioma.
The disease, which killed former Labour cabinet minister Dame Tessa Jowell, is the most common form of brain cancer, with more than 2,200 cases diagnosed each year in England.
Treatment usually involves surgery to remove as much of the cancer as possible, but it can be difficult for surgeons to identify all of the cancer cells while avoiding healthy brain tissue.
Research on 99 patients found that the markers were able to detect the fastest growing tumours, and to improve the accuracy of subsequent surgery.
Scientists used a compound called 5-aminolevulinic acid or 5-ALA, which glows pink when a light is shone on it. Previous research shows that, when consumed, 5-ALA accumulates in fast growing cancer cells and this means it can act as a fluorescent marker of high-grade cells.
The study involved patients with suspected high-grade gliomas treated at the Royal Liverpool Hospital, Kings College Hospital in London and Addenbrooke’s Hospital in Cambridge.
Before surgery to remove their brain tumours, each patient was given a drink containing 5-ALA, and assessed for signs of fluorescence.
Surgeons then used operating microscopes to look for fluorescent tissue while removing tumours.
It was found in 85 cases, of which 81 were confirmed to be suffering from high-grade disease.
In the 14 cases where fluoresence was not seen, seven tumours were subsequently found, but all were low-grade disease, which grows far more slowly.
Scientists said the findings could extend survival for some of the deadliest forms of brain cancer, which often means patients only live months after diagnosis.
Lead researcher Colin Watts, Professor of Neurosurgery and chair of the Birmingham brain cancer programme at the University of Birmingham, said: “Neurosurgeons need to be able to distinguish tumour tissue from other brain tissue, especially when the tumour contains fast-growing, high-grade cancer cells. This is the first prospective trial to show the benefits of using 5-ALA to improve the accuracy of diagnosing high-grade glioma during surgery. These results show that the marker is very good at indicating the presence and location of high-grade cancer cells.”
“The advantage of this technique is that it may highlight more quickly high-grade disease within a tumour during neurosurgery. What this means is that more of the tumour can be removed more safely and with fewer complications, and that’s better for the patient.”
Professor Anthony Chalmers, chairman of NCRI’s Clinical and Translational Radiotherapy Research Working Group said there was a “desperate” need for better treatments for brain tumours, and said he hoped the technique could extend lives.
“The benefit of using a fluorescent marker is that it helps neurosurgeons see more accurately where the high-grade cancer is within the brain, in real time. In treating cancer, we are trying to improve survival by tailoring treatments to each individual patient. This technique provides on-the-spot information to help surgeons tailor the operation according to the location, size and grade of the tumour. We know that patients who have near total removal of their tumour have better outcomes, so we are optimistic that, in the long term, these new data will help to increase survival times for glioma patients,” he said.
Nov 5th 2018
6 Things Every Man Should Know About Penile Cancer, According to a Urologist
Urologist James Wysock, M.D. gives the lowdown on symptoms, treatment, and long-term prognosis.
While not nearly so prevalent as prostate, lung, or colorectal cancers—the primary malignancy risks for men—penile cancer can be just as dangerous when it does occur.
If you are uncircumcised, have a history of penile warts, tested positive for HPV, or if you have ever seen an abnormal area on your penis, you might want to read on. Coming from a urologist who’s seen some severe cases, these are six key points every man should know about penile cancer.
1) Penile cancer is extremely rare in the U.S.
In this country, we are lucky to see penile cancer accounting for less than one percent of all cancers. Globally, however, especially in countries without adequate health care resources, rates of penile cancer diagnosis can reach as high as 10-20% of cancers.
2) Lack of circumcision and exposure to HPV are major penile cancer risk factors.
Penile cancer is almost unheard of in men who have been circumcised. Men with an intact foreskin are nearly twice as at risk. This may be in part due to a condition known as phimosis, in which the foreskin is difficult to fully retract. Another risk factor is a prior infection with genital warts. This often is a result of exposure to HPV, which is the most common viral agent for getting the genital warts that are most commonly the source of squamous cell carcinoma of the penis (as well as cervical cancers in women). HPV can be detected in 30-50% of penile carcinomas.
Especially when it’s not cleaned routinely, the foreskin area can become a danger zone where harmful viruses, like HPV or HIV, are sequestered and made more likely to be picked up by immune cells. Doctors observed the significant health implications of circumcision during the early HIV era, for instance, when it became apparent that countries with a history of performing circumcision reported much lower rates of the disease than those that did not.
3) Penile cancer is usually diagnosed in older men
Men aged 60 and older are the most at-risk age population for penile cancer, while cases among younger men are very uncommon. This results in part from the fact that the risk of developing phimosis increases slightly as uncircumcised men age, which exacerbates exposure of the head of the penis to possible carcinogens such as HPV.
4) The most common symptom is skin changes on the penis
Although they usually present as classic warts, penile tumors also commonly appear as flat red areas on the head (“glans”) of the penis, or along the body and foreskin. These may have a firmness to the touch and are relatively painless. Less commonly the cancer may manifest more as a rash or as an infected lesion similar to those resulting from sexually transmitted disease like herpes. These lesions can be more painful and are associated with fevers. If the disease is more advanced, it can lead to blockage of the urinary passage or metastatic spread to lymph nodes and the groin.
5) Treatment can entail partial or total removal of the penis
In the U.S., penile cancer is presented at a curable stage about 80-90% of the time. The treatment strategy usually begins with taking a tissue biopsy off the penis, just a snip under anesthesia, to confirm what the wart, rash, or lesion might be. From there, patients generally undergo one of two operations: penile sparing surgery (partial penectomy), if the cancer is caught early; or complete removal of the penile gland (penectomy), if it’s caught at a more advanced stage.
The goal in treating with partial penectomy is to maintain a penile length that allows men to urinate standing up—otherwise it may be better to remove the entire penis. Topical chemotherapies are also used when attempting to preserve the penis.
In the case of complete penectomy, the removal is generally followed by a procedure called perineal urethrostomy, where surgery moves the outlet of urine to behind a man’s scrotum, so he can pee through that point while sitting down. In some situations, the creation of a neo-phallus, a complex plastic surgery procedure, uses muscles from other parts of a man’s body, like his forearm or leg, to create a new penis.
When there’s a danger of metastasis, the next level of treatment entails a groin-lymph node dissection, where doctors make a groin incision to eliminate the chance of penile cancer spreading. This procedure can involve a risk of permanent leg swelling, known as lymphedema. At NYU Langone we employ a robotic minimally invasive approach to this surgery in an effort to improve the operative side effects such as skin injury and lymphedema.
6) Long-term prognosis is encouraging.
If it is caught at stage where the cancer can be completely resected, prognosis is very good. If it’s metastatic, the outlook becomes less optimistic. Our goal as urologists is to catch the disease early for the best health outcome. Improving men’s understanding of the risk factors such as phimosis and genital warts is a key factor to aiding early diagnosis and intervention.
Nov 4th 2018
Cervical cancer survival worse after common keyhole surgery, studies warn
Procedure blacklisted after studies associate it with 'three-fold increase' in cervical cancer progression
Cervical cancer patients who have their tumour removed by common keyhole surgery which drastically cuts recovery times, are more likely to die early and have their cancer come back, a pair of studies has found.
US researchers looking at survival rates in early-stage cervical cancer, found 65 per cent more women who had the “minimally invasive” procedure died within four years.
The keyhole (laparoscopic) operation uses long instruments or a “robotic surgeon” to perform the radical hysterectomy, removing the cervix, uterus and surrounding tissue where cancer might have spread via a small incision in the abdomen.
It has become well established in gynaecological cancer surgery in the past decade because most patients are able to go home the same day, compared to days of recovery and extra risk of infection with open surgery.
Currently around 60 per cent of early-stage cervical cancer use this minimally invasive approach in the US. However, a pair of studies published in the New England Journal of Medicine on Wednesday, suggest that these women may have had worse outcomes and several hospitals or surgeons have blacklisted the procedure as a result.
“Given these two studies, we believe that we can no longer recommend minimally invasive radical hysterectomies for our patients with early-stage cervical cancer,” said Dr Alejandro Rauh-Hain, a gynaecological oncology specialist at the University of Texas MD Anderson Cancer Centre.
The first piece of research was an international trial across 33 cancer centres which recruited 631 women with stage one cervical cancer and randomly assigned them to receive either non-invasive or open treatment between 2008 and 2017.
It had intended to recruit 740 women but was stopped early on ethical grounds because the additional risks were already apparent.
Minimally invasive surgery was linked to a three-fold increase in disease progression and just 86 per cent of women disease free after 4.5 years, compared to 96.5 per cent who had open surgery, the study found.
Just 91.2 per cent of women were alive after three years in the minimally invasive group, compared to 97.1 per cent of the open surgery arm.
The second study, led by Dr Rauh-Hain’s group, in collaboration with Harvard, Columbia and Northwestern Universities, reviewed historical records of women who had undergone this procedure.
Of the 2,461 patients in the US National Cancer Database who had a radical hysterectomy for early stage cervical cancer between 2010 and 2013, 9.1 per cent of women who had the minimally invasive procedure died compared to 5.3 per cent in the open surgery group – a 65 per cent increase.
“Minimally invasive surgery was adopted as an alternative to open radical hysterectomy before high-quality evidence regarding its impact on survival was available,” Dr Rauh-Hain said.
“[We] were surprised to find that in our respective studies, surgical approach negatively affected oncologic outcomes for women with early-stage cervical cancer.
“Our research also found that compared with open surgery, minimally invasive surgery increased the risk of death among women who underwent radical hysterectomy for early-stage cervical cancer”.
In England annual cervical screening means many cases are picked up before they become cancerous – while radiotherapy is used in later stages. But there were still 291 of the operations last year and 72 per cent used the minimally invasive approach (18 per cent robotically assisted), according to the British and Irish Association of Robotic Gynaecological Surgeons.
Mr Thomas Ind, a consultant gynaecological surgeon and president of BIARGS told The Independent that the latest findings are subject to intense debate in their field.
Chiefly the trial found an unexpectedly low rate of cancer recurrence in open surgery and he argues that those who had the minimally invasive procedure may not have had high quality surgery because “the number of cases that the surgeons did in this study was probably not enough to keep their skills up”.
“This study has really resulted in more questions than answers and should not change surgical practice at present. However, it does result in more uncertainty for patients – regrettably.
“Discussions would need to be had with patients prior to surgery. It is indeed possible that patients might need to choose between one set of outcomes and another (e.g. survival and complications) in the future.”
Dr Shohreh Shahabi, who co-authored the latter paper, from Northwestern University, stressed that their findings cannot say what was causing this effect but it could be tumour cells being missed or spread by equipment.
“Possible explanations include the potentially limited extent of tumour removal during minimally invasive surgery, or that tools used during minimally invasive hysterectomy may inadvertently disseminate [spread] tumour cells,” Dr Shahabi said.
“It is important to note these results are specific to cervical cancer, and minimally invasive surgery is still a great option for other surgeries and cancers,” he added.
Oct 30th 2018
Stomach pains are common, meaning everything from menstrual cramps to uncomfortable bloating, but for 46-year-old Carla Bradbury they were a sign of something more serious – cervical cancer.
'I was given a Sodastream for my birthday and thought that my stomach pains were coming from having too much fizzy water, so I didn't go to the doctors straight away,' she says. 'I also experienced spotting between periods – which I thought was down to hormones.'
After Carla's stomach pains got gradually worse, she went to see the GP who examined her and gave her a smear test. The smear came back with an abnormal result, which led to further investigations.
Abnormal smear test result
'One of the gynaecologists I saw put it down to endometriosis. I was going to have further tests, but in the meantime, they found out what it really was – and it was cancer,' she says.
An MRI confirmed Carla had cancer at Stage 3B, meaning the cancer had spread from the cervix into the structures around it.
'My lowest point was when I read a report that said there was a 50% chance of long-term control – meaning I had a 50/50 chance of survival,' says Carla.
'Because my tumour was so big (I later found out it was the size of a large plum) and the way it was attached to my pelvic wall, they couldn't operate on it.
'Instead, I had chemotherapy and radiotherapy, which thankfully treated it.'
The importance of smear tests
Five years on from diagnosis, Carla is now days away to be given the all clear. And has an important message for other women.
Like so many, Carla hadn't been keeping up with her smear tests – and she's urging other women not to do the same.
'I did get regular letters to come for a smear test, but for me it was just finding the time to book in and make the appointment,' she says. 'But now I see how important it is.'
Cervical screening saves thousands of lives each year
Every year in the UK, 3,000 women are diagnosed with cervical cancer, yet over one in four women are still choosing to avoid their smear test.
Unfortunately, there aren't always obvious signs of cervical cancer in the early stages, and for many women an abnormal result from a routine smear is the first sign that something's off.
'Cervical screening saves thousands of lives each year by detecting changes in the cervix before they develop into cancer,' says Sophie Lowes, health information officer at Cancer Research UK. 'Women aged 25-64, who are registered with a GP, are automatically invited for screening.'
Challenge of a lifetime
Carla now describes herself as being in a better place than she ever was. She says: 'I've always been quite positive and had a happy outlook on life – but I'd say even more so now.
'My cancer came as a total shock, but it has made me stronger and I'm not scared of anything anymore.
'When you've faced the fear that you may not be here tomorrow, you just live for today. If you have cancer like I did, you've got the opportunity to work out what's really important. Although it's a terrible thing, there are people that suffer a lot worse.'
After losing two friends to cancer this year, one whom she went through treatment with, Carla is now preparing to take part in Stand Up To Cancer's Great Canoe Challenge, where she'll paddle an incredible marathon distance every day for five days to raise awareness and funds.
'Preparing to take on the challenge made me think about when I was going through treatment. I was so weak, I couldn't exercise, I couldn't even stand up in the shower. Reflecting back made me realise how far I've come.'
If you experience any unusual or persistent bleeding or pain, it's a good idea to visit your GP. Chances are it won't be cancer but, if it is, getting diagnosed and treated early can make a real difference.
Oct 25th 2018
Blood pressure pills taken by millions may raise risk of lung cancer, study suggests
ood pressure pills taken by millions of patients could raise the risk of lung cancer by almost a third, according to new research.
A study involving almost one million Britons found those on Ace inhibitors for at least 10 years (ACEIs) were up to 31 per cent more likely to develop the disease.
The drugs work by blocking an enzyme which narrows blood vessels, and raises blood pressure.
The risk rose over time, with those on the drugs for five years at 22 per cent risk, compared with other blood pressure lowering drugs such as beta blockers.
Oct 24th 2018
Cancer immunotherapy treatments of last resort 'should become first choice'
Cutting edge cancer treatments which are currently held back as a last resort for patients with no other options could mean people “live years longer” when used as a first choice, experts have said.
Immunotherapies, which re-programme the immune system to identify and attack tumours, are a promising, but experimental group of treatments usually given after aggressive chemotherapy has failed.
Results from a pair of clinical trials in patients with advanced, treatment resistant cancers found immunotherapy increased survival, with fewer side effects, when used immediately.
Experts said this shows more needs to be done to make these experimental treatments available to patients when they can provide the most benefit, rather than holding off because of risks or costs.
Both sets of findings were reported at the European Society for Medical Oncology Congress in Berlin.
The first of the trials, led by the Institute of Cancer Research and Royal Marsden NHS Foundation Trust, looked at the immunotherapy drug pembrolizumab in nearly 900 patients with advanced head and neck cancers. The disease had returned to them after treatment or spread throughout the body.
But the immunotherapy drug increased life expectancy by 40 per cent when compared to radical chemotherapy.
Among patients where the drug worked best, median life expectancy after diagnosis was 14.9 months, compared to 10.7 months for those given the usual cocktail of chemotherapy and targeted cancer drugs.
Only 17 per cent of patients experienced serious side-effects, compared to 69 per cent on extreme chemotherapy.
The downside of immunotherapies is that not every patient will respond, but modern genetic testing methods can allow doctors to identify which tumours are likely to be vulnerable to certain drugs.
In pembrolizumab’s case, it only worked in around 23 per cent of patients, compared to 36 per cent given chemotherapy.
It was most effective in those whose tumours have particular markers for the immune system to target.
In cases where the drug worked best median cases the results were “unbelievable”, the Royal Marsden researchers said.
“We couldn’t believe it when we saw the results,” said Professor Kevin Harrington, who led the study. “None of us expected pembrolizumab on its own to work so well in some of these patients – and it raises the prospect that we could spare some people chemotherapy altogether.”
He added that it could have major implications for these patients, and said: “The trial is still ongoing, but we expect some patients to go on to live for years longer than they would have done had they received standard chemotherapy.”
Another study presented at the conference on Monday looked at immunotherapy treatment in colorectal cancer which had spread.
In around 4 per cent of colorectal cancer patients, the tumour carries a mutation which affects DNA repair and these patients typically survive between 14-19 months after survival, compared to up to 25 months for other types.
The early stage trial, led by University of Southern California researchers, found that 84 per cent of patients saw at least some shrinkage of their tumours when given the immunotherapy drug nivolumab instead of chemotherapy.
After 12 months 77 per cent were alive with no progression in their tumours.
Professor Paul Workman, chief executive of the Institute of Cancer Research said the Royal Marsden findings show immunotherapy’s potential as a “smarter, kinder and more effective first-line treatment”.
“We now need to do two things to ensure more patients can benefit from immunotherapy – develop ways of getting these drugs to work in a higher proportion of patients, and come to an agreement over the cost of these drugs to make them more affordable for the NHS.”
Oct 23rd 2018
New approach to prostate cancer treatment could help thousands of men
Treating those suffering from prostate cancer with radiotherapy on top of regular treatment could extend the life of men with advanced forms of the disease, research has found.
One of the largest ever clinical trials into prostate cancer found an 11% increase in the survival rate of some patients.
It showed that there could be a benefit to treating the prostate – the site of the primary tumour – with radiotherapy even if the disease has already spread, the researchers said.
Among men whose cancer had spread to their lymph nodes and/or bones close to the prostate gland who were treated with radiotherapy, around 80% survived for at least three years.
On the other hand, only 70% of men who did not have the additional radiotherapy treatment were alive after three years.
The Stampede trial opened in 2005 and has so far involved more than 10,000 participants – 2,000 of whom had advanced forms of the disease – and is based at University College London.
Of those 2,000 with advanced prostate cancer, half were given standard treatment while the other half were given standard treatment plus radiotherapy.
But the team of scientists found the benefit was unique to those whose cancer had spread to their lymph nodes and/or nearby bones, and did not appear to increase survival among men whose cancer had spread to other organs or more distant bones.
Funded by Cancer Research UK, the research suggests radiotherapy could become a standard treatment alongside hormone therapy for men with prostate cancer.
Around 47,000 men are diagnosed with the disease every year and 11,500 die of it, according to Cancer Research UK’s figures.
The findings suggest that pairing radiotherapy with standard treatment could help 3,000 men each year in the UK alone.
Lead researcher Dr Chris Parker, who is based at the Royal Marsden, said using radiotherapy when the cancer had already spread had previously been seen as “shutting the stable door after the horse has bolted”.
He said the findings could change standards of care across the globe, adding: “Unlike many new drugs for cancer, radiotherapy is a simple, relatively cheap treatment that is readily available in most parts of the world.”
Chief investigator Professor Nicholas James, of the University of Birmingham, said: “Although survival times are improving, no one with advanced prostate cancer is cured of their disease by hormone therapy alone.
“These important results move the dial significantly further in terms of what we can do for this large group of men.”
Professor Charles Swanton, Cancer Research UK’s chief clinician, said: “Adding radiotherapy to current treatment shows clear benefit for this subgroup of men with prostate cancer.
“We now need to investigate whether this could also work for other types of cancer. If we can understand exactly why these men benefit from the additional radiotherapy treatment, we could hopefully use this approach to benefit even more patients.”
Professor Mahesh Parmar, director of the MRC Clinical Trials Unit where Stampede is based, said the programme was so significant because different treatment options can be investigated quickly and newly developed treatments can be added.
“This is enabling scientists to get results much more quickly than they usually would,” he said.
“More data will come out in subsequent years, because of the innovative design of the trial.”
Oct 17th 2018
MIT's AI can identify breast cancer risk as reliably as a radiologist
Breast cancer affects one in eight women in the US. There are multiple factors involved in developing the disease, but one issue is dense breast tissue. Some 40 percent of US women have dense breast tissue, which alone increases the risk of breast cancer, and can make mammogram screening more difficult. Now, researchers from MIT and Massachusetts General Hospital (MGH) have developed an automated model that assesses dense breast tissue in mammograms as reliably as expert radiologists.
Breast density assessments have traditionally relied on subjective human exams and calculations, but the deep-learning model -- trained on tens of thousands of digital mammograms -- is able to distinguish different types of breast tissue, from fatty to extremely dense, with 90 percent correlation to radiologists' diagnosis.
In comparison to traditional prediction models, the researchers used a metric called a
kappa score, where 1 indicates the model and human experts agree on a diagnosis every time, and anything lower indicates fewer instances of agreements. The maximum kappa score for existing automatic density assessment models is around 0.6. In the clinical application, the new model scored 0.85, meaning it makes better predictions than previous systems.
"Breast density is an independent risk factor that drives how we communicate with women about their cancer risk. Our motivation was to create an accurate and consistent tool, that can be shared and used across health care systems," says MIT PhD student and second author on the model's paper, Adam Yala. "It takes less than a second per image ... [and can be] easily and cheaply scaled throughout hospitals." The researchers now plan on exploring how the algorithm can be transitioned into other hospitals, and how it can be used in other healthcare applications.
Oct 13th 2018
Detection of cancer could be personalised down to the individual tumour
With this tool we hope to remove one of cancer’s trump cards – the fact that it evolves unpredictably, without us knowing what is going to happen next
The technology, known as Revolver (repeated evolution of cancer), locates patterns in DNA mutations that can predict future drug resistance in tumours.
To create Revolver, the researchers analysed 768 tumour samples from 178 patients with lung, breast, kidney and bowel cancer.
Lead author Dr Andrea Sottoriva, from The Institute of Cancer Research, London: “With this tool we hope to remove one of cancer’s trump cards – the fact that it evolves unpredictably, without us knowing what is going to happen next.”
ICR’s chief executive Professor Paul Workman added: “This new approach using AI could allow treatment to be personalised in a more detailed way and at an earlier stage, tailoring it to the characteristics of each individual tumour.”
Revolver could also be used to predict if patients will develop resistance in the future.
Prof Workman said: “If we are able to predict how a tumour will evolve, the treatment could be altered before adaptation and drug resistance ever occur, putting us one step ahead of the cancer.”
This means doctors would be able to make predictions of what that tumour would look like in the future.
This new technology using AI could have many ramifications for cancer treatment, not only in foiling drug resistance but in preventing recurrences. The scientists also found a link between certain DNA sequences of repeated tumour mutations and a patient’s survival chances.
This suggests that repeating patterns of DNA mutations could be used as an indicator of treatment prognosis, helping to shape future therapies.
For example, researchers found that breast tumours with a sequence of errors in the DNA that codes for the tumour-suppressing protein p53, led to shorter survival times.
Dr Sottoriva said: “We’ve developed a powerful AI tool – this can make predictions about future steps in the evolution of tumours based on certain patterns of mutation that have so far remained hidden within complex data sets.
“By giving us a peek into the future, we could potentially use
this AI tool to intervene at an earlier stage, predicting
cancer’s next move.”
And, hopefully, helping patients live longer.
Oct 3rd 2018
Processed meat 'linked to breast cancer
Regularly eating foods like bacon and sausages may raise the risk of breast cancer, according to researchers.
A review of studies found women who ate high levels of processed meat had a 9% increased risk of the cancer compared with those who ate little of it.
The study backs up previous findings of the World Health Organization, which says processed meats cause cancer.
Experts recommend caution about the findings and say the actual risk for individual women is "very small".
How reliable are the findings?
This review, which included data on more than a million women, shows a link between processed meat consumption and breast cancer risk, but it's not clear if the food is actually causing this.
There are also other pitfalls to consider.
The 15 studies used in the analysis had different definitions of the highest consumptions.
For example, one of the UK studies in the review classed high consumption as more than 9g a day - the equivalent of just two or three rashers a week - while in others it was much higher.
The researchers in these studies noted what people said they ate and followed them up to see which of them developed breast cancer.
But the problem with this is that people who eat different amounts of processed meat may also have other behaviours that might explain the differences in breast cancer risk, such as being more or less healthy in other ways.
What is the risk?
In the UK about 14 out of every 100 women will get breast cancer at some point in their lives.
That means a 9% increase in risk in this population would be expected to translate into roughly one extra case of cancer in every 100 women.
It estimates that about 8% of cases are caused by being overweight and obese and another 8% by alcohol.
Authors of this study, published in the International Journal of Cancer, say the link they found is only for processed meat, not red meat.
The WHO lists processed meat as carcinogenic, primarily because of evidence linking it to a raised risk of bowel cancer, while it says red meat is "probably carcinogenic".
What is processed meat?
Processed meat has been modified to either extend its shelf life or change the taste, usually by smoking, curing, or adding salt or preservatives to meat.
This includes bacon, sausages, hot dogs, salami, corned beef, beef jerky and ham.
There are different theories for why it may raise the risk of cancer, including that curing salt may react with protein in the meat to make it carcinogenic.
So should we cut out processed meat?
Lead author Dr Maryam Farvid, of the Harvard TH Chan School of Public Health in the US, recommends cutting down on the meat rather than eliminating it.
Currently, the NHS recommends eating no more than 70g of red and processed meat a day.
Dr Gunter Kuhnle, associate professor in nutrition and health at the University of Reading, who was not involved in the study, said it was "questionable" whether people should lower their red and processed meat consumption on the back of this study.
He said the actual risk posed by processed meats was "very small" for the individual and more relevant on a population-wide level.
However, he said the study's findings should be followed up to investigate the links between processed meat and cancer and see whether the associated risk could be reduced, for example through new food production methods.
Sept 27th 2018
Cancer patients have better chance of survival if they take aspirin, major review suggests
Cancer patients have a greater chance of surviving the disease if they take a small daily dose of aspirin, a major review suggests.
In a new roundup of 71 studies involving 520,000 people, researchers at Cardiff University discovered that he number of patients still alive was 20 to 30 per cent greater if they had regularly taken the drug.
The spread of cancer to other parts of the body was also substantially reduced in patients using aspirin.
Peter Elwood, Honorary Professor at Cardiff University, who directed the study said: “The use of low-dose aspirin as a preventive in heart disease, stroke and cancer is well established but evidence is now emerging that the drug may have a valuable role as an additional treatment for cancer too.
Patients with cancer should be given the evidence now available and be helped to make their own judgement of the balance between the risks and the benefits of daily low dose.
“Evidence from further studies is urgently required. All patients should consult their GP before starting new medication.”
People in the studies were taking low-dose aspirin which is 100mg a day, or around one third of a regular tablet.
The research showed that in colon cancer a man of 65 years old who took a regular aspirin would have a prognosis of similar to a man five years his junior, when compared to someone who did not take the drug.
For a woman of similar age with colon cancer the addition of aspirin could lead to a similar prognosis of a woman four years younger. Almost half the studies included in the review were of patients with bowel cancer, and most of the other studies were of patients with breast or prostate cancer.
There were very few studies of patients with other less common cancers, but the researchers concluded that the pooled evidence suggested a wide benefit.
Clinical trials in which cancer patients are specifically given aspirin alongside their treatment are currently ongoing and are due to report back in a few years. The study also looked at the possibility of cancer causing internal bleeding, which is a concern, particularly for older people.
Very few patients had serious bleeding. Amongst those who did, the proportion of patients taking aspirin who had a ‘serious’ bleed was no greater than the proportion of patients not taking aspirin who had experienced a ‘spontaneous’ stomach bleed due to causes other than aspirin.
In two studies a very small number of fatal stomach bleeds had occurred, but again the proportion was no greater in the patients on aspirin than in those not taking aspirin. The research was published in the journal Plos One Medicine.
Sept 24th 2018
The charity has called for measures including a ban on TV adverts for junk food before the watershed and for restrictions on price promotions of less healthy food and drinks, echoing the combined awareness and legislative campaigns that have been deployed in recent years in response to other public health issues.
The report marks the first attempt to quantify and compare the predicted rates of cancer caused by smoking and weight issues in the UK.Together, smoking and overweight and obesity could cause more than 95,000 UK cancer cases in 2035 alone – compared with around 75,000 cases in 2015.
Sept 23rd 2018
High levels of fertility hormone increase the risk of breast cancer
Women with high levels of a hormone that can be detected through a simple blood test may have a higher risk of breast cancer, a new study suggests.
Those who have elevated levels of anti-Mullerian hormone (AMH) – which indicates the size of a woman’s ovarian reserve – are 60% more likely to develop breast cancer compared to women with low levels of the hormone.
Tests for the hormone are already incorporated in fertility tests.
Charity Breast Cancer Now, which helped fund the research, said steps could now be taken to discover whether adding the test to current prediction tools may help identify women at risk of the disease.
Researchers from New York University (NYU) School of Medicine examined blood samples from almost 6,000 premenopausal women across the US and Europe.
They analysed data from 10 studies – including the Breast Cancer Now Generations Study at The Institute of Cancer Research, London – to examine the association of AMH levels with breast cancer risk.
They found that those with the highest levels of the hormone were more likely to develop breast cancer.
Publishing their finding in the International Journal of Cancer, the authors said the hormone is a “possible biomarker” for breast cancer.
Study lead author Professor Anne Zeleniuch-Jacquotte, from NYU School of Medicine, said: “The link we found between anti-Mullerian hormone and breast cancer risk is interesting because few markers of risk in the blood have been identified for premenopausal women.
“Our study found a moderate risk increase and we hope additional markers can now be found to help substantially improve individual risk prediction.”
Co-author Anthony Swerdlow, professor of epidemiology at The Institute of Cancer Research, London, who leads the Breast Cancer Now Generations Study, added: “In future, anti-Mullerian hormone could be factored into new ways of predicting individual women’s risk of developing the disease.
“The causes of breast cancer are highly complex and not yet fully understood. Pooling together large datasets is key to understanding how the many different causes interact and affect breast cancer risk.”
Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: “The discovery that high levels of anti-Mullerian hormone in the blood could indicate women at an increased risk of breast cancer is really promising.
“We now need to understand whether adding this blood test to current prediction tools could help give women a clearer picture of their risk and identify those who could benefit from more frequent screening or preventive measures, such as tamoxifen.”
Sept 17th 2018
Skin cancer drug approved for use on NHS
Hundreds of patients with the most aggressive type of skin cancer could benefit from a drug after it was approved for use on the NHS.
Drug company Novartis said the combination of dabrafenib and trametinib has been recommended as a treatment option for the treatment of adult patients with stage III melanoma with a BRAF V600 mutation, following surgery.
More than 500 people are diagnosed with BRAF-mutated stage III melanoma in the UK every year.
Stage III melanoma means that cancer cells have spread into skin, lymph vessels or lymph glands close to the melanoma but not to more distant parts of the body.
Until now, there were no reimbursed drug treatments that offered clear benefits for these patients following surgery, and as a result, nearly half (44%) of those with BRAF V600 mutated melanoma suffer a recurrence within a year after surgery, with the risk that the cancer progresses to an incurable state.
Novartis said clinical trial results showed the drug combination reduced the risk of melanoma returning or death by more than 50%.
The oral treatment is likely to benefit around 550 patients every year in the UK, who would previously have to simply wait and hope their cancer does not return after surgery.
Ruth Plummer, professor of experimental cancer medicine at Newcastle University, said: “This is really significant for these patients and the melanoma community in England and Wales, as the treatment has the potential to transform the standard of care for people with BRAF-positive stage III melanoma.
“We know this can be a stressful and unsettling as over half of all patients with stage III disease will experience a recurrence in the future, leaving people anxious and worried that their disease might return.
“It is clear that treating patients with dabrafenib and trametinib after their surgery reduces the chance of recurrence.”
Melanoma accounts for more deaths than all other skin cancers combined.
There are around 2,400 deaths from melanoma skin cancer in the UK every year, with more than six people dying every day.
Gill Nuttall, chief executive of the charity Melanoma UK, said: “Worryingly, we are continuing to see an increase in the number of people in the UK with melanoma, especially among younger people.
“The availability of this treatment is a huge step forward for the hundreds of BRAF-positive patients who are currently left with very few options following surgery.
“The current ‘watch and wait’ approach is an extremely worrying and stressful time for patients and their families.”
Sept 15th 2018
Cancer predicted to kill nearly 10 million people this year, report says
A major new report predicts that 18.1 million new cancer cases will be diagnosed this year while 9.6 million people will die of the disease in 2018.
The latest global cancer statistics published by the World Health Organisation's International Agency for Research on Cancer (IARC) suggest that one in five men and one in six women worldwide can expect to develop cancer during their lifetime.
One in eight men and one in 11 women will die from the disease, said researchers, as IARC director Christopher Wild warned of an "alarming rise" in cases.
The figures have swelled since the agency last published its global cancer data in 2013, when there were 14.1 million cases and 8.2 million deaths.
The growing global cancer burden is partly down to the world's growing population with an increasing proportion of older people, said researchers.
Lifestyle factors such as obesity and drinking are also causing more cases in high-income countries.
Europe sees 23.4 per cent of the global cancer cases and 20.3 per cent of cancer deaths, despite being home to only 9 per cent of the global population.
The Americas, home to 13.3 per cent of the global population, have 21 per cent of worldwide cases and 14.4 per cent of cancer fatalities.
Meanwhile the death rate from cancer in Asia and in Africa (57.3 per cent and 7.3 per cent respectively) is higher than their proportions of global cases (48.4 per cent and 5.8 per cent respectively).
That means that a higher portion of people on those continents who get cancer will die of it, which scientists said is down to a higher prevalence of deadlier types of cancer along with poorer access to diagnosis and treatment.
Lung, breast, and bowel cancer were the three most common kinds if cancer globally, and are together responsible for a third of cancer cases and deaths worldwide.
“These new figures highlight that much remains to be done to address the alarming rise in the cancer burden globally and that prevention has a key role to play,” said IARC director Christopher Wild.
“Efficient prevention and early detection policies must be implemented urgently to complement treatments in order to control this devastating disease across the world.”
Sept 14th 2018
7 ovarian cancer signs that are incredibly easy to miss
Feel like you’ve got heartburn more than usual?
Ovarian cancer is known as the 'silent killer' for good reason – the disease doesn’t have as many obvious indicators as, say, breast or skin cancer. But that doesn’t mean women don’t experience symptoms.
Often though, those symptoms aren't easy to spot.'They’re very discrete, easy to ignore, and can easily be attributed to other things like changing their diet,' says Shannon Westin, M.D., an associate professor in the department of gynaecologic oncology and reproductive medicine at M.D. Anderson Cancer Center.
'They’re easy to blow off,' says Westin. Unfortunately, dismissing the signs of ovarian cancer allows the disease to progress, making it more difficult to treat when it is detected. 'But often that contributes to a delay in diagnosis.'
22,440 NEW CASES OF OVARIAN CANCER WILL BE DIAGNOSED THIS YEAR, PER THE ACS.
And that can be a real problem – according to the American Cancer Society (ACS), ovarian cancer is the fifth leading cause of cancer deaths in women, and causes more deaths than any other cancer of the female reproductive system.
Again, these symptoms are pretty vague but if you're having one of these that won't quit – or several at once – it's at least worth a conversation with your doctor:
1. You have persistent abdominal or pelvic pain
This is generally a sign that ovarian cancer has spread, says Mitchel Hoffman, M.D., a gynecologic oncologist at Moffitt Cancer Center. 'When we operate in ovarian cancer patients, the majority have metastasis,' he says (meaning, it's spread to other areas).
'There can be quite a lot of tumours in the pelvis, upper part of the abdomen, bowel, and all the way up to the diaphragm,' he says. Ovarian cancer can also cause a fluid build-up in the abdomen called ascites, Hoffman says – and all of these factors can cause pain.
2. You feel nauseous, or that you can't eat as much as you typically do
When ovarian cancer spreads, it can affect the way your bowels work. 'Things can get backed up, and that can cause nausea,' says Westin.
A WOMAN'S RISK OF GETTING OVARIAN CANCER DURING HER LIFETIME IS ABOUT 1 IN 78, PER THE ACS.
The same goes for feeling full sooner than normal or that you aren't able to eat as much as you typically can.
If that's the case, your stomach may have less space than usual because of a growing tumor, or you could have fluid buildup that also makes you feel full.
3. You're always boated and constipated
Ovarian cancer can make you feel bloated, again, because of impaired bowel function, says Hoffman. 'In order for [your bowels] to function normally, the bowels have to have muscular function to push things through,' he says. But when cancer forms on the outer surface of the bowel – which happens when ovarian cancer starts to spread – it can impair that function, says Hoffman.
Bloating is especially suspicious if you haven't changed up your diet or exercise routine, says Westin.
4. You're peeing a whole lot
This could be from an ovarian tumour, Hoffman says. 'There's only so much room in the pelvis,' he points out. 'When a woman starts to get a tumour there, it pushes on the bladder and decreases the amount of bladder capacity,' he says. That, in turn, makes the bladder feel fuller, faster – and like it needs to be emptied often.
5. Your period is really irregular
This is a biggie, Hoffman says. If there's a tumour on your ovary, it can disrupt the way it normally works, ultimately throwing your cycle out of whack, he explains – so if you notice any big change in your cycle (more frequent periods, less frequent periods, no periods at all), it's important to check in with your doctor for a variety of reasons.
Another possibility: some ovarian tumors even produce their own oestrogen and can interfere with your cycle that way by mimicking period bleeding, says Westin. This can happen even after you've gone through menopause and your periods have stopped, which is another red flag.
6. You have pain during sex
There are a few possible things at play here. First, it could be that you have an ovarian tumour that's pushing into your vagina, and penetrative sex rubs against it, Hoffman says.
Another is that the hormonal changes that can happen in your body due to ovarian cancer can lead to vaginal dryness – and that can cause discomfort or pain during sex, Westin says.7. You have crazy heartburn
Again, if ovarian cancer is messing with your bowels, things get backed up, Westin explains. 'Then things push up against your stomach and push reflux into your oesophagus,' she says. 'Everything goes in the wrong direction.'
Ovarian cancer is more common in older women, and your symptoms are likely due to something other than cancer, but it’s important to get it checked out, just in case. So, call your doctor and flag your concerns. 'Schedule a visit and ask them, "Could it be my ovaries?"' says Deborah Lindner, M.D., chief medical officer of Bright Pink – it could save your life.
Sep 12th 2018
Simple urine test for ovarian cancer which could radically improve survival rates on the horizon
A simple urine test for ovarian cancer which could radically improve survival rates is on the horizon.
Scientists at the University of Hull have discovered a protein which is present in the tissue of women suffering from early stage ovarian cancer when there are no symptoms.
Often women do not realise they have the disease until it is too late, and are diagnosed at stage three, when just one in five will survive for five years.
But the new test could spot cancer as early as stage one when there is a 90 per cent chance of survival, which charities said would be ‘the holy grail’ in prevention.
Dr Barbara Guinn, Head of Biomedical Sciences at Hull University, said they had shown the test works in tissue samples and are now carrying out tests to see if it can be spotted in the urine of women suffering from cancer.
“What’s interesting about ovarian cancer is it’s like a silent cancer. It develops in the
middle of your tummy, and it’s not uncommon for women as they get older to start gaining a little bit of tummy weight,” she told the British Science Festival in Hull.
“The problem of having an ovary cancer is it tends to develop right in the middle of this area and it’s not very easy to see, so by the time you become aware of the problem it tends to be quite well developed.
“And it happens at an age when most women are going into menopause so suddenly your periods aren’t working as normal then it is easy to think it is menopause rather than anything more sinister.
“We wanted to look for proteins that were unique to ovarian cancer. We were hoping it would make it easier to diagnose ovarian cancer. A stage three diagnosis can mean survival rates as low as 20 per cent, but with early detection that can be increased dramatically to around 90 pr cent.”
Around 7,200 women are diagnosed with ovarian cancer in Britain each year and just 35 per cent will still be alive within 10 years because so many people are diagnosed too late.
Current tests for ovarian cancer also pick up other disease, such as infections and the false positive rate can be as high as 80 per cent.
In tissues the new biomarker, dubbed ‘ovarian cancer protein’ was detectable in 18 per cent of stage one cancers and 36 per cent of stage two cancers which could potentially save thousands of lives.
The team is currently testing the biomarker in urine samples of women with ovarian cancer to find out if they also contain the protein and are due to publish their results shortly.
If successful, the team hope a simple urine test will be available within the next two o three years and be given alongside other regular health checks.
“Our biggest hope is that we find this protein in urine and it will provide a screening method for patients who go into a Well Woman clinic and have their breasts checked and they will do a test for ovarian cancer,” added Dr Guinn.
“It will help us confirm a diagnosis of ovarian cancer at the earliest stages. We’re on the last step, we’re very close.”
Chief Executive of Target Ovarian Cancer, Annwen Jones, said: “Early detection of ovarian cancer is the holy grail. Research into new biomarkers shows extreme promise and we look forward to a future where more women are diagnosed at the earliest possible stage.”
Sep 5th 2018
NHS to treat young cancer patients with a 'game changer' drug
The NHS is to treat children and young people with an expensive new cancer drug which has the potential to transform how the disease is treated.
Simon Stevens, the NHS England chief executive, will announce on Wednesday that a deal has been done with the drug company Novartis, which makes the immunotherapy drug under the name Kymriah.
How does CAR-T therapy work?
CAR-T therapy is a new type of immunotherapy. The novel idea is to collect T-cells from the blood of the patient and engineer them to recognise the cancerous cells that have been hiding in the body unnoticed and that they have failed to destroy.
The list price of the drug is £282,000 per patient and treatment costs for the NHS could double that. In the United States, the total cost of the therapy can reach $1m.
But Stevens and others have said this form of cancer treatment, known as CAR-T therapy, is the future. It works by genetically engineering the patient’s own immune system’s killer T-cells to recognise and destroy cancer cells.
“CAR-T therapy is a true game changer and NHS cancer patients are now going to be amongst the first in the world to benefit,” Stevens will say in a speech at the Health and Care Innovation Expo in Manchester.
However, only 15 to 20 children with acute lymphoblastic leukaemia (ALL) are expected to be eligible for the drug. It will be given only to those who have failed a series of earlier treatments, including stem cell transplants.
Kymriah has also been licensed to treat adults with a more common blood cancer, diffuse large B-cell lymphoma (DLBCL), but a decision is yet to be made by the National Institute for Health and Care Excellence (Nice) on whether the NHS can afford it. The bill would be substantially higher because about 200 adults could be eligible. A similar drug for adults, Yescarta made by Gilead, has been turned down because of the cost, which is $373,000 (£290,000) in the US.
When Stevens revealed his intention to make CAR-T available to the NHS in April, he appealed to Novartis to reduce the price of Kymriah. Any discount that the manufacturer has offered is a commercial secret.
CAR-T therapy has to be developed for each patient. It involves taking blood and engineering the patient’s own immune system T-cells to recognise and fight the cancer before transfusing them back into the body.
There have been spectacular results in clinical trials, with response rates in blood cancer patients with advanced disease of over 80%. But there have also been deaths, when patients’ immune systems have overreacted to the therapy.
Alasdair Rankin, the director of research at the blood cancer charity Bloodwise, said he was very pleased that children and young adults would get the treatment. “It is very exciting for children with leukaemia,” he said.
This use of CAR-T therapy was “only the tip of the iceberg”, he said, and there were other cancers, from myeloma to solid tumours, that it could help. He likened the arrival of CAR-T therapy to that of radiotherapy, which transformed cancer treatment and substantially improved long-term outcomes.
Prof Charles Swanton, Cancer Research UK’s chief clinician, said: “It’s fantastic news for children and young people with this form of leukaemia that CAR-T cell therapy will be made available on the NHS, making them the first in Europe to have routine access to this exciting new type of immunotherapy. We applaud NHS England, Nice and the company for working together to make this immensely complex treatment available to patients quickly, through the Cancer Drugs Fund.”
The process of producing such a treatment is immensely complex but preparations are in their final stages, according to NHS England, and the first children could be treated within weeks. Three NHS hospitals are going through the international accreditation process for the provision of CAR-T therapy for children, in London, Manchester and Newcastle.
“Today’s approval is proof-positive that, in our 70th year, the NHS is leading from the front on innovative new treatments,” Stevens will say. “This constructive fast-track negotiation also shows how responsible and flexible life sciences companies can succeed – in partnership with the NHS – to make revolutionary treatments available to patients.”
Aug 26th 2018 Men
Five-minute steam treatment offers hope for prostate cancer
A new five-minute steam treatment for an enlarged prostate has been hailed as a breakthrough by NHS surgeons following tests on British patients.
The simple procedure was found to shrink glands on average by 36 per cent - but while the result is similar to other treatments, it has far less severe side effects.
The process, conducted by surgeons at Imperial College Healthcare NHS Trust in London and Hampshire Hospitals NHS Foundation Trust on 150 men, involves injecting an enlarged prostate with jets of steam without the need for surgery.
Current procedures, while effective, can lead to loss of sexual function, bleeding and incontinence with patients kept in hospitals for days at a time.
It was reported that health watchdogs are ready to give it the green light for NHS use.
Two million men in Britain have been diagnosed with an enlarged prostate. However, half of all men over the age of 50, and 60 per cent of those over 60, are thought to have it, studies have suggested
The steam treatment, called Rezum, involves having steam is injected at 1cm intervals, killing enough prostate tissue to shrink the enlarged gland.
Professor Hashim Ahmed, a consultant urological surgeon at Imperial, said other hospitals are poised to roll out the treatment as soon as they get the okay from health watchdog Nice.
"It frees up huge NHS resources because you need much less theatre time," he told the Daily Mail. "You are also opening up tens of thousands of days of bed occupation around the country."
And for Females
New Cervical Cancer Screening Guidelines: What You Need to Know
Some women have a new option for cervical cancer screening — and it doesn't necessarily involve a Pap test — according to updated guidelines from a government-appointed panel of experts.
The guidelines, from the U.S. Preventive Services Task Force (USPSTF), say that women ages 30 to 65 can be screened for cervical cancer with a test for "high risk" strains of the human papillomavirus (HPV) every five years, without undergoing a simultaneous Pap test.
Previously, the USPSTF recommended "co-testing" — or the use of both the HPV test and the Pap test — every five years, for women ages 30 to 65. While "co-testing" is still one recommended way to screen for cervical cancer, it is a less preferable method, because its use may result in women undergoing more tests and procedures overall, compared with either HPV testing or Pap testing alone, the new guidelines say. [5 Cervical Cancer Facts]
Alternatively, women ages 30 to 65 can be screened for cervical cancer with the Pap test alone every three years, according to the guidelines.
Although some women now have more choices for cervical cancerscreening, the most important thing is for them to get screened: Efforts to carry out the guidelines should "focus on ensuring that women receive adequate screening, regardless of which strategy is used," the USPSTF said.
"Regular screening with any method will lead to lower cervical cancer rates," Dr. Joy Melnikow, director of the UC Davis Center for Healthcare Policy and Research, said in a statement. "Our biggest challenge is reaching women who have not been screened," added Melnikow, who led one of the studies on HPV testing that informed the new guidelines.
High-risk strains of HPV are spread through sexual contact and cause about 90 percent of cervical cancers. Although most HPV infections clear up on their own, in some cases, the virus lingers and may eventually lead to cervical cancer.
Both the HPV test and the Pap test look at cells from a woman's cervix, according to the National Cancer Institute. In a Pap test, the cells are analyzed to see if they are cancerous, while in an HPV test, the cells are tested for HPV infection. (Co-testing can be done with just one cervical swab.)
The guidelines, which are published today (Aug. 21) in the journal JAMA, are an update to the USPSTF's previous recommendations on cervical cancer screening, which were issued in 2012. A draft of the new guidelines was released in September 2017, and they have now been finalized.
Here are some important things to know about the updated guidelines:
What are the cervical cancer screening guidelines now?
For women under age 30 and over age 65, the USPSTF's guidelines haven't changed. They are as follows:
· Women under age 21 should not be screened for cervical cancer.
· Women ages 21 to 29 should undergo screening every three years using a Pap test, also called "cervical cytology." (HPV testing isn't recommended for women ages 21 to 29 because, in this age group, HPV infection is common and is often cleared by the immune system.)
· Women over age 65 do not need to be screened for cervical cancer if they are up to date on their screening, their tests in the previous 10 years were negative and they don't have other risk factors for cervical cancer.
For women ages 30 to 65, there are three options: a test for "high risk" strains of HPV every five years, a Pap test every three years, or co-testing with both the HPV and Pap test every five years. Women in this age group should speak with their doctor about which testing method is best for them, the guidelines say.
The guidelines do not apply to women who have symptoms of cervical cancer, regardless of their sexual history, the USPSTF says. Nor do they apply to women who have previously been diagnosed with cervical cancer or with a high-grade precancerous lesion, or to women who have a condition that weakens their immune system, such as HIV.
How are the guidelines different from before?
Although HPV tests have been used for years to help screen for cervical cancer, it's the first time that national guidelines have recommended the sole use of HPV tests for women ages 30 to 65.
The draft guidelines released in September 2017 originally did not include co-testing as a recommended screening method. However, some doctors expressed concern about the need for a transition period before HPV-only testing is adopted as a screening method for women ages 30 to 65, according to an editorial accompanying the study. In the final recommendations, co-testing was added back as a recommended method.
Why were the guidelines updated?
The updated guidelines are based on the findings of recent studies, including one by Melnikow and colleagues, that found that testing for high-risk strains of HPV detected a higher rate of precancerous lesions in the cervix, compared with Pap tests.
"Our work demonstrated that there is now strong evidence for the effectiveness of high-risk HPV testing used alone as a cervical cancer screening test," Melnikow said.
Both HPV testing alone and co-testing were also slightly more effective at reducing deaths from cervical cancer than Pap testing alone, according to a separate study, also published today in JAMA. That study, which used a model to simulate the effectiveness of different screening strategies over women's lifetimes, found that, without screening, about 830 in 100,000 women would die from cervical cancer in a given population. But if women were screened with HPV testing every five years beginning at age 30, the rate of death dropped to 29 per 100,000 women. If women were screened with co-testing beginning at age 30, the rate of death was similar — about 30 deaths per 100,000 women. And if women were screened with the Pap test alone, the rate of death was higher — about 76 deaths per 100,000 women.
Are there downsides to using the HPV test?
Both the HPV test alone and co-testing have higher rates of false positives (meaning the tests detect HPV or abnormal results when a woman does not have HPV, cancer or precancer) than the Pap test, with co-testing having the highest false-positive rate, according to the guidelines. But the USPSTF concluded that, in women ages 30 to 65, all of the recommending screening methods (HPV test alone, co-testing or Pap testing alone) "offer a reasonable balance between benefits and harms" of screening, the guidelines say.
What other effects could the guidelines have?
While a Pap test must be done in a doctor's office, HPV tests could potentially be done at home, meaning that women would collect a sample and mail it to a lab for analysis. Indeed, some small studies have suggested that "at home" HPV tests are a promising method of screening for high-risk HPV infections in women who don't visit the doctor for screening. Therefore, "self-collection may be one strategy for increasing screening rates," the guidelines say. However, more rigorous studies are needed to test this hypothesis and examine how such a method could be implemented, the guidelines say.
Further studies are also needed to examine whether HPV vaccinations, which reduce the risk of HPV infection, could affect how well HPV tests work in screening for cervical cancer.
Aug 16th 2018
More Brits now die from skin cancer than Australians: Deaths rise to 3,000-a-year amid trend for excessive tanning
More Britons now fall victim to skin cancer than Australians due to the increasing popularity of sunbeds and package holidays.
Cases of malignant melanoma have increased sevenfold since the 1970s, and it is now the fifth most common deadly cancer in the UK.
The cancer killed 26,807 people in Britain between 2007 and 2016, compared to just 19,839 in Australia despite the latter country's much higher levels of annual sunshine, figures by the Office for National Statistics revealed.
Recent figures also revealed that in 1975, only 1,800 cases of malignant melanoma were detected in the UK.
This compares to an average of 16,000 today, the Daily Express reported.
Experts have laid the blame for increasing cases of the cancer on the popularity of sun beds, package holidays to sunkissed countries, and a lack of education on the damage sun can do to your skin.
Overexposure to UV rays is the main preventable cause of skin cancer, and simple steps like wearing a hat, t-shirt, or sunglasses could reduce the risk of diagnosis.
Staying away from sunbeds, seeking periodic shelter from the sun, and allowing 20-30 minutes for your sunscreen to sink in could also make a significant difference.
Those with pale skin are much more vulnerable to skin cancer, however, as they have less of a protective pigment called melanin.
Experts say part of the problem is that Britons don't spend time checking their skin for irregularities such as moles changing in appearance or new dark spots developing.
This is common in Australia, where a survey conducted by skin-tracking app Miiskin revealed a quarter of adults regularly photograph their skin.
Consultant dermatologist Dr Anton Alexandroff told the Daily Express: 'Skin cancer rates are so high in the UK because people remain complacent with sun protection in contrast to Australia.
'It is very important to monitor skin regularly. Any changes to an existing mole can be a concern, but in particular look out for growing size, changing shape, developing new colours, bleeding, painful, crusting, red around the edges or itching.'
But the risk of skin cancer is also increased if there is a family history of the cancer, or if you've been diagnosed with it in the past.
Though most non-melanoma cancers don't run in families, research has revealed that some families are at higher risk.
According to Cancer Research UK, there could be some inherited genes that slightly increase the risk of non-melanoma skin cancer in families.
Past radiation exposure, weakened immune systems, and some UV light treatments for skin conditions including psoriasis could also increase risk.
July 22nd 2018
How to prevent bowel cancer with five very simple lifestyle changes
Bowel cancer can strike even the most healthy but nearly half of cases could be prevented by lifestyle changes, according to doctors.
Of the 42,000 people diagnosed each year, 95 per cent are over 50.
Risk factors include being overweight, smoking, drinking too much booze and having type2 diabetes.
Here are our top tips for helping you reduce the odds of getting the deadly disease.
Don't cut out carbs
Carbs might be a dirty word if you are trying to lose weight but experts reckon the fibre can help speed up how quickly food moves through your system.
It is best to stick to wholegrain varieties – brown bread, rice and pasta – or wholewheat couscous or quinoa.
These foods also have anti-inflammatory properties that further helps your gut and are a great source of vitamin E.
Fruit and vegetables are essential for a healthy diet, not least because they are another top source of fibre.
Studies have shown that a high intake of vitamin C can help reduce your risk of bowel cancer. So stock up on oranges and other citrus fruits, plus peppers, berries and kiwis.
Limit processed meat
The charity Beating Bowel Cancer says there is a strong link between the disease and a diet containing lots of red and processed meat. It recommends eating less than 500g of red meat a week.
Processed meats, such as bacon, ham and salami, put you at even greater risk.
The World Cancer Research Foundation says you should try swapping your beef mince for turkey or veggie Quorn alternatives and put chicken instead of ham in your sarnies.
Eat lots of fish
A great alternative to meat is fish, especially oily varieties such as salmon, mackerel, anchovies and sardines.
A 2016 study carried out at King’s College London showed that eating just a few mouthfuls of oily fish a day can significantly reduce bowel cancer risk.
It is thought to be because these types of fish are high in omega 3s and have lots of lovely anti-inflammatory properties.
Plus they contain a load of vitamin D, which also helps keep cancer in check.
Think about drink
Cutting down on alcohol is an obvious but simple way to help prevent bowel cancer.
Don’t panic – you don’t have to give up completely. Cancer Research UK advises drinking no more than 14 units a week, spread evenly over three days.
It suggests drinking spritzers or shandies to make drinks last longer and opting for drinks that are lower in alcohol.
For example, a small gin and tonic has just one unit of alcohol – but a large 250ml glass of wine has more than three.
And if you are drinking alcohol at home, rather than out in the pub, be careful not to pour yourself measures that are way too generous.
July 19th 2018
How to tell if your mole could turn cancerous
We're forever warned about looking after our skin in order to prevent skin cancer, and that includes paying special attention to our moles. But how do you know what to look out for? What tell-tale signs indicate that your mole may have the potential to become cancerous, and how can you reassure yourself they're perfectly normal?
We spoke to Claire Crilly, Skin Cancer Screening Specialist at The MOLE Clinic, who pointed out which mole aesthetics could be cause for concern, and which most likely mean you've got nothing to worry about.
'Moles are like a family, there should always be another mole that looks similar,' explained Crilly. 'If you have a mole on its own and looks as if it does not fit on your body, seek professional guidance from a skin cancer specialist.'
Everyone should self-monitor all of their moles every three months, and this can be done at home using the ‘ABCDE’ technique:
A) Asymmetry: Look for moles that are asymmetrical in shape, where one half of the mole is unlike the other
B) Irregular Border: Does the mole have an irregular border? Is it scalloped, jagged or poorly defined?
C) Irregular Colour: Is the colour of the mole different from one area to another or does it have different shades of tan, brown or black?
D) Diameter: Check the diameter of the mole to see if it is bigger than 6mm (about the size of the end of a pencil)
E) Evolution: Is the mole evolving or changing size, shape or colour?
'Any new or changing moles should be seen by a skin cancer specialist,' adds Crilly, who notes that 'some people are at higher risk of melanoma than others due to for example, family history of melanoma, personal history, having over 100 moles, or atypical moles and should be monitored according to the above guidelines'.
But for more detail about different characteristics of moles, and the level of risk they hold, read on...
Your mole is... asymmetrical
Benign (non-cancerous) moles tend to be symmetrical. If you were to place an imaginary mirror in a line in the middle of the mole, it should be the same on either side. Remember, all moles are individual to the person, and no moles will be perfect. If a mole is asymmetrical seek advice from a skin cancer specialist.
Your mole is... raised above the skin
There are many reasons why moles can be raised, the main one being a healthy benign intradermal mole, which can be genetic, long standing, soft and sometimes wobbly to touch. They may lose colour or get darker with age. These types of moles should be monitored for drastic change, but generally aren't cause for concern.
However, moles that change and become raised could be an indication of melanoma (as pictured above), and as mentioned previously, if a mole changes, seek advice from skin cancer specialist.
Your mole is... big
Some moles may be big due to the type of mole they are, for example a congenital mole (also known as a birthmark) which are present from birth and do not tend to change. However, due to their size and dark pigment they are higher risk for melanoma, so keep an eye out for any changes or for any of the symptoms listed in the 'ABCDE' guide above.
Your mole has... many colours
If your mole has multiple colours you should seek advice from a skin cancer specialist.
Your mole is... very dark/black in colour
Depending on your skin type, your moles may well be darker in colour. Again this reverts back to your individual moles and what is normal for you. If all of your moles are similar then that is a good sign. Also, there is a lesion called simple lentigo, also known as an ink spot, which are extremely black but benign. It is always safe to have these lesions assessed due to the dark pigment.
However, if your mole is dark in colour and different to others, or if it has changed in colour to become dark, do seek advice from a skin specialist. The mole pictured above is an example of a melanoma mole.
Your mole is... growing in size or changing shape
Moles can change over your lifetime, and can become darker, lighter, larger, fade or disappear completely. However, this should never be drastic or in a short space of time. If this does happen do seek advice from skin cancer specialist.
Your mole has... an uneven border
If your mole has an uneven border this can be a sign of change, and again this needs to be assessed by a skin cancer specialist.
Your mole has... hair growing out of it
Our body is covered in hair, many moles will have hair growing out of them and this is therefore not an indicator that it's either a benign or a cancerous mole.
And it's not always about the way a mole looks that might be an indication it's cancerous, you should also pay attention to the way it feels:
Your mole is... itchy or sore
Large intradermal moles may catch on items of clothing which can cause them to be itchy or sore. However, if your mole is itchy or sore you must seek advice from a skin cancer specialist.
July 18th 2018
Eating shortly before going to bed could increase risk of cancer, finds study
Midnight snacking or eating dinner too late could increase the risk of cancer, according to a study showing the damage of disrupting the body’s internal clock.
Spanish scientists have found that people who regularly ate their evening meal after 9pm, or less than two hours before going to sleep, had a 25 per cent raised risk of breast and prostate cancers.
The team, from the Institute for Global Health at the University of Barcelona, said it could be a result of late dinners that force the body’s metabolism to speed up, at a time when it should be winding down to go to sleep.
It follows several major studies which have looked at the harm to health of shift work, routine among nurses and manual workers, with these occupations at particularly high risk of prostate and breast cancers.
These types of cancers are closely linked to hormonal cues and are often treated with testosterone or oestrogen-blocking therapies. Hormones are chemical messengers that can make us sleepy, hungry and stressed and are therefore tightly linked to the body’s circadian rhythms – the internal clock which is set by the day-night (diurnal) cycle.
A recent study suggested that employers were actually harming their staff by forcing those who might be natural night owls to come in early.
“Our study concludes that adherence to diurnal eating patterns is associated with a lower risk of cancer,” said Dr Manolis Kogevinas, lead author of the study published in the International Journal of Cancer.
“[These findings] highlight the importance of assessing circadian rhythms in studies on diet and cancer,” he added.
They surveyed 1,800 Spanish breast or prostate cancer patients, as well as more than 2,000 people unaffected by the disease, about their eating and sleeping patterns, and any steps they take to keep healthy.
It found cancer patients were more likely to be late night snackers even after taking into account other health habits and dietary or sleep patterns.
Currently international guidelines on the prevention of cancer don’t mention the potential impact of meal times on cancer, though the World Health Organisation does list shift working as a potential carcinogen.
Studies on the effects of meal disruption on animals have shown “profound effects on health” and the Barcelona group says if more studies replicate their findings there could be a cause for guidelines to be updated.
“Further research in humans is needed in order to understand the reasons behind these findings, but everything seems to indicate that the timing of sleep affects our capacity to metabolise food,” said Dr Dora Romaguera, who led the research.
July 12th 2018
This is the best sunscreen in the world, according to new report
One of the best ways to protect your skin against the sun’s harmful UV rays is to wear sun cream. But what makes the most effective bottled protection?
For your sun cream to work, there need to be filters in the ingredients that block damaging UVA and UVB rays.
According to the British Association of Dermatologists (BAD), these filters come in two types – organic and inorganic.
“Organic filters absorb harmful UV radiation and convert and give this energy back out as infrared,” the BAD website states. “These are sometimes known as ‘absorbers’, or ‘chemical’ sunscreens.
“Inorganic filters (also known as ‘physical’, ‘natural’, ‘reflective’, ‘zinc’) contain titanium dioxide or zinc oxide, which reflect UV radiation away from the skin.”
So in basic terms, organic filters absorb the UV, while the inorganic reflect it off the skin.
With more than 100,000 new cases of skin cancer diagnosed each year in the UK, protecting your skin against sun damage is crucial.
The BAD websites reveals that "extensive sun exposure is thought to be responsible for the vast majority of cases – in more than four out of five cases skin cancer is a preventable disease."
The best sunscreen in the world
To help you decide which sunscreen is best to use, the Annual Sunscreen Guide by the Consumer Report has ranked products to find the most effective in the world.
The Consumer Report carries out its sunscreen product reviews by testing more than 70 sunscreen lotions, sprays, sticks, and lip balms, revealing that “you can’t always rely on the sun protection factor (SPF). That number is a measure of protection from ultraviolet B radiation, which is the chief cause of sunburn and a contributor to skin cancer.
“We also tested for protection against ultraviolet A rays, which tan and age skin, and also trigger skin cancer. We found more than a dozen sunscreens that did well enough against both UVA and UVB to recommend.”
And the winner is La Roche-Posay’s Anthelios SPF 50 Comfort Cream, which has gained a 100% score, four years in a row.
The sunscreen contains the antioxidant, Baicalin, to help anti-ageing, and offers the highest UVA and UVB sun protection.
June 26th 2018
Flight Attendants 'More Likely To Develop Cancer' Than Others, Study Finds
Breast and skin cancers among those highlighted in new study.
Cabin crew are more likely to develop a range of cancers than other people, a scientific analysis of the health of more than 5,000 flight attendants has found.
Researchers found those whose job is to make passengers feel comfortable and safe at 30,000 feet had elevated rates of several different cancers when compared with the general population, even when age was taken into account.
Breast cancer was especially prevalent among cabin crew, alongside non-melanoma skin cancers, the study published in the Environmental Health journal said.
It found that the prevalence of skin cancers was linked to the length of a flight attendant’s career.
The findings, derived by comparing a long-standing cohort of US flight attendants with other Americans, mirrored similar studies in Europe.
The study was led by the Dr Eileen McNeely of Harvard’s Department for Environmental Health.
“Despite low smoking and obesity levels indicative of positive health behaviors (sic), we report that flight attendants have elevated rates of several cancers, especially breast, melanoma, and non-melanoma skin cancers,” McNeely and her fellow authors said.
Previous research has noted that those working in the skies, especially on high-altitude, long-haul routes, have an increased exposure to cosmic radiation, similar to that of people working in nuclear power plants.
It follows growing pressure from trade unions representing cabin crew for additional safety measures onboard flights, amid fears over so-called “toxic air” and fumes.
Unite, which represents thousands of British Airways crew, among others, said the coroner of a recent inquest into the unexpected death of a flight attendant issued an “unprecedented” call for greater awareness of aerotoxic syndrome - a catch-all term for claims of ill-effects on health of breathing cabin air.
Meanwhile reports of so-called “fume events”, whereby air drawn into the cabin through an aircraft’s engines takes on particles from fuel to become toxic, are being collated as part of a campaign. But there is no suggestion that such toxic air leads to cancer and airlines and manufacturers say cabin air is safe.
EasyJet announced last year that it would trial a new filtration system on some of its Airbus aircraft “to identify unusual smell and fumes” in the cabin.
June 23rd 2018
Is it safe to get a "base tan" in the summer?
No. There is no safe amount of tanning.
Tanning isn't bad for you just because it comes with the risk of burning, which can cause skin cancer. Tanning is bad for you because your body doesn't even begin to tan until dangerous ultraviolet (UV) rays have pierced your skin and started to mess with your DNA.
And that alone significantly increases the risk of skin cancer, said Dr. Roxana Daneshjou, a dermatology resident at the Stanford University School of Medicine. [5 Things You Must Know About Skin Cancer]
"There's really no such thing as safe tanning, other than … putting a fake color on your skin," Daneshjou told Live Science. "Fairer-skinned people may not even tan until they burn."
And while burning represents a more significant danger — because it means that skin cells have become so sun-damaged that they die — the skin damage that begins at the very start of the tanning process is still dangerous, Daneshjou said.
"Some people say, 'Well, I should tan, because that extra melanin will protect me.' But that logic doesn't make sense. You're doing so much damage just to get that little bit of protection," she said.
Melanin is a pigment found in skin cells that's produced when UV rays hit the skin. The more melanin produced, the darker the tan. (And people with more melanin in their skin have darker skin tones.)
It's true that melanin can protect the body to some extent against UV rays — it absorbs UV rays to a point, acting as the skin's natural sunscreen, Daneshjou said. But the process of adding an extra dose of melanin to the skin — in other words, tanning — is actually a defense mechanism that begins only after damage has been done.
Daneshjou also noted that people who tan for aesthetic reasons are hurting themselves in the long run. [7 Beauty Trends That Are Bad for Your Health]
Dermatologists break down the dangerous portion of UV light into two categories: UV-A and UV-B. Both cause the kind of DNA damage that can lead to skin cancer, but UV-A in particular can contribute to a second problem: It breaks down the natural collagen in the skin, which can lead to premature aging.
"Collagen is the support structure for the skin," Daneshjou said. Without the support structure, she said, skin wrinkles, thins and weakens, taking on a papery appearance.
No anti-aging product, even the dermatologist-recommended ones, can slow skin aging as much as simply using sunscreen in the first place, she said.
Daneshjou said that to prevent these kinds of problems, dermatologists recommend everyone (light- or dark-skinned) use sunscreen (broad-spectrum products, or clearly marked as protecting against both UV-A and UV-B) year-round. UV-B exposure increases in the summer and decreases in the winter, but UV-A exposure occurs year-round. And both forms of UV light can pierce clouds and cause damage on cloudy days.
"People say, 'Oh, I don't spend time in the sun,'" Daneshjou said. But such people should still wear sunscreen. UV light pierces car windshields, and can cause damage over the course of even short walks outside.
Daneshjou said people should apply about a shot-glass worth of sunscreen to their bodies when wearing a typical summer outfit.
June 13th 2018
Simple £10 saliva test to identify the men with 50 per cent chance of developing prostate cancer
For years medics have hoped for an accurate way of predicting if a patient is likely to get prostate cancer – and experts think they have found the answer.
The simple £10 saliva test could save thousands of lives.
It can identify the one in 100 men with a 50% chance of getting the disease, and the one in 10 with a 25% risk. The DNA discovery could mean most men not having to undergo invasive prostate examinations.
Professor Ros Eeles, of the Institute of Cancer Research, which led the research, said “it could save the NHS millions”.
She added: “We now finally have a genetic profiling test we can try on the general population. If it does pull out these men at higher risk, which we think it will, it will mean only 10% of men need prostate cancer screening tests and the rest we can leave alone.”
The researchers have identified 63 new genetic variations in DNA that predict the onset of prostate cancer.
It is the first time enough genetic mutations have been found to develop a test fit for clinical use.
Doctors are trialling it in London. If successful, it could be offered on the NHS in a few years to men over 40.
Those identified at increased risk in the pilot scheme will undergo MRI scans, a blood test and a biopsy.
The London-based ICR said it is a big leap forward in the attempts to prevent the disease.
It is the most common cancer in men. Around one in eight will get it at some point. The study on oncoarray gene analysis was published yesterday in the journal Nature Genetics.
Public Health England called it “a very welcome development in the urgent need for a better, more accurate test for prostate cancer”.
June 4th 2018
Cancer patients on antibiotics live half as long as those who aren't
Cancer patients who take antibiotics live half as long as those who don’t, a shock study has found.
NHS doctors have shown for the first time the devastating impact that over-prescribing the pills has on life expectancy.
Research unveiled at the world’s biggest cancer conference in Chicago showed that multiple courses of antibiotics cuts lifespan by more than two-thirds.
Scientists warn GPs that giving antibiotics to patients with minor infections, such as earache, is costing lives.
Researchers from the Christie Hospital in Manchester studied data on 303 patients diagnosed with either skin cancer, renal cancer or lung cancer being treated with immunotherapy pills.
They have found that cancers also grow almost twice as fast in those given the drugs.
Study co-author Dr Matthew Krebs said: “Sometimes they are for a genuine infection but other people get antibiotics unnecessarily.
"The patient might just have had a temperature but this is affecting their (cancer)outcome. It’s potentially quite a big, big problem.
“Sometimes oncologists are a bit cautious and if you’ve got a bit of a temperature you might get antibiotics.
“Or they go and see their GP and the GP thinks, ‘oh my goodness it’s a cancer patient, they need antibiotics’.”
Researchers followed 94 who were given antibiotics during an eight-week period and 209 who were not.
Patients who had been given antibiotics died on average 317 days later, compared to 651 days for those who had not.
Those who had been prescribed multiple courses fared even worse – lasting, on average, just 193 days.
Watchdog NICE confirmed it currently has no national guidelines on the use of antibiotics in cancer patients.
Study co-author Nadina Tinsley, clinical research fellow at the Christie, said: “Clearly we need to treat serious or life-threatening infections with antibiotics.
"The challenge is striking the right balance.”
May 28th 2018
I was given weeks to live, but then my cancer disappeared
After a terminal cancer diagnosis, Tiff had prepared to die. Aged 32, she had already planned her funeral. But a miracle happened.
Leicester Tigers captain and former England rugby player Tom Youngs' wife Tiff was diagnosed with cancer, which she was told was terminal in 2013.
His brother, Leicester and England scrum-half Ben Youngs, pulled out of the British and Irish Lions squad following their family's devastating news.
Here, Tiff shares her journey with Sky News:
I had just had my daughter Maisie in 2013 when I developed an awful cold and cough.
It just wouldn't shift so I went to the doctor and had a blood test which showed "something" in my bloods.
I was sent for a chest x-ray that day and then my doctor called me a little while later to tell me he thought I had blood cancer.
Tom was at the club training and I called his PA to try to get into contact with him.
I was in a state.
Tom rang me straight back and rushed home - which is pretty much unheard of during training.
A biopsy confirmed I had Hodgkin's lymphoma, a cancer of the lymphatic system, which is a network of vessels and glands spread throughout your body.
I was 28. You never think you're going to get that news.
Tom collapsed to the floor with shock.
We didn't know what to do.
But everyone was telling me that it's treatable and lots of people were
saying it's the most curable one you can have.
So I thought I'd have six months of treatment and that would be it.
I had a donor's stem cell transplant, but I had to wait a while due to three or four donors failing, so I had to go onto another lot of treatment in Manchester.
I had four years of treatment in total.
I had my head shaved twice throughout treatment over the four years.
I didn't see my daughter at one point for four weeks while I was in hospital.
"Unfortunately you're terminal and there is nothing else we can do."
In 2017, they gave me four weeks to a year to live.
I had to tell my daughter.
Me, Tom and Maisie were sat on my bed, having a giggle and I just had to tell her.
I said mummy has been very poorly, and that mummy would be going to heaven.
She started crying. It's the worst thing I have ever had to do and I don't wish it on anyone.
I then started getting my affairs in order.
I wrote down the cleaner's number, the neighbour's number, I gave people our house keys, I had guardians in place and I started looking for a full-time nanny to help Tom.
I sold all my clothes, gave everything to charity shops, I had a massive clear out and threw lots of stuff away.
I planned my funeral - I chose my picture, my music, told my family how I wanted to die.
I felt guilty and a burden to everybody, I didn't want anyone to have anything to do.
Tom is very close with his brother Ben, and Ben took the decision to miss the Lions tour when we found out I was terminal.
I just felt awful, like I was jeopardising his career and like I was a burden on everybody.
But of course nobody saw it that way, it was just me.
Tom even banned me from using the word "burden".
It probably took me about two and a half years after I was diagnosed to actually accept help from people.
I did worry a lot about how my illness was affecting everybody else.
But in July, I decided "I'm not going anywhere".
I decided that I hadn't had a child for her to grow up without a mother.
I want to bring her up, so I decided to try an alternative treatment.
I had nothing to lose - if it gave me an extra week with her it was worth it.
So I went to London twice a week to see these two ladies recommended to me by someone.
I told Tom we needed to be open-minded.
I went on a very, very strict diet plan of juices, no dairy, no red meat, no sugar, no tea or coffee - basically just fish and green juices.
I was fasting from 7pm until noon the next day.
I did that for three months and I felt amazing on it.
Then the other lady treated me with an ENS cosmodic machine treatment which basically tells your brain to tell your body to produce the cells it's not producing.
It's like a rollerball deodorant and it has three metal prongs and you just go up and down your back.
My dad bought me the same machine and I started to do it.
I also started taking THC cannabis oil after reading so much about it in the news.
I just started to feel better and I even woke up on a few mornings feeling like "I don't think I've got it anymore".
But obviously I was very cautious about thinking that way.
In February this year, I came down with a cold and went into hospital because I didn't feel well.
I had a scan and the consultant came in and told me it was clear.
I was in remission.
I was on my own - my mum, Tom and my daughter had gone out to get some food - so I called Tom and I told him to put me on loudspeaker.
I shouted: "It's gone!"
I rang my dad, he was very emotional, he dropped the phone I think.
I told my brother and sister.
It was just unbelievable.
From being told you are going to die, to then finding out you're not, it's incredibly hard and it's such an adjustment.
I had told my parents and Tom where I wanted to be, where I wanted to end my life, I'd written my will.
I'd given my godchildren money, one of my friends had a tattoo to remember me.
I had prepared to die.
But Maisie kept me going.
I wanted to see her start school.
I wanted to see her birthday.
I would set goals and I would achieve them and that pushed me through.
I have so many people to thank as well as my family.
The rugby fans, everybody at every club have sent messages; coaches, players, and Leicester Tigers have been absolutely amazing.
I really can't thank them enough.
Especially my husband, who did everything to help and support me through this long journey.
:: You can listen to Tiff's story in the podcast Learning to Live Again.
May 25th 2018
Breast cancer screening scandal 'may have affected extra 140,000'
An error that led to hundreds of thousands of women missing out on breast screening invitations could date back further than previously thought and have affected an additional 140,000 people, a cancer expert has said.
Health Secretary Jeremy Hunt revealed earlier this month that 450,000 women aged 68 to 71 had not been invited to their final routine screening due to a computer error dating back to 2009 .
But Professor Peter Sasieni, a cancer screening and prevention researcher at King's College London, believes the problems could have started as early as 2005. Public Health England (PHE) said his analysis is "flawed".
Video: 309,000 women need breast cancer screening in six months (Provided by ITN News)
Prof Sasieni studied data from the breast cancer screening programme between 2004 and 2017, looking at the number of eligible women who were sent invitations each year from the ages of 45 to 70.
In a letter published in medical journal The Lancet, Prof Sasieni said that between 2004 and 2005 - when the programme was extended to the age of 70 - the number of invitations sent to women aged 65 to 70 was "very low".
A third of eligible women should have been invited every year - but Prof Sasieni claimed the figures showed it was 31 per cent in 2005-06, rising to almost 35 per cent in 2016-17.
By comparison, between 34 per cent and 38 per cent of people aged 50 to 64 were invited each year.
The difference amounts to 140,000 between 2005 and 2008 - adding up to a total of more than 502,000 missing out since 2005, Prof Sasieni concluded.
The letter states: "Data that might have alerted people to the lower-than-expected number of invitations being sent to women aged 70 were publicly available, but no-one looked at them carefully enough.
"Some of the fault lies in the way the data was presented, but it is also unclear whose responsibility it is to monitor such outcomes."
Professor John Newton, director of health improvement at PHE, told the BBC : "This is a flawed analysis which fails to take into account some important facts, such as when the breast screening programme was rolled out to all 70-year-olds in England or when a clinical trial was started called Age X."
He said PHE was focused on supporting those not invited to their final screening.
An independent review has been launched into the computer error, which Mr Hunt said was discovered in January and may have led to up to 270 women having their lives cut short.
Related Video: Jeremy Hunt: Lives may have been cut short by breast cancer screening failure (Provided by Press Association)
Professor John Newton, PHE director of health improvement, disputed the analysis.
He said: "This is a flawed analysis which fails to take into account some important facts, such as when the breast screening programme was rolled out to all 70-year-olds in England or when a clinical trial was started called Age X.
"Our top priority is making sure that all the women that did not receive an invitation for a screen are supported.
"The independent review will look at all aspects of the Breast Screening Service to identify any lessons PHE and the NHS can learn."
May 20th 2018
Breath test for cancers 'could help tackle late diagnoses'
A breath test that can quickly and accurately detect cancers of the throat and stomach, could help to speed up screening and diagnosis of the disease which is often caught too late for treatment.
In clinical trials, researchers from Imperial College London were able accurately identify oesophagogastric cancers from breath samples 85 per cent of the time, in patients attending for a diagnostic endoscopy or surgery.
These account for 15 per cent of UK cancer deaths.
Existing tests require a tube to be inserted down a patient's throat when they are under anaesthetic, at a cost of £600 per patient.
They cannot be widely used to diagnose people with early and often unspecific symptoms, like indigestion or acid reflux, so these cancers are often diagnosed late.
There are 15,000 new cases of these cancers diagnosed in the UK each year, of which only 38 per cent are potentially curable by the time they have been identified. The long-term survival is just 15 per cent.
“Alarming symptoms often indicate late cancer stage,” said Professor George Hanna, lead author of the study, published today in the Lancet Oncology journal.
“There is a real need for early detection of cancer when symptoms are non-specific and shared by benign diseases. Our breath test could be used as a first-line test before invasive investigations.”
The test's accuracy will need to be refined with much larger trial involving GP practices to assess its effectiveness in detecting earlier symptoms and its ability to pick up cancers in other parts of the body such as the pancreas.
The test examines chemical markers of the cancers that are passed into our airways and exhaled when we breathe out.
These volatile organic compounds (VOCs) are distinctive in oesophagogastric cancers and by analysing the gases and materials, using mass spectroscopy, they were able to calibrate the test to identify cancers from among the other components.
Trials included 335 patients from the Royal Marsden and University College London Hospitals who had not eaten for four hours before the test.
Of these 163 had already been diagnosed with an oesophagogastric cancer while 172 had other benign diseases of the stomach or no issues.
Patients breathed into the measuring device to collect a sample, which was then analysed by technicians - who did not know whether the patient had cancer or not.
It proved accurate 85 per cent of the time.
Up to 95 per cent of endoscopies for these cancers come back negative, but the breath test in practices could be performed by nurses and sent for analysis at a regional lab as samples can be kept for up to 1.5 months.
“A breath test prior to endoscopy could substantially reduce the number of negative endoscopies and increase the cancer yield making the diagnostic pathway more effective with improved patient experience,” the study noted. “Avoiding unnecessary investigations would also free up resources in the NHS.”
“Our breath test could be used as a first-line test before invasive investigations,” added professor Hanna. Early detection of cancer gives patients more treatment options and safe more lives.”
May 8th 2018
'Why I am handing out roses this World Ovarian Cancer Day'
Tuesday 8th May is World Ovarian Cancer Day. It’s the one day where we come together to speak up about an often overlooked disease; a disease that kills more women than all other gynaecological cancers combined; a disease I feel that I almost miraculously survived.
‘Miraculously’ because in 2003 I was diagnosed with stage 3 ovarian cancer – only 19% of women who receive that diagnosis today will survive another five years.
15 years later, as an ovarian cancer survivor I am supporting the campaigning efforts of research charity Ovarian Cancer Action. To raise awareness of this devastating illness, on World Ovarian Cancer Day we will be handing out 7,400 roses across the country with cards on the stems that describe the main symptoms of ovarian cancer. The number of roses represents the number of women diagnosed each year with the disease. At present there is no screening process for ovarian cancer. Until we have one, the main priority is to educate women on the vague symptoms of ovarian cancer that do manifest themselves. Awareness is key if we’re to catch it early; the earlier the condition is diagnosed the better the outcome.
Nothing illustrates the truth of this more than the cold fact that a woman has a 90% chance of living for five years if diagnosed at stage 1, but only a 4% chance if diagnosed at stage 4.
As I learnt first-hand, an early diagnosis is a relatively rare thing in the ovarian cancer community.
I had been a nurse and a midwife but had given up work to bring up our three children. I was a busy full time mum and as a Christian very involved in our Church. I believed it was because of this busy lifestyle that I constantly felt tired. It was only after I recovered from chemotherapy did I realise how abnormal my fatigue had been. I had also had one episode of abdominal pain. Things became more serious when I started bloating. The bloating increased gradually over a few months, not helped by going on a diet as I initially thought it might be ‘middle aged spread’. I decided to visit the GP as I thought I might have a cyst or a fibroid.
The GP immediately thought I was pregnant. As I had been a midwife and had had three children I knew I wasn’t but he insisted that I did a pregnancy test. It was only the negative result that convinced him. At this point he ordered an urgent ultrasound scan. The scan revealed a tumour on both ovaries with cancer spots on my bowel, bladder and omentum. I was told that I would have a full hysterectomy followed by six sessions of chemotherapy.
Even though I had been in the medical profession the news came as a real shock. I was in a low risk category for cancer: 40 years old, a non-smoker who did moderate exercise.
At the time, I didn’t know of anyone that had survived ovarian cancer - my aunt had died of ovarian cancer (although there was no genetic link). The diagnosis was stage three ovarian cancer so I knew this was advanced and that the survival rates weren’t very good. But my consultant used to say, “I deal with individuals, not statistics.”
I knew that the medical profession would do all that they could but when I asked my husband honestly, “Do they think I’m going to die?” he answered, “They don’t know”.
Even now there are many women who don’t make it. This is why I have become a ‘Voice’ (someone who raises awareness of ovarian cancer) for Ovarian Cancer Action. With one woman dying every two hours of ovarian cancer in the UK something needs to be done. It is 15 years since I was diagnosed and I’ve been discharged from medical care for eight years, which I never thought would happen. As a Voice I give awareness talks in Wales, where survival rates are some of the poorest in the UK. I also raise money for research through cake sales, and generally support women going through treatment and beyond.
I am so grateful that I am well and able to hopefully be an encouragement and offer hope to women being diagnosed with the disease now.
On World Ovarian Cancer Day, I hope lots of women pick up a rose and get to know the symptoms of ovarian cancer. You can find our more at ovarian.org.uk
May 7th 2018
Exercise should be prescribed to all cancer patients, and not to do so would be harmful, some of Australia’s leading experts on cancer have warned.
The Clinical Oncology Society of Australia has launched its position statement on the role of exercise alongside surgery, chemotherapy or radiation in cancer care.
Endorsed by a group of 25 influential health and cancer organisations, including Cancer Council Australia, it is the first researcher-led push anywhere in the world for exercise to be an essential component of treatment.
The lead author, Prof Prue Cormie from the Australian Catholic University, said the statement was based on “indisputable” evidence. “Really we are at the stage where the science is telling us that withholding exercise from cancer patients can be harmful,” Cormie said.
“Exercise is the best medicine someone with cancer can take in addition to their standard cancer treatments. That’s because we know now that people who exercise regularly experience fewer and less severe treatment side-effects; cancer-related fatigue, mental distress, quality of life.”
They also have a lower risk of their cancer coming back or dying from the disease, Cormie said.
“If the effects of exercise could be encapsulated in a pill, it would be prescribed to every cancer patient worldwide and viewed as a major breakthrough in cancer treatment,” she writes for the Conversation. “If we had a pill called exercise it would be demanded by cancer patients, prescribed by every cancer specialist, and subsidised by government.”
Gone are the days of wrapping cancer patients in “cotton wool”, according to Dr David Speakman, chief medical officer at the Peter MacCallum Cancer Centre.
“Our attitudes to treating cancer, what it takes to give people their best chance at survival, have to change. All cancer patients will benefit from an exercise prescription.’
Nicole Cooper, 33, was diagnosed with stage 4 bowel cancer last year, and believes one reason she is still alive is the exercise regime she followed while undergoing treatment. “When I received a terminal cancer diagnosis, I was prescribed two potentially lifesaving cancer treatments: chemotherapy and exercise,” she said.
“A year later, I am in remission, having taken just as much exercise as I have chemotherapy.”
Cormie said the evidence-based guidelines recommended people with cancer be as physically active as their current ability and conditions allowed. For significant health benefits, they should aim for at least 150 minutes of moderate intensity aerobic exercise weekly and two to three resistance exercise sessions (such as weightlifting).
“These recommendations should be tailored to the individual’s abilities to minimise the risk of complications and maximise the benefits.”
May 6th 2018
End of ageing and cancer? Scientists unveil structure of the ‘immortality’ enzyme telomerase
Making a drug is like trying to pick a lock at the molecular level. There are two ways in which you can proceed. You can try thousands of different keys at random, hopefully finding one that fits. The pharmaceutical industry does this all the time – sometimes screening hundreds of thousands of compounds to see if they interact with a certain enzyme or protein. But unfortunately it’s not always efficient – there are more drug molecule shapes than seconds have passed since the beginning of the universe.
Alternatively, like a safe cracker, you can x-ray the lock you want to open and work out the probable shape of the key from the pictures you get. This is much more effective for discovering drugs, as you can use computer models to identify promising compounds before researchers go into the lab to find the best one. Now a study, published in Nature, presents detailed images of a crucial anti-ageing enzyme known as telomerase – raising hopes that we can soon slow ageing and cure cancer.
Every organism packages its DNA into chromosomes. In simple bacteria like E. coli this is a single small circle. More complex organisms have far more DNA and multiple linear chromosomes (22 pairs plus sex chromosomes). These probably appeared because they provided an evolutionary advantage, but they also come with a downside.
At the end of each chromosome is a protective cap called a telomere . However, most human cells can’t copy them – meaning that every time they divide, their telomeres become shorter. When telomeres become too short, the cell enters a toxic state called “senescence”. If these senescent cells are not cleared by the immune system, they begin to compromise the function of the tissues in which they reside. For millennia, humans have perceived this gradual compromise in tissue function over time without understanding what caused it. We simply called it ageing.
Enter telomerase, a specialised telomere repair enzyme in two parts – able to add DNA to the chromosome tips. The first part is a protein called TERT that does the copying. The second component is called TR, a small piece of RNA which acts as a template. Together, these form telomerase, which trundles up and down on the ends of chromosomes, copying the template. At the bottom, a human telomere is roughly 3,000 copies of the DNA sequence “TTAGGG” – laid down and maintained by telomerase. But sadly, production of TERT is repressed in human tissues with the exception of sperm, eggs and some immune cells.
Ageing versus cancer
Organisms regulate their telomere maintenance in this way because they are walking a biological tightrope. On the one hand, they need to replace the cells they lose in the course of their ordinary daily lives by cell division. However, any cell with an unlimited capacity to divide is the seed of a tumour. And it turns out that the majority of human cancers have active telomerase and shorter telomeres than the cells surrounding them.
This indicates that the cell from which they came divided as normal but then picked up a mutation which turned TERT back on. Cancer and ageing are flip sides of the same coin and telomerase, by and large, is doing the flipping. Inhibit telomerase, and you have a treatment for cancer, activate it and you prevent senescence. That, at least, is the theory.
The researchers behind the new study were not just able to obtain the structure of a proportion of the enzyme, but of the entire molecule as it was working. This was a tour de force involving the use of cryo-electron microscopy – a technique using a beam of electrons (rather than light) to take thousands of detailed images of individual molecules from different angles and combine them computationally.
Prior to the development of this method, for which scientists won the Nobel Prize last year, it was necessary to crystallise proteins to image them. This typically requires thousands of attempts and many years of trying, if it works at all.
Elixir of youth?
TERT itself is a large molecule and although it has shown to lengthen lifespan when introduced into normal mice using gene therapy this is technically challenging and fraught with difficulties. Drugs that can turn on the enzyme that produces it are far better, easier to deliver and cheaper to make.
We already know of a few compounds to inhibit and activate telomerase – discovered through the cumbersome process of randomly screening for drugs. Sadly, they are not very efficient.
Some of the most provocative studies involve the compound TA-65 (Cycloastragenol) – a natural product which lengthens telomeres experimentally and has been claimed to show benefit in early stage macular degeneration (vision loss). As a result, TA65 has been sold over the internet and has prompted at least one (subsequently dismissed) lawsuit over claims that it caused cancer in a user. This sad story illustrates an important public health message best summarised simply as “don’t try this at home, folks”.
The telomerase inhibitors we know of so far, however, have genuine clinical benefit in various cancers, particularly in combination with other drugs. However, the doses required are relatively high.
The new study is extremely promising because, by knowing the structure of telomerase, we can use computer models to identify the most promising activators and inhibitors and then test them to find which ones are most effective. This is a much quicker process than randomly trying different molecules to see if they work.
So how far could could we go? In terms of cancer, it is hard to tell. The body can easily become resistant to cancer drugs, including telomerase inhibitors. Prospects for slowing ageing where there is not cancer are somewhat easier to estimate. In mice, deleting senescent cells or dosing with telomerase (gene therapy) both give increases in lifespan of the order of 20% – despite being inefficient techniques. It may be that at some point other ageing mechanisms, such as the accumulation of damaged proteins, start to come into play.
But if we did manage to stop the kind of ageing caused by senescent cells using telomerase activation, we could start devoting all our efforts into tackling these additional ageing processes. There’s every reason to be optimistic that we may soon live much longer, healthier lives than we do today.
May 6th 2018
SPF in makeup isn't enough to protect your skin, experts warn
The season of sun is almost upon us and with it comes one of beauty’s biggest dilemmas.
Because, while we all crave that sun-kissed beachy glow, we’re also well aware of the havoc it can wreak on our skin.
Of course, we also know that we should be wearing a sunscreen year round but no matter how hard we try, that extra step in your beauty routine can be hard to get on board with.
So, could two-in-one cosmetics that smooth the appearance of your skin and deliver SPF be the answer?
It seems not. Unfortunately, while the beauty industry is overflowing with makeup products containing SPF including foundations, primers and even powders, they just don’t get the job done on their own and should by no means replace sunscreen altogether.
“Many people believe that having an SPF in their moisturiser or foundation for example will suffice,” consultant dermatologist for La Roche-Posay, Justine Hextall told The Independent.
“But, it is important to remember that SPF only refers to protection against UVB. UVA is a longer wavelength that can penetrate glass. It is the main wavelength that damages our collagen and also can increase our risk of skin cancer.
“As such I recommend a factor 50 sun cream with both good UVB and UVA protection and preferably anti-oxidants to protect against the more visible light spectrum.”
And the British Association of Dermatology agrees adding: “SPF used in moisturisers are tested the same way as sunscreens, so an SPF 15 moisturiser should provide an SPF of 15.
“However, these formulas are less likely to be rub-resistant and water resistant, and most importantly are likely to be applied a lot more thinly than sunscreen. They therefore are unlikely to offer the same level of protection.
“A moisturiser with an SPF will help protect you against small amounts of UV exposure, such as when you walk to the car or pop outside to hang out the washing, but sunscreen is better suited for longer, more deliberate UV exposure, such as spending your lunch hour outside.”
But one expert is quick to point out that cosmetics containing SPF aren’t completely pointless. Instead, they should be used in conjunction with sunscreen and other SPF products.
“As we tend to touch our faces a great deal and remove products slightly, layering of SPF products is always a good thing to ensure protection and maximum coverage across the face,” Boots Soltan Suncare Expert, Clare O’Connor told the Daily Mail.
“Really go for a minimum of SPF 15 as there is a tendency to apply a much thinner layer that recommended and using a minimum of 15 will allow a good level of protection when used in conjunction with a minimum of SPF 15 day cream.”
May 1st 2018
‘Landmark’ drug extends life by 54 per cent in women with incurable breast cancer
A chemotherapy drug normally used for ovarian and lung cancer extended average survival for “triple negative” breast cancer patients with BRCA mutations by 54 per cent.
Baroness Morgan, chief executive of Breast Cancer Now, which co-funded the trial, said: “This is a landmark and long-awaited step forward for women with incurable and aggressive breast cancers who carry BRCA mutations — who until now have had no targeted options to rely on.”
The results are set to change international guidelines by ensuring that women with triple negative breast cancer who are young or with a family history of the disease have BRCA testing.
About 15 per cent of breast cancers are triple negative. There are limited treatment options because it does not respond to standard hormone therapies or drugs such as Herceptin. This means that patients only survive for about one to two years after the cancer has spread to other parts of the body.
Hollywood star Jolie revealed in 2013 that she had a preventative double mastectomy after discovering she had a BRCA1 mutation. The trial, involving the Institute of Cancer Research and King’s College London, found the “platinum chemotherapy” carboplatin delayed the disease’s progression by 6.8 months, compared with 4.4 months on docetaxel, the current standard of care.
“For those living with the impossible reality of incurable cancer, these precious extra months of better quality life before their condition worsens could mean absolutely everything,” Baroness Morgan said.
Professor Andrew Tutt, who co-led the study at the ICR, said women with triple negative breast cancer should now be tested for BRCA mutations to see whether they could benefit from carboplatin. The drug had fewer side-effects and resulted in tumours shrinking in 68 per cent of patients, compared with 33 per cent in those on docetaxel.
The trial, published in Nature Medicine, involved 376 women with metastatic triple negative breast cancer in UK hospitals. The drugs were similarly effective in women without BRCA mutations — but the 43 women with BRCA mutations were twice as likely to respond to carboplatin, probably due to its ability to damage the tumour’s DNA.
April 30th 2018
Eating garlic can reduce risk of certain cancers, study finds
Garlic has been highly regarded as a health-boosting ingredient for a very long time, used to treat human disease for thousands of years.
However, the way that garlic benefits the body has perplexed researchers for eons.
In a recent study published by scientists from the University of Nottingham, researchers concluded that garlic can in fact reduce the risk of developing certain kinds of cancers, cardiovascular disease and type 2 diabetes.
Furthermore, the way in which garlic is prepared can have a positive effect on the bulb’s ability to benefit your health.
However, scientists have been unable to determine which method of preparation is the most effective.
Garlic produces a variety of sulphur compounds when prepared, whether it’s chopped, fermented in alcohol or pressed for oil.
According to researchers, these sulphur compounds can affect “gaseous signalling molecules” such as nitric oxide and hydrogen sulphide that are naturally produced in the human body.
Altered levels of gaseous signalling molecules can be detected in people suffering from many diseases, as they can have a huge impact on cell communication and maintaining balance in the body.
“These molecules give the plants an ecological advantage when they’re growing out in the wild,” said Dr Peter Rose, a biochemist at the University of Nottingham and senior author of the study.
“As it happens, they’re also biologically active within mammalian cells and tissues, but we do not know how they are metabolised in humans.”
While the optimum technique for preparing garlic is still being debated, the researchers did agree that garlic is one of several plant species that has strong restorative abilities.
“There is a lot of possibility within this area for finding approaches that could reduce the risk of diseases and improve human health, but it all comes back to those fundamental questions of what actually happens to these compounds when we metabolise them,” Dr Rose said.
“There’s a whole spectrum of human work that still needs to be done to further explore some of these weird and wonderful sulphur compounds that we find within our diets.”
April 19th 2018
'Artificial mole' could warn of cancer: study
Swiss scientists have developed an experimental skin implant that darkens like a mole when it detects subtle changes in the body that may be an early warning sign of cancer, a study said Wednesday.
The implant, or "biomedical tattoo," as researchers call it, has been tested in lab animals, lasts about a year and recognizes the four most common types of cancer: prostate, lung, colon and breast cancer.
It works by reacting to the level of calcium in the blood, which rises when a tumor is developing. About 40 percent of cancers could theoretically be detected this way, researchers said.
"The biomedical tattoo detects all hypercalcemic cancers at a very early, asymptomatic stage," lead author Martin Fussenegger, Professor at the Department of Biosystems Science and Engineering at ETH Zurich, told AFP by email.
"If blood calcium levels remain high over longer periods of time, the calcium sensor in the biomedical tattoo cells produces an enzyme, tyrosinase, which converts the amino acid into the black skin pigment, melanin."
If the wearer notices the spot darken, they should see a doctor to clarify the reason for the change and determine if or what treatment is warranted, he said.
"Early detection increases the chance of survival significantly," he said.
"Nowadays, people generally go to the doctor only when the tumor begins to cause problems. Unfortunately, by that point it is often too late."
The implant was tested in mice with either cancerous tumors that cause hypercalcemia or tumors that do not affect calcium blood levels.
During a 38-day experiment, the tattoos appeared only on the skin of the hypercalcemic mice, which showed no symptoms of illness.
More research and funding is needed to advance the tattoo to clinical trials in people, and the process could take a decade, Fussenegger said.
A paper describing the prototype was published in the journal Science Translational Medicine.
April 3rd 2018
'One-stop' cancer shops to open across UK aiming to speed up diagnosis of disease
New “one-stop shops” which aim to spot cancer more quickly are opening across the country.
The assessment centres hope to give a final diagnosis in two weeks but some patients could get the all-clear in a day.
GPs can refer patients who are suffering from “vague” symptoms such as pain and fatigue to the clinics.
While there they can undergo multiple tests for different cancers.
The initiative aims to ensure a quick diagnosis in those not showing “alarm” signs for a specific type of cancer, NHS England has said.
Cally Palmer, national director for cancer at NHS England, said: “Early diagnosis is crucial to saving lives and providing peace of mind for patients.
“These new one-stop shops represent a real step change in the way people with unclear symptoms are identified, diagnosed and treated.”
The scheme, co-ordinated by NHS England, Cancer Research UK and Macmillan Cancer Support, is being piloted in 10 areas.
Patients with unexplained weight loss, appetite loss, abdominal discomfort or pain, fatigue, sweating or who feel generally unwell could be referred to the service.
These symptoms can indicate a number of diseases including cancer.
Sara Hiom, Cancer Research UK’s director of early diagnosis, said: “We’re confident that these 10 pilot centres will give us a much better understanding of what’s needed to speed up the diagnosis and treatment of people with less obvious symptoms.”
March 27th 2018
Thousands of bowel cancer patients at risk as hospitals ignore genetic test
The lives of thousands of bowel cancer patients are being put at needless risk because hospitals are failing to perform a simple genetic test, an investigation has found.
More than eight out of 10 hospitals are ignoring official guidelines by not carrying out screening for Lynch syndrome when patients are diagnosed with the cancer.
Carried by an estimated 175,000 people, the faulty gene makes a person 80 per cent more likely to develop bowel cancer and means chemotherapy is less likely to work.
Failing to screen for the syndrome means patients are put at unnecessary risk that their tumours will continue to grow but that this will only be discovered by the time the disease is too advanced to cure.
It also deprives the children of Lynch syndrome carriers, who have a 50 per cent chance of inheriting the gene, the opportunity of discovering if they are at risk and undergoing preventative cancer screening.
Bowel cancer is the fourth most common form of the disease in the UK, with almost 42,000 diagnoses each year, and the second biggest cancer killer.
Bowel cancer | Six signs to watch out for
Lynch Syndrome has been likened to bowel cancer equivalent the BRCA or “Angelina Jolie” gene for people at a high risk of cancer.
Related: 15 Surprising Signs of Cancer (provided by Woman's Day)
Using Freedom of Information requests, the charity Bowel Cancer UK established that around 83 per cent of hospitals in England do not follow guidance set out by the National Institute for Health and Care Excellence.
At £200, the test costs just over a third that of a colonoscopy, and less than the 1 per cent cost per bowel cancer patient to the NHS of around £25,000.
Currently only around five per cent of people with Lynch syndrome know they carry the gene.
Deborah Alsina MBE, Chief Executive of Bowel Cancer UK, said: “Until there is clear local and national leadership and a firm commitment to improve the services for people at high risk of developing bowel cancer, the estimated 175,000 people who carry this inherited faulty gene will continue to fall through the gaps.”
The charity’s FOI results found that those hospitals who aren’t testing for Lynch syndrome, 91 per cent cited ‘financial’ reasons as the main barrier, followed by nearly two-thirds listing “staff resources” as a common obstacle.
Other reasons included a lack of awareness of the NICE guidelines (17 per cent), policies (14 per cent) and patient consent (three per cent).
Related: Scientists Develop New Immunotherapy For Prostate Cancer (provided by Wochit News)
March 13th 2018
Aggressive breast cancer tumours can be 'transformed' into more treatable form, scientists find
Aggressive breast cancer tumours that are usually only treatable with intensive chemotherapy can be made hyper-sensitive to conventional treatments by a new technique developed by Swedish researchers.
Experts say the approach used opened up new research and treatment possibilities, and it could provide a “real opportunity” to improve the survival chances of the 15 per cent of patients whose breast cancer is resistant to front-line therapies.
In laboratory tests the team from Lund University, showed that disrupting the tumour cells communication with the connective tissue cells of the breast could render it vulnerable to hormone therapy treatments like tamoxifen.
They used an experimental drug to block a signalling molecule that transmits information between breast cancer cells and surrounding connective tissue.
Detailed analysis of around 1,400 breast cancers showed that women with high levels of the signalling molecule, PDGF-CC, in their tumours had a poor prognosis.
Lead scientist, Professor Kristian Pietras from Lund University, said: “We have developed a new treatment strategy for aggressive and difficult-to-treat breast cancers that restores sensitivity to hormone therapy.
“These findings have major implications in the development of more effective treatments for patients with aggressive breast cancer.”
Most breast cancers are fuelled by female hormones, mostly oestrogen. They generally respond to treatments that either block activity of the hormones or cut off their supply.
The 10-15% of breast cancers that do not respond to hormone therapy treatments are known to be more aggressive and likely to recur.
Previously it was thought that different mammary gland cell types gave rise to different types of breast cancer. Hormone sensitivity was therefore “set” at the start of a cancer’s development.
The new research shows that communication between breast cancer cells and connective tissue via PDGF-CC can “switch off” hormone sensitivity.
When the Swedish team used an antibody drug to block the signalling pathway, non-hormone sensitive “basal” cancers were transformed into hormone sensitive “luminal” cancers.
Laboratory mouse studies showed that the altered tumours became “highly responsive” to standard hormone therapy.
The scientists wrote in the journal Nature Medicine: “Out of all breast carcinomas, basal-like tumours have the highest recurrence rate, the shortest time to recurrence and the worst overall survival rate owing to a paucity of therapeutic targets.
“Thus, new treatment approaches for patients with basal-like breast cancer are urgently required.”
The promising lab results justified evaluating the new treatment approach in clinical trials, they added.
Independent experts said the findings were exciting but any benefits for humans were likely to be a long-way off.
Cancer Research UK’s Dr Catherine Pickworth, who was not involved with the study, said: “This study is a step towards tackling the big challenge of breast cancers that are resistant to treatments.
“The next steps will be to see if this improves survival, and whether it’s safe and effective in people. One day, this approach could offer a new option for patients with breast cancer when other treatments aren’t working.”
Holly Palmer, research communications officer at Breast Cancer Now, said: ““Transforming aggressive breast tumours so that they resemble more treatable forms of the disease is a fascinating approach. If proven effective in breast cancer patients, it could provide a real opportunity to improve survival for those with this aggressive form of the disease.
“This research has highlighted the crucial role of the microenvironment surrounding tumours in determining breast cancer subtype – an avenue of research that we hope will continue to be explored in further detail. If proven effective in patients with basal-like breast cancers, this approach could unlock an array of new therapeutic options for those who so desperately need them.”
March 11th 2018
Here's how thousands of women could be saved from cervical cancer surgeries
Thousands of women with abnormal smears could be monitored instead of going through invasive surgery, a major study suggests.
Research involving more than 3,000 women with precancerous changes found that half of cases defined as moderately severe returned to normal within two years without any treatment.
Just 18 per cent progressed, with just 0.5 per cent becoming cancer, within the time frame, the study found.
Among women below the age of 30, the rate of regression was even higher, with just 11 per cent of cases progressing.
Researchers from Imperial College London said the findings published in the BMJ suggested many more women should be offered “active surveillance” rather than immediate operations to excise tissue, which are invasive, and can harm future pregnancies.
However, experts said women should not be dissuaded from treatment if they wanted it, with even a small risk of cancer too much of “a gamble” for some to contemplate.
The findings should help women make more informed choices with their doctor, but study limitations mean that the results should be interpreted with caution.
Abnormal cells on the surface of the cervix are called cervical intra-epithelial neoplasia (CIN) and graded 1, 2 or 3, based on severity.
Currently most women classed as CIN1 will be offered regular checks, while those who are found to be CIN2 or CIN3 are offered excision surgery. Researchers, led by Maria Kyrgiou at Imperial College London, analysed results from 36 studies involving 3,160 women with a laboratory confirmed diagnosis of CIN2 who were actively monitored for at least three months.
Researchers said differences between the studies and possible misclassification of some lesions meant the findings “should be interpreted with caution.”Dr Kyrgiou said: “Most CIN2 lesions, particularly in women aged less than 30, regress spontaneously. Active surveillance, rather than immediate intervention, is therefore justified, especially among young women who are likely to adhere to monitoring.”
Professor Maggie Cruickshank at the University of Aberdeen, said women should be given an in formed choice. In a linked editorial, she wrote: “Knowing that the chance of regression is 50-60%, still means taking a gamble that surveillance is simply delaying treatment. Even a small risk of cancer may still be unacceptable to some,” she said.
The study found that after two years, 50 per cent of the lesions had regressed spontaneously, 32 per cent persisted, and 18 per cent progressed to CIN3 or worse. In women aged under 30, 60 per cent of cases went back to normal, 23 per cent remained the same with progression in 11 per cent of cases.
In total just 15 cases of cancer, were reported - 0.5 per cent of the full sample, mostly in women over the age of 30, the study found.
March 4th 2018
How to spot the signs of ovarian cancer
Each year in the UK 7,300 women are diagnosed with ovarian cancer and 4,100 die from the disease.
Statistics show that around 65% of UK women aren't confident about spotting the common signs of ovarian cancer, despite it being the fifth biggest cancer killer in the UK and the sixth most common cancer in women.
Research conducted by BMI healthcare suggests that 40% of women claim to experience symptoms similar to those of ovarian cancer, but 70% of these did not seek medical opinion. In addition, it was found that one in five didn't know any ovarian cancer symptoms.
So, to boost knowledge and mark the start of Ovarian Cancer Awareness month, we've teamed up with Mr Jafaru Abu, Consultant Gynaecological Oncology Surgeon at BMI The Park Hospital in Nottingham, to answer some of the most common questions about the condition.
What are the symptoms of ovarian cancer?</h3>
Pain in the lower abdomen or side
Irregular periods or vaginal bleeding after menopause
Bloated, full feeling in the abdomen
A swollen abdomen
Pain during sex
Feeling of fullness or loss of appetite
Passing urine more often than usual
Feeling or being sick
"It is wrong to say that ovarian cancer is a 'silent killer'. It isn't. About 95% of women with ovarian cancer do report symptoms. The only problem is that most of the symptoms are vague and could be non-gynaecological. The common symptoms include abdominal bloating (increased girth), feeling full quickly after small meals and difficulties eating, fatigue, bowel related symptoms or change in bowel habit such as constipation and diarrhoea, urinary symptoms, abdominal/pelvic pain, and menstrual irregularities, loss of appetite and loss of weight."
What kind of women are most at risk of ovarian cancer?
"There is a strong association between ovarian cancer and age. The incidence rises exponentially from 35-40, peaking at around the age of 80. In the UK, about 75% of all ovarian cancers are diagnosed in women above the age of 55. About 20% are related to some major life style patterns such as hormone replacement therapy, exposure to asbestos, tobacco smoking, irradiation, strong family history (about 3% of cases occur in those with ovarian cancer in their families), infertility, personal history of cancer and genetic factors (5-15% of ovarian cancer cases are due to inherited conditions, majority of which are due to BRCA1 and 2 mutations)."
If there is a family history of ovarian cancer, should extra precaution be taken?</h3>
"The risk of ovarian cancer is three times higher in those whose mother or sister either has or has had ovarian cancer compared with women from families who have not had the disease. There is no nationwide screening for ovarian cancer. However, women who are at risk or have a family history may be offered an annual scan as well as a blood test called CA125. The latter is an ovarian cancer tumour marker and is raised in about 80% of cases. However there is no evidence so far that these tests can pick up cancer early to save lives. For instance, CA125 is only raised in about 50% of women with the early stage disease. The advice is that if you think you are at an increased risk of ovarian cancer, you should talk to your GP."
How is ovarian cancer detected?
"If you think you have any of the symptoms of ovarian cancer, you should see your GP who will examine you first and then may order some blood tests, which will usually include CA125. If the result of the blood test and the examination suggests you may have ovarian cancer, your GP will then refer you to a specialist in gynaecological cancer. Your specialist will again examine you and may arrange some imaging investigations such as an ultrasound scan or computed tomography (CT) scan. These investigations should give your specialist a good idea as to whether you may have ovarian cancer or not and be able to proceed to the next stage of your management."
Feb 27th 2018
Breast cancer care inequality puts lives at risk
Women face "unacceptable differences" in breast cancer care across England caused by variations in screening, the availability of drugs and a staffing crisis, a new report has concluded.
The All Party Parliamentary Group (APPG) on Breast Cancer found "stark" variations in the standard and availability of care across England, sometimes within the same town or region.
Marked differences in the volume and effectiveness of screening means that some women are far more likely to have their cancer diagnosed early.
In areas with complete diagnosis records for at least nine out of 10 women, Rushcliffe covering Nottingham was the best-performing area with 88% of breast cancers identified at stage 1 or 2. Gloucestershire on the other hand was the worst performing with just 62%.
In Slough, just 32% of breast cancers were identified at stage 1 or 2, but the area only has complete records of the diagnosis path of 40% of cases so was not highlighted by the report.
In some areas only just over half of women take up invitations for screening compared with four in five women in other parts of the country.
In addition, life-saving drugs are not offered evenly across the country, and some women receive the care of specialist nurses unavailable elsewhere.
Workforce shortages are also a significant factor, with 13% of all radiology posts currently vacant, and one in five radiographers due to retire within the next five years.
The result, the report found, is that some women are more than twice as likely to die from breast cancer under the age of 75 based on where they live.
In a joint statement, MPs Thangam Debonnaire, Craig Tracey and Dr Philippa Whitford, who co-chair the All-Party Parliamentary Group on Breast Cancer, said: "Our inquiry has uncovered a concerning postcode lottery in screening uptake, early diagnosis and access to breast cancer services across England"This variation in NHS services can have a devastating impact on patients' lives and must be addressed.
"In particular, the demographic time bomb facing the breast cancer workforce poses a worrying threat to the significant progress made in recent decades.
"We now urgently need to bring the worst performing areas in line with the best. While such inequalities exist, we cannot hope to meet the Government's ambition of world-class outcomes for all NHS cancer patients."
Baroness Delyth Morgan, chief executive at the charity Breast Cancer Now, added: "All women with breast cancer deserve the best possible chance of surviving and living well, no matter where they live, their age or the colour of their skin.
"This alarming report shows many women are missing out on the best breast cancer care this country has to offer, and this is totally unacceptable."
Public Health Minister Steve Brine said: "We have made huge progress on tackling cancer with survival rates at a record high.
"Our NHS breast screening programme is estimated to save 1,300 lives a year alone, but we know we need to go further. That’s why we’ve committed £200m to find innovative ways to drive earlier diagnosis and support people living with and beyond cancer so we can reach our goal of saving a further 30,000 lives a year by 2020.”
Feb 25th 2018
Irish oesophageal cancer rates remain among the highest in Europe
NEW DATA HAS revealed high success rates in curative approaches to the treatment of oesophageal cancer, as the 17th Lollipop Day approaches.
Barrett’s Oesophagus is a condition that is frequently a precursor to full-scale cancer.
The National Registry & Biobank for Barrett’s Oesophagus patients, which links six Irish hospitals, helps identify at-risk persons earlier and track their progress with regular surveillance, using endoscopies and bioscopies. The Registry is funding by the Oesophageal Cancer Fund (OCF).
Since 2010, the national data has revealed that of 6,000 patients, some 1033 (18%) at first diagnosis with Barrett’s had worrisome changes in their condition, with 5% having early cancer.
On follow-up for an average of four years, 20% of patients who had no worries from the first scope developed concerning changes, just over 15.7% were found with dysplasia and no cancer, and 4.3% were found with high-grade dysplasia or cancer.
In patients with low-grade changes – dysplasia – on first scope, 33% progressed to cancer in the follow-up.
Suitable patients who are monitored on the Registry can then receive endotherapy - curative approaches to treatment that may heretofore have been treated with major surgery to remove the oesophagus.
Endotherapy can minimise or prevent abnormal cells from developing into a cancerous condition of the oesophagus.
The data collected by the Registry has found that 264 patients with worrisome changes in their Barrett’s Oesophagus condition have undergone endotherapy.
In this period, 100 patients had their oesophagus removed for early cancers. Of these, 60% went straight to surgery as not suitable for endotherapy.
30% had attempted treatment with endotherapy which showed features demanding oesophageal surgery.
In just 10 patients (10%) did endotherapy fail and their cancer relapsed, leading them with no choice but major surgery.
Irish oesophageal cancer rates remain among the highest in Europe with a 25% increase in cases of the disease over the last two decades here, and around 450 new diagnoses a year.
However, the above outcomes show a large success rate to date as a result of the curative approaches to treating cancer that is caught early.
The 17th annual Lollipop Day, run by the OCF, takes place on the 23-24 February.
Lollipop Day is the charity’s main fundraising event every year. Hundreds of volunteers sell lollipops throughout Ireland during the event to help raise funds for the charity.
The lollipops were chosen as the emblem for the campaign to highlight the most comment symptom of suspicion of oesophageal cancer – difficulty swallowing.
“Improving patients’ quality of life and providing support are our priorities and the OCF is proud to be part of a national effort which makes treatment accessible and is always pushing the boundaries and progressing options,” Noelle Ryan, chief executive of the OCF said.
Feb 18th 2018
Prostate cancer: The two drugs that can radically delay the spread of the disease
They are among the most challenging prostate cancer patients to treat: about 150,000 men worldwide each year whose cancer is aggressive enough to defy standard hormonal therapy, but has not yet spread to the point where it can be seen on scans.
These patients enter a tense limbo that often ends too quickly with the cancer metastasising to their bones, lymph nodes or other organs – sometimes causing intense pain.
Now, for the first time, researchers have results from two independent clinical trials showing that two different drugs help these patients – giving them about two more years before their cancer metastasises. That means two additional years before pain and other symptoms spread and they need chemotherapy or other treatments.
“We’re going from rags to riches,” says Dr Judd Moul, a professor of surgery and director of the Duke Prostate Centre, who was not involved in either study. “Up until now, we haven’t had anything for these guys. We just had to tell them ‘We’ll keep an eye on it.’”
The studies, each involving more than 1,200 patients in countries around the world, were presented last week at the Genitourinary Cancers Symposium in San Francisco. They used very similar drugs – both androgen receptor inhibitors, which block testosterone from binding to prostate cancer cells and entering them.
The study of an experimental drug called apalutamide was published in the New England Journal of Medicine. The other study of a drug called enzalutamide, currently approved for treating prostate cancer that has already metastasised, has not yet been peer-reviewed for publication.
Prostate cancer is the second most common cancer in men worldwide. There were 1.1 million new cases and about 307,000 deaths in 2012, according to the most recent data available from the World Health Organisation.
The patients in both studies were men who had previously received some treatment for prostate cancer, such as surgery or radiation, but who later began to show rapid increases in their prostate-specific antigen or PSA, a protein associated with prostate cancer. They did not respond to the standard treatment to suppress testosterone, called androgen deprivation therapy.
Each year, about 150,000 worldwide fall into this category, called nonmetastatic castration-resistant prostate cancer. (The medical term for blocking male hormones is chemical castration.) Globally, about 200,000 of the 4 million men with prostate cancer are estimated to have this diagnosis, says Dr Matthew Smith, director of the Genitourinary Malignancies Program at Massachusetts General Hospital’s Cancer Centre, who was a leader of the apalutamide study.
In the studies, two-thirds of the men took one of the androgen receptor inhibitors, while a third took a placebo. They all continued to receive androgen deprivation therapy.
In the study of men receiving apalutamide, it took, on average, 40.5 months for cancer to spread to the point where it could be detected by conventional scans. For men receiving the placebo, the cancer spread in 16.2 months, on average. In the enzalutamide study, metastasis took 36.6 months on average in men receiving that drug compared with 14.7 months with placebo.
“Delaying median time to metastases by over two years is a big deal,” says Dr Scott Eggener, a urologic oncologist and professor of surgery at University of Chicago, who was not involved in the studies. He says the studies were also important scientifically because they show that “maximally decreasing testosterone production and its ability to bind or enter cancer cells leads to meaningful clinical improvement for these men.”
Still, he says, while the studies both show preliminary indications that the drugs might extend patients’ survival, researchers will have to follow the patients longer to know.
Both studies were funded by the companies that make the drugs. Janssen Pharmaceutical Cos. of Johnson & Johnson, the maker of apalutamide, has applied for approval from the Food and Drug Administration, which has put it under priority review, Smith says.
The developers of enzalutamide, Pfizer and Astellas Pharma, have applied to the FDA for approval to expand the use of the drug, marketed as Xtandi, to patients in this category, says Dr Maha Hussain, deputy director of the Robert H Lurie Comprehensive Cancer Centre at Northwestern University’s Feinberg School of Medicine. She co-led that study with Dr Cora Sternberg, chief of medical oncology at San Camillo and Forlanini Hospitals in Rome.
Both drugs appear to be safe with relatively few serious side effects, experts say. Negative effects for some patients included fatigue, hypertension, rashes, fractures, falls, nausea, and mild cognitive and memory slippage.
Ron Scolamiero, 72, of Marshfield, Massachusetts, a patient of Smith’s, began taking apalutamide in 2012 for an earlier phase of the clinical trial. He still takes a four-pill dose daily.
In the drug’s initial formulation, side effects included hot flashes, diarrhoea and nausea, but those diminished greatly after it was reformulated, says Scolamiero, who owns a financial services company. About 18 months ago, a tumour that had developed at the site of his prostate had to be removed, but his cancer has not metastasised to other parts of his body.
“It’s controlled my cancer,” he says. “I’m so grateful.”
Still, some experts say enthusiasm about the new drugs should be tempered by other changes occurring in the prostate cancer landscape.
“I don’t want to say this is the best thing since sliced bread – it’s not,” says Dr Oliver Sartor, medical director of Tulane Cancer Centre. “You’re taking a person with no symptoms and potentially giving them side effects, definitely giving them an expensive drug. And it is unclear if this is the optimal management of these patients.”
The current list price of enzalutamide is more than $10,000 (£7,200) a month; a price hasn’t been set for apalutamide, which is not yet on the market.
Sartor and others noted that another androgen receptor inhibitor, abiraterone, which is used to treat cancer once it metastasises and is also produced by Janssen, is likely to go off-patent soon and will therefore become much cheaper because generic versions will be produced. Since abiraterone operates on the same biological pathway, experts expect that it will be tried for patients with cancer that has not metastasised and could end up working as well.
Increasingly sophisticated imaging techniques are allowing doctors to spot previously undetectable signs of metastasis. While some patients in these trials might have had cancer spread that was not detected by conventional scans, Smith says what matters is that they were early in the cancer trajectory and the drug helped them stay in that early state longer.
The two new studies did not compare the drugs against each other, only against a placebo. “You can look at that as being a challenge for physicians,” says Dr Ian Thompson Jr, president of Christus Santa Rosa Hospital-Medical Centre in San Antonio. “You can also look at that as being an advantage for the patient.”
Besides giving patients options, Hussain says, having both apalutamide and enzalutamide “opens up the door for more investigation to happen to even prevent this disease stage from happening in the first place”.
Feb 14 2018
New mum's crippling stomach pains were actually 'deadliest form of cancer'
A new mum who suffered crippling stomach pains just weeks after giving birth was horrified to discover she actually had the 'deadliest form of cancer'.
Amy Blackrock, 28, was terrified for her two young children’s futures after falling ill with pancreatic cancer - which kills four in five sufferers within a year.
She was diagnosed just weeks after giving birth to her second daughter Annabelle in January last year and needed chemotherapy and two life-saving operations.
One year on, Amy is now in recovery and has shared her story to raise awareness of a cancer.
The mum, from Kirkby, said: “I was feeding Annabelle at 5am in the morning, and was vomiting with really bad pains in my abdomen - worse than childbirth.
“I couldn’t breathe and they put me on morphine in intensive care in hospital.
“I had the illness again five weeks later, and my skin started turning yellow with jaundice.
“They thought a growth on my pancreas was a cyst but it turned out to be a cancerous tumour seven centimetres long and five centimetres wide.
“I had a sense it might be cancer, but I felt like my whole world would fell apart when I found out.
“I kept looking at my children, thinking - am I going to be here to see them grow up?
“Nothing matters apart from getting through it, you start only caring about your kids, family and life.
“I saw the diagnosis on the notes the doctor had left by my bed before they came in to tell me. There’s no good way to find out, but that wasn’t the best way to hear it.
Amy, who also has son Jack, said she felt lucky to have survived “the worst form of cancer you can get”, with the lack of symptoms in its early stages making it a hard disease to diagnose until it is often too late.
She told the Liverpool Echo: “I’m a bit of a freak case. I’m the oldest by about 30 years at my clinic, and they think I’m one of the youngest in the world.
“It’s really bizarre to face your mortality at 28. But I was lucky it hadn’t spread despite its size.
“My kids are the reason I could keep going, and my partner, who has given up work for now to look after me.”
Her partner Anthony Seddon, 31, proposed to Amy just before her operation, saying he wanted to her to go in knowing she would come out and get married.
The journalist and PR professional admitted: “I was absolutely delighted - but I thought he was joking at first.”
The surgery to remove the tumour saw Amy left with only half her pancreas and with no gall bladder.
She suffered a “life-threatening bleed” shortly afterwards at home when an artery burst, but pulled through and praised pancreatic specialists at the Royal.
She added: “The operation was completely successful, and I’m now in remission, and currently cancer-free.
“At the moment I can’t digest food as well as other people - so I have to take tablets every time I eat. I lost about three-and-a-half stone from the damage to the tumour and chemo, but I’ve but some back on.
“I wore a wig though, as it was my safety blanket.
“I still have some chemotherapy - one last burst. I lost a lot of my hair from the treatment, and it came back really thick and curly. I look like a ketwig.
“But I’m hoping to go back to work soon, and I’m getting back to normal.”
The causes of pancreatic cancer are not widely understood, but illnesses like pancreatitis, diabetes and stomach ulcers can increase the risk.
It mainly affects people older than 50, and one in three cases is linked to smoking.
Symptoms include pain in the stomach or back area which may come and go, unexpected weight loss, jaundice, bowel changes, fever, indigestion and blood clots.
But NHS chiefs say these symptoms can be caused by many different conditions, and suggest contacting your GP if concerned or the symptoms start suddenly.
Pancreatic cancer is the fifth most common cause of cancer death in the UK, according to Cancer Research UK.
Feb 11th 2018
A model has warned people about the dangers of using sunbeds after being forced to have several moles removed.
Ella Ravenscroft is a 20-year-old model and high-definition brow technician from Manchester who’s signed with Nemesis Model Agency.
She believed using sunbeds was harmless… until moles appeared on her body as a result.
Ravenscroft has now had to have her moles surgically removed, which has left scars all over her body.
Sunbeds emit ultraviolet rays that can drastically increase your risk of developing skin cancer.
According to the NHS, sunbeds can give out ultraviolet rays that are stronger than those emitted by the sun during the hottest time of the day.
Ravenscroft has shared her story on Facebook in order to spread the message that using sunbeds is extremely inadvisable.
“Girls/boys this is why it’s really important NOT to use the sunbeds, I had two tiny moles on my tummy that have grown due to using sunbeds!” she wrote.
“Never thought this would happen as I didn’t realise it was possible but they’ve now had to be replaced by scars.
“Just want to make people more aware how dangerous they are as you don’t think something as little as a mole could cause cancer.”
Ravenscroft has had to have several moles removed, including two on her stomach, one on her back and one below her breast.
“If your moles feel itchy or grow make sure to get them checked out!” Ravenscroft advised.
“Better to be safe than sorry.”
One of the main causes for melanoma, which is a type of skin cancer, is excessive exposure to ultraviolet light, which means that sunbeds pose a great risk.
If you develop a new mole or spot an area of your skin changing, it’s worth visiting a doctor to get checked.
Cancer Research UK also advises going to see a medical professional if you notice a mole that’s enlarging, irregularly shaped, changing colour, asymmetrical, itchy, bleeding or inflamed.
The International Agency for Research on Cancer has concluded from a number of studies that using sunbeds can increase your risk of melanoma by as much as 16 to 20 per cent.
Feb 9th 2018
'Should I stop eating asparagus to stop cancer's spread?'
An amino acid found in asparagus could be responsible for the spread of breast cancer, according to a new study. So should you stop eating it?
Scientists discovered that restricting an amino acid called asparagine stopped cancer cells from invading other parts of the body in mice.
Amino acids are the building blocks that cells use to make proteins. The body can make asparagine, however it’s also found in high concentrations in foods like asparagus, seafood, soy, dairy and poultry products.
Despite the startling findings, researchers and breast cancer experts agree that people with cancer and the general public should not stop eating asparagus or other products rich in asparagine.
Baroness Delyth Morgan, chief executive at Breast Cancer Now, said in a statement: “On current evidence, we don’t recommend patients totally exclude any specific food group from their diet without speaking to their doctors.”
How does cancer spread?
The place where a cancer starts in the body is called the primary cancer or primary site, according to Cancer Research UK. Cells from the primary site may break away and spread to other parts of the body through the bloodstream or lymphatic system. There they can start to grow into new tumours. This is known as metastases or secondary cancer.
Most breast cancer patients do not die from their primary tumour, but from the spread of cancer to the lungs, brain, bones or other organs. Currently, around 11,500 women die from breast cancer each year in the UK. Finding ways to stop this from happening is therefore fundamental to increasing survival.
How did researchers stop it from spreading?
Researchers at the Cancer Research UK Cambridge Institute did two things: they put the put the mice on a low-asparagine diet and were able to block the body’s production of asparagine with a drug called L-asparaginase.
Both of these changes greatly reduced breast cancer’s ability to spread.
Interesting, the drug L-asparaginase is already used to treat acute lymphoblastic leukaemia, which is dependent on asparagine. Professor Charles Swanton, Cancer Research UK’s chief clinician, said in response to the study: “It’s possible that in future, this drug could be repurposed to help treat breast cancer patients. The next step in the research would be to understand how this translates from the lab to patients and which patients are most likely to benefit from any potential treatment.”
Could this apply to other types of cancer?
Researchers examined data from breast cancer patients, which showed the greater the ability of breast cancer cells to make asparagine, the more likely the disease was to spread. In several other cancer types, increased ability of tumour cells to make asparagine was found to be associated with reduced survival.
In future, the scientists believe that alongside conventional treatments like chemotherapy, breast cancer patients could be given a diet in hospital that restricts asparagine to help stop the disease spreading and improve outcomes. However more research needs to be done to confirm this.
They said their findings could also have implications for other cancer types, including kidney, and head and neck cancers.
So should you give up asparagus?
In short, no. Martin Ledwick, Cancer Research UK’s head nurse, said: “At the moment, there is no evidence that restricting certain foods can help fight cancer, so it’s important for patients to speak to their doctor before making any changes to their diet while having treatment.”
While asparagine is investigated further by scientists, Baroness Delyth Morgan, chief executive at Breast Cancer Now, encourages cancer patients to follow a healthy and varied diet rich in fruit, vegetables and pulses, and limited in processed meat and high fat or sugar foods.
This, she said, will “help give them the best chance of survival”.
Feb 1st 2018
‘Life-changing’ breast cancer drugs given final go-ahead for routine NHS use
A ‘life-changing’ drug for breast cancer patients has been given the final go-ahead for routine NHS use in England.
The National Institute for Health and Care Excellence (Nice) issued its final decision recommending Perjeta, also known as pertuzumab, for some women with breast cancer.
Nice has recommended the drug for use for women who have HER2-positive breast cancer which has returned to the breast but is inoperable, or where it has spread to other parts of the body.
When combined with other medication, users have been shown to survive for 16 months longer than those only using the current standard pills.
Around 53,000 cases of breast cancer are diagnosed every year in the UK, and up to 25% of cases have HER2-positive disease.
Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: “This is the best news patients with HER2-positive breast cancer and their doctors could have hoped for.
“Perjeta is a truly life-changing drug and we are absolutely delighted and relieved that Nice has finally been able to recommend it for routine NHS use in England.
“Perjeta’s benefits are extraordinary, offering women with incurable metastatic breast cancer over four-and-a-half years to live - nearly 16 precious extra months with their loved ones compared to existing treatments.”
The drug could previously only be accessed through applications to the Cancer Drugs Fund.
Manufacturer Roche said the move ends years of uncertainty over how the treatment would be funded in the long term.
General manager Richard Erwin said: “These are positive examples of how solutions can be reached when all parties show flexibility.
Jan 23rd 2018
Six early signs of cervical cancer to look out for, according to a doctor
In the UK, up to nine women per day are diagnosed with cervical cancer. On average, a third of these women lose their lives to the disease.
This type of cancer is most common for women under 35, but luckily is can be prevented and effectively treated with regular smear tests available to women over 25 as well as HPV vaccinations.
This week it’s Cervical Cancer Prevention Week so the Standard spoke to Dr. Jan Schaefer, Chief Medical Officer at MEDIGO to find out more about detecting early signs.
What are the earliest signs of cervical cancer?
During the early stages of cervical cancer, you may not see any symptoms at all.
Dr Schaefer explained: “The first to appear are typically unusual discharge or bleeding. As the cancer progresses, some other subtle signs might include constipation, blood in the urine, loss of appetite or fatigue. However, it is important to note that these signs alone are not indicative of cancer but, if they are, they won’t be warning signs but symptoms of the cancer progressing.
“This is why it is so important to attend your screenings regularly. In the UK, screenings are routinely offered to women from the age of 25 and repeated every three years.”
Below are six subtle symptoms of cervical cancer.
1. Vaginal discharge that is unusual in terms of smell, colour or amount
2. Abnormal bleeding between periods
3. Bleeding after intercourse
4. Increased menstrual bleeding
5. Pelvic pain
6. Pain during intercourse
While these symptoms don’t necessarily point to cervical cancer, they are reason enough to see your GP.
What should you do if you think you have cervical cancer?
The first thing you need to do is make an appointment with your GP.
Dr Schaefer said: “The GP can then conduct a screening, which means that any cell changes can be caught before they become cancerous, or at the earliest stages.
“In the UK, the NHS offers cervical screening for women aged between 25 and 49 every three years, while women aged between 50 and 64 can be screened every five years. Those aged over 65 who have been screened in the past no longer need to be screened.
“A pap screening allows the doctor to test for any cell changes and deal with potential cancerous cells before they become cancerous, while an HPV test screens for the most common risk factor for cervical cancer, HPV. This is a sexually transmitted infection that can lead to cell changes and eventually to cancer. An HPV test can also be used in cases where a pap screening is inconclusive.”
Is there any way to prevent cervical cancer?
While there is no way to completely prevent cervical cancer, there are some things you can do to decrease your chances of developing it.
“Girls between the ages of 12-13 are offered the cervical cancer vaccination, which protects against four types of HPV,” Dr Schaefer said. “While the vaccine doesn’t guarantee that you will never develop the cancer, it does reduce the risks.
“Practising safe sex can also decrease your chances of developing cervical cancer, as HPV, spread through sex and sexual contact, is linked to cervical cancer. Lastly, smoking can increase your risks of developing cervical cancer, for smokers are less able to rid the body of the HPV infection.”
If you think you might have symptoms relating to cervical cancer, make an appointment with your GP
Jan 22nd 2018
'Embarrassed' women avoiding smear tests due to body fears
Young women are not attending smear tests because they are embarrassed about their bodies, a cancer charity has warned.
Jo's Cervical Cancer Trust said it was concerned that body image issues, including the perception of what is "normal," could be putting women's lives in danger.
One in four eligible women (aged 25-64) do not attend smear tests, the charity warned as it emerged figures shot up to one in three among 25-29 year olds.
It is even as high as one in two in some areas of the UK.
The charity conducted a survey which found that more than a third of women (35 per cent) are failing to get tested because of their body shape, while 34 per cent were worried about the appearance of their vulva.
Concerns over smelling "normal" (38 per cent) was also a factor.
A poll of women aged between 25 and 35 also found a third (31 per cent) admitted they would not go if they had not waxed or shaved their bikini area.
But despite low screening attendance, almost every woman (94 per cent) said they would have a free test to prevent cancer if one was available.
The charity is releasing the data at the start of Cervical Cancer Prevention Week and as it launches its smear test campaign #SmearForSmear.
It is also concerned that not enough is being done to increase attendance, with a third of local authorities and Clinical Commissioning Groups in England not having done so in the last year.
Lindsay was diagnosed with cervical cancer at 29 after ignoring invitations for a smear test.
She said: "I was too busy with a baby and a small child, working, and I didn't like the thought of having to get naked in front of anyone I didn't know.
"I don't want other women to have to go through what I experienced, diagnosis and treatment was awful.
"I needed a radical hysterectomy and still struggle with some side effects of treatment today.
"Please don't put off your smear test, the alternative is so much worse."
The charity's chief executive, Robert Music, said: "Smear tests prevent 75 per cent of cervical cancers so it is a big worry that so many young women, those who are most at risk of the disease, are unaware of the importance of attending.
"It is of further concern that body worries are contributing to non-attendance.
"Please don't let unhappiness or uncertainty about your body stop you from attending what could be a life-saving test.
"Nurses are professionals who carry out millions of tests every year, they can play a big part in ensuring women are comfortable."
Cervical cancer is the most common cancer in women under 35, yet the poll of 2,017 women found three out of five (61 per cent) were unaware they were in the most at-risk age group for the disease.
Just under 1,000 women die from cervical cancer every year in the UK.
Jan 19th 2018
Doctors take 'critical' step towards universal blood test for cancer
A newly developed single blood test has the potential to change the way doctors screen for cancer, researchers have said.
Scientists at Johns Hopkins University in the US have developed a test that screens for eight common forms of cancer and helps identify the location of the disease.
The test, called CancerSEEK, looks for mutations in 16 genes and evaluates the levels of eight proteins usually released by cancer sufferers.
The researchers said overall the test's ability to find cancers was successful 70% of the time - and ranged from a high of 98% for ovarian cancer to a low of 33% for breast cancer.
Nickolas Papadopoulos, senior author and professor of oncology and pathology, said: "The use of a combination of selected biomarkers for early detection has the potential to change the way we screen for cancer, and it is based on the same rationale for using combinations of drugs to treat cancers."
Cristian Tomasetti, associate professor of oncology and biostatistics, said the test is unique because it looks for both mutated DNA and proteins.
He said: "A novelty of our classification method is that it combines the probability of observing various DNA mutations together with the levels of several proteins in order to make the final call."
The test was evaluated on 1,005 patients with cancers of the ovary, liver, stomach, pancreas, esophagus, colorectum, lung or breast.
Professor of oncology Bert Vogelstein said that although the test does not spot every cancer, it identifies many cancers that would likely otherwise go undetected.
He said it could be a great step towards early detection of the disease and ultimately save lives.
"Many of the most promising cancer treatments we have today only benefit a small minority of cancer patients, and we consider them major breakthroughs. If we are going to make progress in early cancer detection, we have to begin looking at it in a more realistic way, recognising that no test will detect all cancers," he said.
"This test represents the next step in changing the focus of cancer research from late-stage disease to early disease, which I believe will be critical to reducing cancer deaths in the long term."
Jan 13th 2018
‘What is cancer?’: Answering the most Googled health question of 2017
With more information at our fingertips today than our brains can possibly process, it’s no surprise that many of us consult “Dr Google” about our ailments. And according to experts from Google, the health question people in the UK asked most in 2017 was: What is cancer?
Cancer rates continue to climb. Today 1 in 2 of us in the UK will be diagnosed at some point in our lives. So it makes sense that people want to know more about a topic that will undoubtedly touch all of us in one way or another. And although the internet can be a useful source of information, if people have symptoms they’re worried about then they should visit their GP for advice. But with the internet being so easily accessible, it’s no surprise that people are also seeking answers online.
So what were people presented with when they tapped those three words into their keyboards? A staggering 26,000,000 results. That’s an overwhelming amount of information.
Thankfully, those asking the question don’t have to browse far to find decent answers. Cancer Research UK sits among the top results, with a website dedicated to bringing readers the most accurate and up to date evidence-based information on the subject, from trials and treatments to pages sorting fact from fiction.
When it comes to health, gathering information from reliable, easy to understand sources such as this is critical. Choices regarding health and medicine can have profound impacts on a person’s life and wellbeing. So these decisions should be based on the best available evidence. Unfortunately, there are far too many websites that don’t offer this.
Search the internet for long enough and soon you’ll be enveloped in conspiracy theories and quack ideas about the supposed causes of and cures for cancer. These can look very convincing at first glance, too. For example, some websites claim that cancer is a disease caused by eating an overly ‘acidic’ diet, and therefore eating what’s claimed to be healthier so-called ‘alkaline’ foods can cure people.
This unfounded idea, alongside many others, has been thoroughly debunked.
So, what really is cancer?
The word ‘cancer’ may be singular, but it reflects much more than just one disease. More accurately, it’s a term spanning hundreds of diseases. They all share a fundamental characteristic though: rogue cells growing out of control, overcrowding healthy tissues. Another defining feature is that cancers are caused by faulty DNA, allowing cells’ control systems to go haywire and permit this unregulated division.
While different types of cancer may share similarities, research is showing that each person’s individual cancer is unique and presents its own set of challenges. That’s why it’s extremely unlikely that there will be one single cure against all cancers. This means researchers have their work cut out to thwart these diseases. But that isn’t reason to give up hope. Far from it.
Thanks to research, many cancers can already be cured. Testicular cancer for example is very sensitive to chemotherapy drugs, and most cases can be cured.
Today, survival for testicular cancer is as high as 98%, and that’s just one example among many others.
More research will give us a greater chance of developing new ways to treat and cure more people’s cancer. And also a greater understanding of cancer in all its forms. So while we may have a textbook definition of cancer, there is much still to be learned about this complex disease. That’s why Cancer Research UK exists, and why we won’t stop until we reach the day that all cancers can be cured.
If anyone has questions about cancer they can call our dedicated nurses helpline, free phone 0808 800 4040, or email firstname.lastname@example.org
Jan 8th 2018
Women who work nights are more at risk of cancer - and it's higher for nurses
Women who work nights are more at risk of cancer than those who do days, a study claims.
Researchers looking at reviews done exclusively on women found skin cancer cases up by almost half in those who did the shifts long-term.
They found cases of breast cancer up by a third, and stomach cancer by nearly a fifth.
For nurses the increase was even worse, with cases of breast cancer 58% higher than in those who only worked days.
And lung cancer cases in night-shift nurses were higher by a quarter.
Assistant professor Xuelei Ma said: “Our study indicates night shift work serves as a risk factor for common cancers in women. The research, at Sichuan University in China, used data from 61 different studies covering nearly four million people across North America, Europe, Australia, and Asia.
“Long-term night shift workers should have regular physical examinations and cancer screenings.”
She said the increased risk in nurses could be down to more intensive shifts – or because nurses are more likely to seek check-ups.
Prof Ma also revealed the increased breast cancer risk across all professions was only found in North America and Europe.
She said: “We were surprised. It’s possible women in these locations have higher sex hormone levels.”
Jan 6th 2018
This virus could effectively treat brain tumours and cancer
Scientists have found that a naturally occurring virus could be used to treat people with aggressive brain tumours by drastically boosting the immune system.
The study, which has been published in Science Translational Medicine, found that reovirus was able to cross the blood-brain barrier where it would then replicate and kill the cancerous cells.
Up to now, scientists believed it would be impossible for a virus to cross through the blood-brain barrier, making it significantly more difficult to administer the virus as a form of treatment.
However the results of the study have shown that the virus can be administered through a simple intravenous drip and can then travel up to the brain.
In addition to attacking the cancer cells the team also found that the virus was able to ‘switch-on’ the body’s immune system which could then attack the cancer.
This second point is significant.
'Our immune systems aren’t very good at ‘seeing’ cancers ― partly because cancer cells look like our body’s own cells, and partly because cancers are good at telling immune cells to turn a blind eye. But the immune system is very good at seeing viruses.' explains Co-lead author Alan Melcher, Professor of Translational Immunotherapy at The Institute of Cancer Research, London.
'In our study, we were able to show that reovirus could infect cancer cells in the brain. And, importantly, brain tumours infected with reovirus became much more visible to the immune system.'
The study itself involved nine patients. Each of them had cancers that had either spread to the brain from other parts of the body or were gliomas, a type of brain cancer that’s very difficult to treat.
All nine were due to have their tumours removed surgically, however in the days leading up to the operation they were given the virus through a drip.
After the surgery they looked at tissue samples from the nine patients and then samples from other patients who had had the surgery but not the virus drip.
Despite it being such a small sample, the results of the study were so conclusive that a clinical trial is already underway.
'Now we know we can get reovirus across the blood-brain barrier, we have begun clinical studies to see just how effective this viral immunotherapy can be at extending and improving the lives of patients with brain tumours, who currently have very limited treatment options available to them.' explains Professor Melcher.
Leading the clinical trial is Susan Short, Professor of Clinical Oncology at the University of Leeds. She said:
'Brain cancer is a devastating disease. For a long time, there have not been many new developments that we could offer patients but the research that is happening at the University Leeds and elsewhere is beginning to offer a new approach.'
Jan 4th 2018 1st item
Eating bacon and sausages increases the risk of breast cancer in older women, a study has found.
Scientists discovered the strongest evidence yet that there is a connection between processed meats and breast cancer. They said that the food could account for 1 in 6 cases of the disease.
Middle aged women who eat more than 9g of sausages and bacon per day were approximately 20 per cent more likely to develop breast cancer than those who avoid processed meats.
In younger women, there was no connection found between the meats and breast cancer.
The World Health Organisation already classifies salted, cured and fermented meats as being a leading cause of bowel cancer.
Researchers at the University of Glasgow analysed more than 260,000 middle-aged British women for the study and found that processed meats could have been behind hundreds of avoidable cases of breast cancer per year.
The findings which were published in the European Journal of Cancer, showed that women who ate small portions of processed meats infrequently were still 15 per cent more likely to develop breast cancer.
Naveed Sattar, professor of metabolic medicine at Glasgow, told The Sun: “My public health advice for women would be: if you’re particularly concerned about breast cancer, then it might be another incentive to improve your quality of diet by eating less processed meats.”
Dr Jasmine Just from Cancer Research UK said that the study does not conclusively suggest a link between processed meats and breast cancer as it “didn’t take into account other important factors that affect breast cancer risk like screening and family history.”
However, she said: “The best ways to reduce the risk of breast cancer are to keep a healthy weight, cut down on alcohol and be physically active.
"Eating a lot of processed meat does increase the risk of bowel cancer though, so while the odd salami sandwich won’t do much harm, it’s still a good idea to cut down where you can.”
Jan 4th 2018 2nd item
Link between drinking and cancer proved by scientists
Drinking causes cancer by permanently damaging genes, according to new research.
Scientists have shown for the first time how alcohol breaks up the DNA in the blood's stem cells - changing its sequence.
The breakthrough finally explains the link between booze and seven types of tumour - including those of the mouth and throat, liver, colon, bowel and breast.
It has been estimated almost six percent of all cancer deaths worldwide could be attributed to alcohol.
Even light drinking can slightly raise a woman's risk of breast cancer. Heavy drinkers face much higher risks of mouth and throat cancer, cancer of the voice box, liver cancer and, to a lesser extent, colorectal cancers.
But scientists have remained unsure exactly why - until now.
Previous research looking at the precise ways in which alcohol causes cancer has been done in cells grown in the lab.
But the latest study published in Nature used mice to show how alcohol exposure leads to irreperable genetic damage.
A team at the MRC (Medical Research Council) Laboratory of Molecular Biology, Cambridge, gave diluted alcohol - chemically known as ethanol - to mice.
They then combined a technique called chromosome analysis - which provides a "birds eye view" of genetic information - with DNA sequencing to examine the damage caused by acetaldehyde.
This is a toxic chemical produced in the liver when alcohol is broken down.
The researchers found it can break and damage DNA within blood stem cells - altering their sequences within cells for good and rearranging whole stands, or chromosomes.
They said it is important to understand how the DNA blueprint within healthy stem cells is damaged because when they become faulty it can give rise to cancer.
Blood stem cells make lots of different blood cells which all play a specific and vital part in keeping our blood healthy.
Dec 27th 2017 Paterson
Deborah Douglas, who helps run the Breast Friends support group, said: “For me the big thing now is how many other people were affected. We want those facts – we want those figures.”
Douglas, who was “mutilated” by Paterson in a mastectomy operation, said she did not think the inquiry would uncover significant new information as it had no powers to compel people to give evidence. But she said it could provide a “step forward” if full statistics on patient numbers, both those still alive and those who had since died, came out as a result.
“The NHS have got some figures now. They have got the mastectomy figures,” she said. “In the private sector we haven’t got any figures. We haven’t got the data for those patients that were involved. What we have got is a promise that we will have those figures. And that would be a step forward.”
Reviews were carried out by Spire in 2014 and Heft in 2013, with the NHS hospital trust saying it had reviewed or cross-checked nearly 24,500 patient records to assess whether Paterson was involved in their care.
Douglas said she had regular communication from former patients of Paterson who had not been contacted by the NHS or Spire. “He was a general surgeon as well as a breast cancer surgeon. How many people out there, with wide local excisions, had recurrences and had secondary cancer?”
Heft said it had not contacted all patients who had had other breast operations by the surgeon, but in 2011 and again in 2016-17 it had reviewed samples of those who had had other breast cancer operations and “no concerns were identified”.
The trust said: “A review of the deceased patients cannot repair any damage that has already been caused, nor is it likely to inform the trust of anything that it is not already aware of or provide any tangible benefit to the survivors in this cohort.
“It is reasonable to assume there were similar deficiencies in the treatment of the deceased patients, which may have impacted adversely on their period of life without disease and their survival.”
During a seven-week trial this year, jurors heard that the surgeon had carried out “extensive, life-changing operations for no medically justifiable reason” on 10 patients between 1997 and 2011.
The court was told that Paterson regularly “miscoded” procedures, charging for more expensive treatment. He was accused of carrying out the often pointless surgery for “obscure motives”, which may have included a desire to earn extra money.
For several years before the trial, concerns had been raised about his practice of carrying out what he called “cleavage-saving mastectomies”, a controversial operation that left breast tissue behind for cosmetic reasons after the removal of cancerous cells. This method meant that the chances of a relapse within five years doubled.
Dec 26th 2017
A new and more effective way of detecting cancer in the human body has been developed from CONKERS.
Researchers have shown that cancer imaging can be simplified by a process utilising molecules derived from horse chestnuts.
Researchers developed a radiation responsive esculin-derived molecular gel, that is both bright and fluorescent, to enhance image mapping for cancer imaging.
Esculin, or sculin, is a chemical that naturally occurs in the horse chestnut, a plant extract. It is beneficial to circulatory health.
Researchers explained that a challenge currently in cancer imaging is that optical imaging often produces light that is typically low in intensity.
The gel has been developed to address the problem.
Dr Jan Grimm, of Sloan Kettering Institute in the US who worked on the project, added: "The possibility of developing a topical application from the gel makes this innovation an attractive potential improvement to current techniques of cancer imaging."
Study leader Professor George John, of The City College of New York and a Fellow of Britain's Royal Society of Chemistry, said his research is rooted in the idea that innovation can be inspired by nature to develop economical and green technologies for a sustainable future.
Prof John added: "Tailoring bio-based materials to synthesise thixotropic thermo-reversible hydrogels offers image-aiding systems which are not only functional but also potentially economical, safe, and environmentally friendly."
Dec 21st 2017
Dr Andy Zamar is a Medical Director and Consultant Psychiatrist at The London Psychiatry Centre.
A staggering one in two people in the UK will get cancer at some point in their lives so it's little wonder there is a tremendous focus on support for cancer patients once they have been diagnosed and are undergoing treatment. But what about afterwards? What happens when a patient has been given the all-clear from cancer?
I know from my own personal experience as a psychiatrist that those who have had cancer and have recovered, can suffer Post Traumatic Stress Disorder (PTSD) due to the traumatic nature of the experience and its impact on them and their loved ones.
PTSD symptoms have been found in 80% of women after breast cancer diagnosis according to recent research. That's why I believe it's time to acknowledge that those who have been diagnosed with cancer should be screened for PTSD as a matter of course.
What is PTSD?
PTSD is a mental health problem that can occur when someone has witnessed, experienced or even learned about a life-threatening or traumatic event occurring to themselves or a loved one.
It affects people of all ages, and between 25-30% of those experiencing a traumatic event will develop PTSD. Although many people associate it with war, this condition is also seen in patients who have suffered serious illnesses, like cancer, and can occur any time during or after treatment – weeks, months, even years later.
Whilst cancer itself does not cause PTSD, it may trigger the condition. The life-threatening nature of cancer means that people are not only frightened about what is going to happen to them but also about the unknown. When faced with a cancer diagnosis our first thought focusses on the medical aspect of the disease: How severe, what treatments are available and the prognosis. The psychological aspect of the disease can be a secondary concern. I would encourage all of us to recognise that the impact of cancer is psychological as well as physical.
I would also advise we pay attention to the mental health aspects of those sufferers who have had a cancer diagnosis and those who have had successful treatment but still live with worry or fear. Anyone diagnosed with cancer may feel apprehensive because they don't know how they are going to get on with chemotherapy, radiotherapy or surgery – or if these treatments will improve their condition. Even though these are all things that are explained to patients with cancer, living with it is very different to hearing about it.
PTSD can be triggered by any cancer or treatment related to a traumatic event like having lost a breast, a testicle, or having colostomy or tracheostomy. These significant changes mean adjusting to a more challenging lifestyle and can affect confidence, self-esteem, daily routine – every aspect of life. PTSD can have a significant impact on daily life and adjusting to these changes is what can trigger PTSD. The sudden removal of encouragement from the support network after someone has been given the all clear from cancer, could also act as a trigger.
Those suffering with it often experience depressive symptoms like low self-esteem and confidence issues, and can become irritable. When reminded of the traumatic event – perhaps at their annual post-cancer check-up – they may feel anxious and upset, physically tense, sweat more, and even try to avoid their check-ups and further treatments in some cases.
What are the symptoms of PTSD?
Symptoms of PTSD can include nightmares and disturbing flashbacks. The person may jump when they hear a noise, actively avoid reminders, feel withdrawn and isolate themselves – both physically and emotionally. PTSD is often misdiagnosed as depression because it is common for patients to also experience depressive symptoms which can be extensive. It is often this that is picked up on by healthcare providers.
It is important to screen for the presence of PTSD in the cancer survivor population, particularly those with depressive symptoms.
Treatment for PTSD
The National Institute for Health Care Excellence (NICE), the body that provides guidelines for recognition and treatment of medical, surgical and psychiatric conditions in the UK, advises not to use antidepressants for treatment of PTSD unless there are significant depressive symptoms – which often there are. In this instance, depression should be treated first, and once the depressive symptoms are managed then PTSD can be treated.
Repetitive Transcranial Magnetic Stimulation (rTMS) may be the most appropriate treatment for depressive symptoms for various reasons. Antidepressants have many side effects, withdrawal symptoms, and achieve full recovery in around 30% of cases only. Those who do not find antidepressants helpful will often find it difficult to come off the medication. rTMS is an effective, drug-free, non-invasive and pain-free treatment for depression. rTMS uses magnetic pulses to stimulate areas of the brain that regulate mood. Side effects are minimal and treatment results are also impressive. Of 44 centres in the US and Australia that have published rTMS treatment results for treatment-resistant depression, the remission rate is 29%. At The London Psychiatry Centre, the remission rate is more than 60%.
Once the depression has improved, there are two options for treatment of PTSD, which are both equally effective. The first is trauma-focussed CBT (TF-CBT), which helps patients to identify and cope with thoughts, behaviours and emotions. The second isEye Movement Desensitisation and Reprocessing (EMDR), a highly regarded treatment which helps to change the way the traumatic memories are reacted to despite them remaining stored in the brain, thus making them easier to manage.
If you are concerned you may be experiencing PTSD post-cancer, such as irritability, despondency, feeling ashamed or isolated, having trouble sleeping, getting upset by reminders or get unduly tense or worried around your annual cancer check-up, visit your GP or a mental health professional.
For more information on rTMS visit www.psychiatrycentre.co.uk.
Dec 17th 2017
Chemotherapy has a lot of terrible side effects and that's partly because the drugs being used to fight cancer also attack healthy cells. Figuring out a way to deliver drugs to tumors without affecting healthy tissue is a challenge and a problem that researchers are trying to solve. One group working on this problem, New Scientist reports, is a team at the Leibniz Institute for Solid State and Materials Research Dresden and in a recent study, they showed that sperm could be turned into an effective drug delivery tool.
Sperm offer quite a lot of benefits when it comes to delivering drugs. They're naturally mobile, they can encase the drug so that it doesn't get diluted by body fluids or leak out and they protect the drug from enzy
they showed that sperm could be turned into an effective drug delivery tool.
Sperm offer quite a lot of benefits when it comes to delivering drugs. They're naturally mobile, they can encase the drug so that it doesn't get diluted by body fluids or leak out and they protect the drug from enzymes that can break them down. They also don't cause immune responses like other other cell types -- bacteria, for example -- and they don't duplicate and form unwanted colonies.
The researchers first showed that just soaking sperm in a drug, in this case a cancer treatment called doxorubicin, will allow sperm to take that drug up and store it inside of themselves. And when those drug-loaded sperm were turned on a type of experimental tumor, they caused a nearly 90 percent reduction in living cancer cells after just 72 hours. Further, the researchers attached tiny, iron-coated hats onto the sperm cells that allowed the cells to be guided by a magnet, which let the researchers control their direction and steer them to a tumor. When the cells bumped into the tumor, the prongs of the hat spread open, releasing the sperm and allowing it to penetrate the tumor. The researchers showed that the sperm were better at fighting the cancer cells than just soaking the tumor in the drug because the sperm could get inside of the cells and deliver the drug deeper than a drug bath could alone.
Dec 3rd 2017
Health officials have become increasingly alarmed at campaigns aimed at blocking the take-up of the human papilloma virus (HPV) vaccine, which protects women against cervical cancer.
Three leading nations have now seen major reductions in the take-up of the vaccine and a growing number of doctors fear its use could be blocked elsewhere, despite its capacity to provide protection against a condition that kills hundreds of thousands of women a year.
Last week, doctors and health officials gathered in Dublin – centre of one of the most vociferous anti-vaccine campaigns – to discuss future tactics. Many believe the use of social media has added new impetus to anti-vaccine campaigners’ protests, and that this factor has been closely involved in the success of the attacks that have been made on immunisation programmes.
“Whenever a new vaccine is introduced, there is always a group of people who say it is unsafe,” said Professor Margaret Stanley of Cambridge University. “But the HPV vaccine seems to raise extraordinary levels of hostility.”
Japan, Ireland and Denmark have already witnessed sustained campaigns that have seen take-up rates plummet. (UK take-up rates are high.) In each case, the vaccine – which scientists insist is safe – has been linked to alleged cases of seizures, walking problems, and neurological issues. Photographs have been exchanged and video clips uploaded to YouTube.
“The vaccine is given at the age of 13 when young people are highly emotional and react to events very strongly,” said Stanley. “In addition, some parents feel they might be encouraging promiscuity by allowing their daughters to be vaccinated against a virus that spreads through sexual contact. Add to this the use of social media and you have quite an explosive mixture.”
The controversy about the HPV vaccine was also raised last week when doctor Riko Muranaka – who has stood up to intimidation from anti-vaccine groups in Japan – was awarded the international John Maddox prize for promoting science in the public interest. In Japan, parents have posted videos of their children online, claiming symptoms of seizures and walking problems were caused by the HPV jab. Japan’s health ministry could find no evidence the vaccine was to blame, but take-up rates have plunged from more than 70% to less than 1%.
“With this vaccine we could prevent many deaths from cervical cancer in Japan, but we are not taking the opportunity,” Muranaka said.
Delegates in Dublin outlined one possible solution that has been adopted in Austria, where doctors now give the HPV vaccine to both girls and boys (who will gain protection against a form of throat cancer in later life). Crucially, the jab is also given at an earlier age: around nine. “The apparent link with alleged promiscuity is not perceived to be so strong at this age and the timing also comes when children tend to be less emotional,” said Stanley. “Giving the vaccine a few years earlier than at present could be very effective.”
Responding quickly to claims of links between outbreaks of ill-health and vaccination is also extremely important, said Heidi Larson, of the London School of Hygiene and Tropical Medicine. “England reached 87% full-dose coverage in 2014, having averted a potential public public confidence crisis in 2009 when a 14-year-old girl died after being vaccinated. Health officials expressed concern, promptly investigated the girl’s death and found it unrelated to the vaccine.”
For their part, scientists insist that the HPV vaccine is safe and effective. It protects against the two strains of the human papilloma virus that are most commonly linked to cervical cancer, and which account for more than 80% of cases. “Globally there are around 528,000 new cases of cervical cancer and 266,000 deaths linked to human papilloma virus a year,” said Larson. “The HPV vaccine has the potential to eradicate the vast majority of these.”
This point was emphasised by Prof Helen Bedford of University College London, who said that although the HPV vaccine had only been in use for around a decade, its benefit were already being observed: “Impressive data are already accumulating to show the impact of the vaccine in reducing HPV infections and pre-cancerous cervical lesions.”
In 20 years, that reduction should be mirrored in a corresponding drop in deaths from cervical cancer, added Stanley. “Given that cervical cancer often kills women who are relatively young – sometimes in their 20s or 30s – the benefits of this vaccine are particularly sharp.”
Nov 31st 2017 Treatment Item 1 of 2
Drug-delivering nanoparticles seek and destroy elusive cancer stem cells
Champaign, IL | Posted on November 28th, 2017
In a study led by Dipanjan Pan, an
Illinois professor of bioengineering, researchers designed nanoparticles that
specifically bind to a protein that marks the surface of breast cancer stem
cells. Encapsulated in the particles is the drug niclosamide – a drug commonly
prescribed around the world to treat tapeworm infections, but in cancer stem
cells it turns off key gene pathways that give the cells the stemlike
properties that enable them to grow and spread.
“It is critical to administer treatments for already-developed tumors; however, long-term survival and not allowing it to come back are equally important,” Pan said. “We want to destroy the cells that are hidden in the tissue and cause the cancer to come back or spread to other parts of the body.”
Cancer stem cells represent a tiny fraction of cells in a tumor, but it only takes one or two to seed a new tumor, Pan said. The challenge for physicians and researchers is not only finding these cells, but treating them. Pan’s group created nanoparticles that target a protein called CD44, which only appears on the surface of cancer stem cells, and tested them on breast cancer tumors in cell cultures and in live mice.
“I call them ‘GPS-enabled nanoparticles,’ because they seek out only the cells that have cancer stem cell properties. Then they latch onto the cells and deliver the drug,” said Pan, also a faculty member of the Carle Illinois College of Medicine and the Beckman Institute for Advanced Science and Technology. “To the best of our knowledge, this is the first demonstration of delivering cancer stem-cell-targeted therapy with a nanoparticle.”
The researchers used the nanoparticles to deliver niclosamide, which is on the World Health Organization’s List of Essential Medicines, an index of the safest and most effective drugs in the world. Pan’s group previously found that niclosamide works on a particular gene-regulation pathway in cancer stem cells.
In the new study published in the journal Molecular Cancer Therapeutics, the cancer stem cells lost their stemlike properties after treatment with the niclosamide-bearing targeted nanoparticles, making them less able to cause the cancer to recur or metastasize. The researchers also saw a significant decrease in overall cancer cell growth, both in the cell cultures and in the mice.
By using an already-approved drug and easy-to-manufacture nanoparticles, Pan hopes that this system can become an accessible and cost-efficient treatment to prevent cancer recurrence in patients
“We purposely used an extremely inexpensive drug. It’s generic and we can mass produce it on a very large scale,” Pan said. “The nanoparticles are a polymer that we can make on a large scale – it’s highly defined and consistent, so we know exactly what we are delivering. The rest of the process is just self-assembly.”
“This work also is important to future researchers working in the field of cancer stem cells,” said postdoctoral researcher Santosh Misra, the first author of the study. “We described and confirmed the proteins and genes responsible for vital processes in these cells, and that is opening up new avenues to make better therapies.”
The researchers are working to create a combination therapy that can deliver drugs for the primary cancer, such as traditional chemotherapies, as well as targeted agents that can treat cancer stem cells. They are also testing the nanoparticle drug-delivery system in large animal models to bring it a step closer to the clinic.
The National Institutes of Health and the University of Illinois supported this work.
Nov 31st 2017 Lung Cancer item 2
Lung cancer is often associated with smokers, but in reality it doesn't discriminate - experts are seeing the numbers of diagnosed non-smokers rising. It is the most common cancer in the world, and in the UK it's the leading cause of cancer deaths for both sexes.
Because of the stigma surrounding lung cancer there are a lot of misconceptions about the condition. This Lung Cancer Awareness Month Dr Tom Newsom-Davis, Consultant Medical Oncologist, and Mr Eric Lim, Consultant Thoracic Surgeon, both from HCA Healthcare UK, set the record straight about the disease.
1. It's not just a smokers' disease
It's widely understood that lifestyle choices can affect or increase the chances of developing cancer, for example eating certain foods, lack of exercise, drinking alcohol, and smoking. Lung cancer in particular has, for many years, been associated with smoking, and people diagnosed with the condition are often seen to have 'brought it upon themselves'.
While there is strong evidence that smokers and ex-smokers have an increased risk of getting lung cancer, it is not the only cause. Every year, one out of every seven people
diagnosed with lung cancer have never smoked.
EL: "We identified that the frequency of non-smoking lung cancer has doubled in the last seven years. As a surgeon, a third of my work is now on non-smokers, and I can only see this number rising."
Daniel Cohen's wife Katie – a fit, healthy 32-year-old who had never smoked - was diagnosed with lung cancer in January 2015. Talking about her experience, he comments: "When she told people about her diagnosis, one of the first questions she was always asked was 'Did you smoke?' Or loosely translated, 'was it your fault?' It's the shame and guilt that people make you feel when you have no reason to. There's still a huge stigma attached to the disease and this needs to change. There needs to be more education about it."
TND: "For such a long time there was so much embarrassment and prejudice surrounding lung cancer – and this stopped people getting their symptoms checked. Treatment is most effective when lung cancer is detected early so it is really important to visit a GP or doctor as soon as possible if you think you might have any symptoms of lung cancer.
2. Get it diagnosed quickly
EL: "As with most cancers, the quicker you can confirm a diagnosis the better, as it opens up more treatment options, including the possibility of surgery. Currently,
approximately 20 per cent of patients are diagnosed with early stage disease and are able to have surgery, while 80 per cent are identified too late. We need to increase the number of people who are able to have the surgery.
"There have been a lot of improvements and changes in lung cancer treatments over the past few years. As a surgeon, one of the most important advances for patients that I treat has been key-hole surgery. This type of surgery now enables us to operate using just a single 3cm cut in the chest, which some studies shown to be less painful with and helps patients to recover quicker. Many of my patients who have this type of surgery can be out of hospital within just two days.
"I'm currently undertaking a NIHR funded UK multicentre trial to evaluate the benefits of keyhole surgery versus open surgery and early findings have indicated that it is a procedure of interest to both patients and clinicians alike."
LUNG CANCER SYMPTOMS
3. Treatments are improving
TND: "Over the past five years treatments for lung cancer have advanced radically, and they are now improving outcomes for patients across the UK. For example, there is targeted radiotherapy, which can pick out individual areas of the cancer and target them more accurately than could be done previously.
"Other developments have allowed us to identify specific mistakes in the DNA of the cancer cell, called mutations, which have caused the tumour. Sometimes we can even detect these mutations from a simple blood test. We now have a number of drugs that target these mutations and which are usually more effective than traditional treatments such as chemotherapy.
"There has also been a huge step forward in immunotherapy. This uses a person's own immune system to attack the cancer and can be very effective for those with advanced stages of disease. At HCA UK we have been treating suitable patients with immunotherapy since it was approved by the FDA in 2015, and are now the biggest private facility offering this treatment.
"While immunotherapy and other targeted drug treatments are not curative, they are very effective for treating lung cancer. Thanks to these improvements in care, there are patients we diagnosed three, four, five years ago with advanced lung cancer who are still here and still doing well. It is time to get over the old, nihilistic, view of lung cancer and instead see this as a treatable disease."
Daniel Cohen adds: "Thanks to these new treatments my wife Katie and I had more time together. The chemotherapy had terrible side effects and eventually stopped working, but immunotherapy drug Nivolumab allowed us to go on holiday together and let her live her life for longer. It's time we wouldn't have had together otherwise and I am grateful for every minute."
4. More women die of lung cancer than any other
While a lot of attention is often given to breast and ovarian cancers in women, it is not commonly known that 44 women die of lung cancer in the UK every day - more than both cancers combined. In addition, young women are also more likely to die of lung cancer than young men.
EL: "We have seen a growth in women being diagnosed with lung cancer, and it has now overtaken breast cancer as the biggest killer for women. It's difficult to say why this is, however we don't think this is due to environmental factors as it would affect both men and women. Cooking fumes and aerosols have been considered but more research needs to be done to identify any potential carcinogens women are exposed to, or if there is a differential effect of day-to-day carcinogens in women."
5. Screening is key to early detection of lung cancer
EL: "Early detection by CT screening has been demonstrated to improve lung cancer survival by 20%. The current accepted method is through CT screening, however there's no national screening programme available, and non-smokers will never be screened. Most diagnoses are picked up through incidental scans or once symptoms have become advanced.
"At HCA UK, screening is undertaken using a low-radiation CT scan, which provides more accurate images than a chest x-ray, and can help to identify early signs of the disease. It's recommended that those over 50 who currently smoke or who have a heavy smoking history undertake screening. Additionally it's recommended that people who have worked in a role where they may have had exposure to respiratory carcinogens such as asbestos, or who have a strong family history of lung cancer get screened too."
TND: "The most common, symptoms of lung cancer include cough, chest pain, persistent chest infections and coughing up blood. As with other cancers we should also look out for unexplained weight loss, fatigue and loss of appetite. If you have any concerns about any of these symptoms visit your GP as soon as possible."
Daniel comments: "Early screening is so important. The journey from our first GP visit with a persistent cough to diagnosis took five months, and by that stage the lung cancer was advanced. This is a huge discrepancy. We were luckier than most as we were given more time by the immunotherapy treatment but this won't be the case for everyone."
Jane Lynch, Cancer Lead Nurse says: "Lung cancer is a challenging disease to manage as it is often diagnosed at a later stage when curative treatment is not an option. However, with a skilled holistic nursing support team and expert medical intervention we are helping people with this cancer live longer, and with an improved quality of life."
Nov 15th 2017
A compound in dark chocolate and red wine could help rejuvenate cells, according to a scientific breakthrough.
Researchers from the Universities of Exeter and Brighton have made the sizeable breakthrough on ageing and discovered a way to rejuvenate inactive senescent cells.
They found that they could make the cells both look and behave like younger cells.
The researchers applied compounds called reversatrol analogues, which are chemicals based on a substance naturally found in red wine, dark chocolate, red grapes and blueberries, to cells in culture.
Previous research by the University of Exeter had found that a class of genes called splicing factors are progressively switched off as we age.
But the new study found that applying the reversatrol analogues to the cells caused splicing factors to be switched back on.
Within hours of treatment, older cells had started to divide and had longer telomeres, which are the ‘caps’ on the chromosomes which shorten as we age.
The researchers hope that the breakthrough could lead to therapies that help people age better and without many of degenerative problems people encounter as we get older.
One of the reasons we become more susceptible to disease as we age is that our tissues accumulate senescent cells which are alive but do not grow or function as they should.
Splicing factors ensure genes function as they should, but as we get older they start to work less efficiently or not at all, which restricts the ability of cells to respond to challenges in their environment.
Senescent cells, which can be found in most organs from older people, also have fewer splicing factors, the researchers explain.
Professor Lorna Harries, Professor of Molecular Genetics at the University of Exeter, said: “This is a first step in trying to make people live normal lifespans, but with health for their entire life.
“Our data suggests that using chemicals to switch back on the major class of genes that are switched off as we age might provide a means to restore function to old cells.”
Harries went on to explain that the research proves that the cells can be treated to regain some features of youth.
Dr Eva Latorre, Research Associate at the University of Exeter, who carried out the experiments was surprised by the extent and rapidity of the changes in the cells.
“When I saw some of the cells in the culture dish rejuvenating I couldn’t believe it. These old cells were looking like young cells. It was like magic,” she said.
“I repeated the experiments several times and in each case the cells rejuvenated. I am very excited by the implications and potential for this research.”
Sept 28th 2017
"The plane had just landed when I felt the rush of blood. I stood up from my seat, and a heavy and immediate bleed soaked my trousers. They were covered in it, right down to the knees, and I was shrouded with embarrassment. Young and humiliated - I was only 22 at the time - I stood in the passport queue for 40 minutes with my coat tied around my waist, contemplating what had happened.
When I was finally able to retreat to a toilet, where I threw my trousers in the bin, I cried. I hadn’t been sexually active for several months but the bleed was so heavy the only explanation I could come up with was that I had been unknowingly pregnant with my ex-boyfriend’s child, and had suffered a miscarriage. In that moment, I was devastated. I was still heartbroken over the relationship, and it felt gut-wrenching to stand there, alone and covered in your own blood, wondering if you’d just lost a baby you never even knew you had.
At no point did the incident make me think about cancer, although it wasn’t the first time I’d had issues with bleeding. Months before, I’d gone to the GP after noticing I’d been bleeding during sex. I was examined and found to have an eroded cervix, which can happen to women with high levels of oestrogen over a prolonged length of time. They assumed this was to do with being on the pill, but on reflection it must have been linked to the fibroid the doctors believed they had discovered in my uterus a year earlier. A fibroid is a very common, benign, and usually harmless lump of tissue, and although it was slightly surprising because usually women over 30 get them, I wasn’t concerned about it. I'm generally not much of a worrier, and tend to underplay health issues.
My periods had grown slightly heavier in the lead up to the incident on the plane, but it wasn’t until that happened that I felt compelled to go back to the doctor. They confirmed I hadn’t miscarried, but refused to re-scan me to check everything was okay with my fibroid. Because I was young, I got the feeling they thought there wasn’t much reason to worry too extensively about my gynaecological health, and instead they put my heavy bleed down to stress. I told them I hadn’t been stressed. Now I was stressed, because I wanted answers and I wasn’t getting them.
The weeks rolled on, and my periods became unmanageably heavy. I was having to set alarms during the night to change my sanitary wear, I was unable to exercise during my week-long period, and it was beginning to rule my life. In January 2016 I started to feel dizzy, light headed and tired. My words started to jumble, and I was unable to keep my eyes open by 2pm. I went to my GP and found I was severely anaemic. My doctor finally ordered scans, and by this point they confirmed I now had two fibroids, which needed removing.
I was finally getting taken seriously, and surgery was ordered. It took 8 months for the procedure to get booked in, but when it eventually came around, I didn’t for one moment expect they’d find what they did.
After removing what they’d previously assumed was a fibroid, doctors realised what I actually had was an extremely rare uterine tumour. Actually, I had two. And although they’d managed to remove one, the other was embedded deep in the wall of my womb, and wasn’t removable by surgery. I would need a complete hysterectomy, which would leave me infertile at the age of 24.
I couldn’t believe I had cancer. Apart from bleeding, I generally was fit and healthy. I ate well and exercised 5 or 6 times a week. I had abs and could hold my body weight like it was nothing. How could I, me, have cancer?
When I found out, my mind went into a weird place. It was like I was there, hearing what they were saying, but at the same time I wasn't present. I was numb and distant. But the reality of it hit me like a ton of bricks when my clinical nurse specialist told me I would need a hysterectomy. All I'd ever wanted was children - lots of children, I wanted a busy house full of noise and chaos - but in that moment, I suddenly realised everything I'd ever wanted for myself and my future had been taken away. I came out of blurry shock mode and into the room, and I cried. I didn't really know what to do from there.
Following my diagnosis, I spent hours on end in waiting rooms and I couldn’t help but notice I was the youngest person there by decades. The only young women around me were going to the women's hospital because they were pregnant. I’d sit there, watching pregnant women come in with their toddlers, full of excitement and expectation, and my heart would break every time. I wished they could understand from my perspective how lucky they are. Having children seems like the most natural thing in the world, and that makes it easy to take it for granted.
I still have ovaries - my womb and cervix were removed in the hysterectomy I had earlier this year - which means when my time comes I could technically use a surrogate and IVF to have a family. But thinking about the future is a difficult task. I don't ever think ahead anymore. I don't even think ahead to next month; just the next immediate task or day of relevance.
I don't know what’s in store for me, and I don't even know what I want it to be anymore, because any conceivable life for me is now a plan B. The permanence and loss of control is unIike anything I've ever had to face before, and it's smothering. I guess ignoring the future and keeping my mind on the present helps me put off my pain. It will come one day and I can't ignore it forever, but for now I've had enough to deal with and I’m just trying to be happy.
I’ll let future Lydia worry about being infertile. I've lost two years of my life to this illness, feeling miserable and tired and unable to do the things I want to do. It's time for me to make up for that and enjoy a few more years of my twenties before I face the struggle of working out how I'm going to be a mum, and the difficulty I'll have to face to make it happen."
In the UK 53 women are diagnosed with a gynaecological cancer each day, and 21 will die. Not all of them are of menopausal age. Grace is a charity dedicated to supporting women with gynaecological cancers by raising awareness, funding research and providing local hospitals with vital surgical equipment.
Stomach pains are common, meaning everything from menstrual cramps to uncomfortable bloating, but for 46-year-old Carla Bradbury they were a sign of something more serious – cervical cancer.
'I was given a Sodastream for my birthday and thought that my stomach pains were coming from having too much fizzy water, so I didn't go to the doctors straight away,' she says. 'I also experienced spotting between periods – which I thought was down to hormones.'
After Carla's stomach pains got gradually worse, she went to see the GP who examined her and gave her a smear test. The smear came back with an abnormal result, which led to further investigations.
Abnormal smear test result
'One of the gynaecologists I saw put it down to endometriosis. I was going to have further tests, but in the meantime, they found out what it really was – and it was cancer,' she says.
An MRI confirmed Carla had cancer at Stage 3B, meaning the cancer had spread from the cervix into the structures around it.
'My lowest point was when I read a report that said there was a 50% chance of long-term control – meaning I had a 50/50 chance of survival,' says Carla.
'Because my tumour was so big (I later found out it was the size of a large plum) and the way it was attached to my pelvic wall, they couldn't operate on it.
'Instead, I had chemotherapy and radiotherapy, which thankfully treated it.'
The importance of smear tests
Five years on from diagnosis, Carla is now days away to be given the all clear. And has an important message for other women.
Like so many, Carla hadn't been keeping up with her smear tests – and she's urging other women not to do the same.
'I did get regular letters to come for a smear test, but for me it was just finding the time to book in and make the appointment,' she says. 'But now I see how important it is.'
Cervical screening saves thousands of lives each year
Every year in the UK, 3,000 women are diagnosed with cervical cancer, yet over one in four women are still choosing to avoid their smear test.
Unfortunately, there aren't always obvious signs of cervical cancer in the early stages, and for many women an abnormal result from a routine smear is the first sign that something's off.
'Cervical screening saves thousands of lives each year by detecting changes in the cervix before they develop into cancer,' says Sophie Lowes, health information officer at Cancer Research UK. 'Women aged 25-64, who are registered with a GP, are automatically invited for screening.'
Challenge of a lifetime
Carla now describes herself as being in a better place than she ever was. She says: 'I've always been quite positive and had a happy outlook on life – but I'd say even more so now.
'My cancer came as a total shock, but it has made me stronger and I'm not scared of anything anymore.
'When you've faced the fear that you may not be here tomorrow, you just live for today. If you have cancer like I did, you've got the opportunity to work out what's really important. Although it's a terrible thing, there are people that suffer a lot worse.'
After losing two friends to cancer this year, one whom she went through treatment with, Carla is now preparing to take part in Stand Up To Cancer's Great Canoe Challenge, where she'll paddle an incredible marathon distance every day for five days to raise awareness and funds.
'Preparing to take on the challenge made me think about when I was going through treatment. I was so weak, I couldn't exercise, I couldn't even stand up in the shower. Reflecting back made me realise how far I've come.'
If you experience any unusual or persistent bleeding or pain, it's a good idea to visit your GP. Chances are it won't be cancer but, if it is, getting diagnosed and treated early can make a real difference.
Sept 22nd 2017
Blood cancer is the fifth most commonly diagnosed cancer in the UK, and our third biggest cancer killer, and yet misunderstandings about the signs and symptoms of this cancer exist. We've spoken to the experts to explain the symptoms of blood cancer, diagnosis and how to improve awareness.
The Make Blood Cancer Visible survey, launched this September for Blood Cancer Awareness Month, finds that nearly a third of people wrongly believe headaches, nausea and double vision might be signs of blood cancer, which they are not.
The most common signs are fatigue, fever or night sweats, bone and joint pain, swollen glands, bruising and unusual bleeding.
Moreover, a second survey (Blood cancer: What you need to know CARE patient survey) reveals that 80% of patients admit they didn't expect their symptoms to be blood cancer, prior to diagnosis. Indeed, a third had never heard of their specific condition and knew nothing about it.
Boost up your awareness about blood cancer
Last year, the former Lib Dem leader, Nick Clegg's son Antonio, now 15, was diagnosed with the same condition as Ellie. He visited his GP with a painless lump on the side of his neck, and fortunately his GP sent him for scans and a biopsy. This quick assessment improved Antonio's chances, and like Ellie, he too is now in remission.
While cancer is relatively rare in young people, each year blood cancer is diagnosed in around 1,100 people up to the age of 24 in the UK, and someone is diagnosed with blood cancer (or a related disorder) every 14 minutes.
Blood cancer is an umbrella term for cancers affecting the blood, bone marrow and lymphatic system (the vessels that transport white blood cells throughout the body). There are 137 types of blood cancer, the main three being: leukaemia (the uncontrolled growth of undeveloped white blood cells), lymphoma (cancer of the lymphatic system) and myeloma (cancer of the bone marrow).
These different subtypes typically affect people at different ages, but lymphomas (including Hodgkin's lymphoma, as experienced by Ellie), are the third most common type of childhood cancer, while acute lymphoblastic leukaemia is one of the few forms of cancer that is more common in children than in adults.
Diana Jupp, Chief Executive of Bloodwise (formerly Leukaemia & Lymphoma Research) saya: "Despite 230,000 people being affected by blood cancer across the UK, it is still a much-misunderstood and little-known disease area. We know that low awareness can lead to late diagnosis and can make it hard for people to find the information and support they need, leading to a greater sense of isolation." She hopes the campaign will change that by helping to raise awareness and make blood cancer 'visible'.
Diagnosis and treatment of blood cancer
More importantly, perhaps it will lead to earlier diagnosis and treatment. Currently most patients are treated with a combination of chemotherapy drugs, but new therapies are starting to emerge.
"Many different types of treatment are becoming available due to recent advances in our understanding of blood cancers. These include treatments that control or mimic the immune system, and treatments that are targeted for the characteristics of the cancer cell," says consultant haematologist, Dr Jane Stevens, a Bloodwise Trustee.
"Over 8 in 10 survive blood cancers such as Hodgkin lymphoma and childhood acute lymphoblastic leukaemia. People should seek medical advice if their symptoms are unexplainable, unusual and persistent – in other words, they have been experienced for more than two weeks or if there is unexplained weight loss. The fatigue experienced is usually disabling and not helped by sleep or resting. Symptoms will feel more intense than a usual cold or flu and will not normally respond to antibiotics."
A National Cancer Patient Experience survey shows that blood cancer patients generally have to see their GP more times before finally being diagnosed, which may be due to the symptoms being 'vague'. However, diagnosis can be made through a simple blood test.
Ellie's blood cancer story
Ellie Philpotts, 21, from Kidderminster, is typical in this respect. When, at the age of 14, she began to suffer breathlessness, cancer couldn't be further from her mind.
"It started small-scale - I felt a little more fatigued than normal, but soon it escalated. Walking up the road to school was a massive struggle, I was breathless, had drenching night-sweats and a lump in my neck."
She knew something was amiss, but suspected 'flu, a winter virus or glandular fever.' Her GP referred her to hospital for scans and a biopsy, which revealed Hodgkin's Lymphoma - a type of blood cancer that mostly affects young people.
By now 15 and in Year 10 of her GCSEs, the diagnosis came as a huge shock.
"I went to the GP expecting the problem to be much less serious. I was aware of how it might affect other areas of my life, such as my education and future ambitions, but at the same time I was also a little relieved that my illness now had a name, meaning I could get on with treatment and the recovery process."
Four months of chemo ensued, during which time Ellie pressed on with her studies.
"I was determined to keep up-to-date with my education, as I felt I still had an element of control over this area of my life. Of course, sometimes it wasn't possible for me to make it to school, but I took revision books to chemo sessions, and saw an in-hospital tutor during my early days on the ward. This gave me a focus and something else to dedicate my energies to alongside treatment."
Battling hair loss, nausea and tiredness (the side-effects of chemo), Ellie 'powered through', bolstered by the opportunity to connect with other young people in her situation.
"I tried to remember my end goal. My protocol [treatment] finished in the May, and I sat some GCSE exams during that month and June. I tried to stick to a routine as best as I could. It was also beneficial connecting with others in similar situations, through charities and the hospital itself. Meeting teenagers who'd also been diagnosed with cancer inspired me and made me feel more positive and less alone."
Her hard work paid off, and Ellie, recently graduated from Cardiff University with a degree in Journalism, Media and English Literature. She has been in remission since 2011, and believes her timely diagnosis made all the difference.
Ellie, who is currently job-hunting, is spending time volunteering to help raise awareness.
"My biggest message to others going through what I went through, is hope. It might not always seem it, but things can get better. You're definitely not alone - there are a range of incredible support systems throughout the country, and that means opportunities to try new experiences or give back, so aim to say, 'yes' to things if you get the chance."
If you need support or information about blood cancer, head to Bloodwise or Anthony Nolan.
Sept 17th 2017
Around 140,000 Americans are diagnosed with colon cancer every year. Colon and rectal cancers are striking adults at younger and younger ages, and millennials born starting in 1990 and have more than twice the risk of developing colorectal cancer than those born in 1950. “Colorectal cancer is one of the most common cancers,” according to Edward L. Giovanucci, MD, ScD, in a press release by the American Institute for Cancer Research (AICR).
An exciting new report by the AICR and the World Cancer Research Fund (WCRF) yields some good news: “There is a lot people can do to dramatically lower their risk.” The findings are “robust and clear,” Dr. Giovanucci says: “Diet and lifestyle have a major role in colorectal cancer.”
Specifically, the report demonstrates that eating whole grains daily reduces the risk of colorectal cancer by a whopping 17 percent. This adds to previous scientific evidence that foods containing fiber decrease the risk of this particular cancer. The report consisted of a comprehensive analysis of 99 existing scientific studies, including data on 29 million people, of whom over a quarter of a million had been diagnosed with colorectal cancer.
So what exactly qualifies as whole grains?
Our colorectal cancer expert, Darrell Gray, MD, MPH, of The Ohio State University Comprehensive Cancer Center, who was not directly involved in the study but who specializes in gastroenterology and colorectal cancers, explained to Reader’s Digest that whole grains include both the grain’s bran and germ.” The bran is the multi-layered outer skin of the edible kernel. It contains important antioxidants, B vitamins, and fiber. The germ is the part of the grain that has the potential to sprout into a new plant. It contains many B vitamins, some protein, minerals, and healthy fats. “The whole grain is a rich source of phytochemicals and antioxidants that have anticancer properties,” Dr. Gray explains. Further making sense of the connection between eating whole grains and reducing cancer risk, he adds that “whole grains are thought to exert beneficial effects in colorectal cancer prevention by lowering fasting insulin levels.”
How much do we have to eat in order to see these amazing benefits?
According to the study, three servings of whole grains per day (a total of 90 grams) is the magic number associated with the 17 percent decreased cancer risk. The Whole Grains Council, a not-for-profit consumer advocacy group, states that a single serving of whole grain is equal to a 1/2 cup of cooked brown rice, oatmeal, or other whole grain, or a cup of whole grain cereal. Dr. Gray suggests bran-flake cereal, but there are many other options. For foods that contain not only whole grain but also other ingredients (for example, whole grain crackers, granola bars, bread, and muffins), you’ll have to eat a larger amount to get the optimal dose of whole grain.
In addition to eating whole grains daily, the report warns against these habits, which can raise your risk of colorectal cancer:
Eating lots of red meat such as beef or pork (more than 500 grams, or a little over 1 pound, cooked, per week)
Eating hot dogs, bacon, and other processed meats on a regular basis (these are the among the foods cancer docs never eat)
Being overweight or obese
Consuming two or more daily alcoholic drinks (30 grams of alcohol), such as wine or beer
In addition, the report states that people who are more physically active (at least 30 minutes of physical activity per day) have a lower risk of colon (but not rectal) cancer compared to those who do very little physical activity. It also found limited evidence that eating fish and foods containing vitamin C (such as oranges, strawberries, and spinach) can lower the risk of colorectal cancer, in spite of some claims otherwise.
“All of this points to the power of a plant-based diet,” says Alice Bender, MS, RDN, AICR Director of Nutrition Programs. “Replacing some of your refined grains with whole grains and eating mostly plant foods, such as fruits, vegetables, and beans, will give you a diet packed with cancer-protective compounds and help you manage your weight, which is so important to lowering risk.”
“When it comes to cancer there are no guarantees,” she adds, “but it’s clear now that there are choices you can make and steps you can take to lower your risk of colorectal and other cancers.”
Sept 15 2017
When you think about breast cancer, what do you think of? A young woman with nipple discharge? Probably not. And that's because we often associate a lump as a sign of breast cancer, as well as assuming it only affects older women.
But what about the other symptoms? There are plenty of indicators you might have breast cancer that you're not familiar with, so breast cancer charity CoppaFeel! is helping us all out by shining the light on the lesser known signs and symptoms...
1. Changes in skin texture (e.g puckering/dimpling)
This is why it is so important to feel AND look at your boobs. Dimpling and puckering of the skin can look similar to orange peel.
2. Lumps and thickening
Some boobs are naturally lumpy and this can be perfectly normal. The key is to get to know how your boobs feel, so you would notice if any new lumps appear or if your boob starts to feel thicker in one area compared to the rest.
3. Swelling in your armpit or around collar bone
It is important to check not just your boob but your upper chest and armpit too, as these areas also contain breast tissue.
4. Constant, unusual pain in your breast or armpit
Some breast pain can be perfectly normal, especially around your period. But keep an eye out for any unexplained pain in your breast or your armpit that’s there all or almost all of the time.
5. Nipple discharge
This is liquid that comes from the nipple without squeezing it.
6. A sudden change in size or shape
Most women may naturally have one boob bigger than the other or experience their boobs gradually changing as they get older. Many changes are perfectly normal, however if you notice a sudden, unusual change in size or shape then get it checked out.
7. Nipple inversion and changes in direction
All this means is your nipple has become pulled into the boob or looks different to usual. This could be a change in its position or shape. That’s why it's important to pay special attention to your nipple during your regular checks.
8. A rash or crusting of the nipple or surrounding area
There are many reasons why your skin could become irritated, especially if you are breast feeding, but if you notice any redness or a rash on the skin and/or around the nipple or any crusting of the nipple, make sure you get it checked out by your doctor.
CoppaFeel! holds an annual festival, Festifeel, curated by Fearne Cotton and hosted by Lauren Laverne, which will take place on October 14th at House of Vans, Waterloo in London. For tickets, please click here or go on the DICE app.
Here's what CoppaFeel's founder, Kris Hallenga, had to say about the festival:
"Festifeel raises a heck of a lot of money and awareness too - otheriwse we wouldn’t keep doing it. It’s a great way to make a noise about what we do, about what we can achieve and that our work must continue. Every penny raised is ploughed back into running and developing our education programmes - so that might be making sure we can keep sending monthly texts to 40,000 people reminding people to check their boobs (you can sign up for that here), sending a Boobette into a school or training more students to be boob advocates on campuses up and down the country."
Related: Drug Shows Promise As New Treatment For Breast Cancer (provided by Wochit News)
Sept 14th 2017
Women with excess abdominal fat are at greater risk of cancer, a new study has found.
Researchers revealed that those with apple-shaped figures were more than 50 per cent more likely to develop lung and bowel tumours.
Something they say is down to an increase in insulin, which is known to disrupt hormone production, while excess body fat increase chronic inflammation
Starting in 1999, 5,855 postmenopausal women with an average of 71 had their body fat scanned and were categorised as having either high or low abdominal fat ratios.
After 12 years of additional scans, the results found that women carrying fat around their abdomens were over 50 per cent more likely to develop lung or gastrointestinal cancers.
The data recorded a total of 811 cancers with 293 breast and ovarian cancers, 345 lung and gastrointestinal (GI) cancers and 173 other cancers.
BMI and fat percentage did not present a heightened tumour risk.
“In women, it is known that menopause initiates a shift of body fat toward higher level of abdominal adiposity, which may mediate obesity-related cancer risk,” said study author Line Mærsk Staunstrup from Nordic Bioscience and ProScion in Denmark.
“Elderly women should be especially aware of their lifestyle when they approach the pre-menopause age.
“Avoiding central obesity may confer the best protection.”
Commenting on the findings, Dr Andrea De Censi, from Galleria Hospital in Genova, Italy added, “'While obesity has previously been linked to cancer risk, the link to lung cancer is new and intriguing.
“Increases in insulin result in fat accumulation that is specifically visceral and abdominal.
“Insulin also has detrimental effects on hormone production, and adipose cells in fat tissue increase chronic inflammation throughout the body, another risk factor for several cancers.
“These data open the door for clinicians to initiate a number of interventions in obese patients.
“In addition to fat loss with diet and exercise, there may be a potential role for a diabetes drug, such as metformin, which can lower insulin effects and contribute to cancer prevention.”
Sept 9th 2017
The alcohol industry is misleading consumers with distorted and distracting health messages that downplay any related risk of cancer, researchers claim.
The industry is using “denying, distortion and distraction” strategies to minimise evidence in activities that have parallels with those of the tobacco industry, according to a study led by the London School of Hygiene and Tropical Medicine (LSHTM) with Sweden’s Karolinska Institutet.
Researchers analysed information relating to cancer on the websites and documents of almost 30 alcohol industry organisations between September and December last year, finding that most showed “some sort of distortion or misrepresentation” of evidence.
— LSHTM press (@LSHTMpress) September 8, 2017
The industry most commonly presented the relationship between alcohol and cancer as highly complex, implying there was no evidence of a consistent or independent link, the study, published in the journal Drug and Alcohol Review, found.
Other tactics included denying that any relationship existed or claiming that there was no risk for light or moderate drinking, as well as presenting alcohol as just one risk among many.
The researchers said one of their most important findings was that the industry appeared to specifically omit or misrepresent evidence on breast and colorectal cancer, possibly because they were among the most common cancers.
They urged policymakers and public health bodies to reconsider their relationship with the industry, which is involved in developing alcohol policy and disseminating health messages to the public in many countries, in light of the findings.
LSHTM press (@LSHTMpress) September 8, 2017
Alcohol consumption is an established risk factor for a range of cancers, including oral cavity, liver, breast and colorectal cancers, and accounts for about 4% of new cancer cases annually in the UK.
There is limited evidence that alcohol consumption protects against some cancers, such as renal and ovarian cancers, but in 2016 the UK’s Committee on Carcinogenicity concluded that the evidence is inconsistent, and the increased risk of other cancers as a result of drinking alcohol outweighs any possible decreased risk.
The authors said it was important to highlight that those who drink within the recommended guidelines – not more than 14 units a week for both men and women – “shouldn’t be too concerned when it comes to cancer”.
Mark Petticrew, Professor of Public Health at the LSHTM and the study’s lead author, said: “The weight of scientific evidence is clear – drinking alcohol increases the risk of some of the most common forms of cancer, including several common cancers.
— IAS (@InstAlcStud) September 8, 2017
“Public awareness of this risk is low, and it has been argued that greater public awareness, particularly of the risk of breast cancer, poses a significant threat to the alcohol industry.
“Our analysis suggests that the major global alcohol producers may attempt to mitigate this by disseminating misleading information about cancer through their ‘responsible drinking’ bodies.”
He added: “Existing evidence of strategies employed by the alcohol industry suggests that this may not be a matter of simple error.
“This has obvious parallels with the global tobacco industry’s decades-long campaign to mislead the public about the risk of cancer, which also used front organisations and corporate social activities.”
Institute of Alcohol Studies chief executive Katherine Brown said: “This report shows that, like the tobacco industry before them, alcohol companies are misleading consumers about the evidence linking their products to cancer.
“We cannot rely on a profit-driven industry to promote public health. Consumers have a right to know the truth about alcohol and cancer, so they can make fully informed decisions about their drinking.”
Sept 8th 2017
When it comes to treating cancer, surgeons want to get rid of as much cancerous tissue as possible during tumor removal. Now a new technology—the size of a pen—is attempting to make that easier by distinguishing between tumors and healthy tissue in just 10 seconds.
The MasSpec Pen is a real-time diagnostic tool created by researchers at the University of Texas at Austin. In a new study published Wednesday in the journal Science Translational Medicine, the researchers report that their handheld device (which is not yet FDA-approved) uses tiny droplets of water to analyze human tissue samples for cancer with 96% accuracy.
“It’s a gentle, simple chemical process,” says study author Livia Schiavinato Eberlin, an assistant professor of chemistry at UT Austin. “It’s highly specific and highly sensitive. The fact that it’s non-destructive brings a new approach to cancer diagnosis.”
Getting rid of all cancerous tissue while also preventing any harm to healthy tissue is a delicate process. When operating on a woman with breast cancer, for example, a doctor needs to remove the tumor and other affected tissues while maintaining the rest of the breast. Currently there are other tools available to surgeons for tissue diagnosis, but many use gases or solvents that can be harmful for the human body. In 2016, researchers in Massachusetts reported that they developed a probe that can find and light up cancer cells, making them easier for surgeons to see. But other methods currently available to surgeons today are slower than the MasSpec Pen, the study authors say, in some cases by 30 minutes or more.
Human cells produce a variety of small molecules, and cancer creates a unique set of them that can be used for pattern identification. The MasSpec Pen produces a small drop of water that extracts molecules from a person’s cells during surgery. Through machine learning, the MasSpec Pen is able to determine what molecular fingerprint is normal and what is cancer, Eberlin says.
In the study, the researchers tested 253 human tissue samples from lung, ovary, thyroid and breast cancer tumors and compared them to samples of healthy tissues. The device was 96% accurate at identifying cancerous tissues. The researchers also tested the MasSpec Pen in live mice with tumors and found that the device was able to identify the presence of cancer without harming healthy surrounding tissues. The device can also identify different subtypes of lung and thyroid cancer, and the team hopes to make it more specified for other types of cancer, too.
The researchers say they need to continue validating their work and that they plan to start clinical testing in humans in 2018. Until then, it’s unclear how exactly the device will work when integrated into surgery. While the pen-sized device that the surgeon would use is small, the device is connected to a large mass spectrometer, which helps the process of analyzing individual molecules. That large machine would need to be wheeled in and out of a surgery room for each procedure. The pen is disposable, so surgeons would replace it with each surgery.
“This is a good example of a tool that empowers our transition to precision medicine where the treatment can be done with much higher levels of confidence,” says study author Thomas Milner, professor of biomedical engineering in UT Austin’s Cockrell School of Engineering. “Treatment can be planned and given where the outcomes are known. This is one tool along that path.”
Aug 28th 2017
A new drug that could help reduce the risk of heart attacks and cut cancer deaths has been hailed as an "exciting" breakthrough.
Canakinumab, an anti-inflammatory, was used in a trial involving more than 10,000 patients, all of whom have had a heart attack but had not been diagnosed with cancer.
They were treated with the drug, which is given by injection, once every three months and monitored for up to four years.
The study showed a 15% reduction in the risk of heart attacks and strokes and the number of cancer deaths cut by half.
One of the researchers, Dr Paul Ridker of Brigham and Women's Hospital in Boston, said the findings have "far-reaching implications".
He said: "For the first time, we've been able to definitively show that lowering inflammation independent of cholesterol reduces cardiovascular risk.
"It tells us that by leveraging an entirely new way to treat patients - targeting inflammation - we may be able to significantly improve outcomes for certain very high-risk populations."
The benefits seen in the patients were "above and beyond" those seen in patients who just took statins, the hospital said.
Dr Ridker said: "In my lifetime, I've gotten to see three broad eras of preventative cardiology.
"In the first, we recognised the importance of diet, exercise and smoking cessation. In the second, we saw the tremendous value of lipid-lowering drugs such as statins. Now, we're cracking the door open on the third era.
"This is very exciting."
Regarding the cancer findings, Dr Ridker said more research was needed but there was the "possibility of slowing the progression of certain cancers".
Gary Gibbons, director of the National Heart, Lung, and Blood Institute, said: "Although this trial provides compelling evidence that targeting inflammation has efficacy in preventing recurrent cardiovascular events, we look forward to findings from additional trials, such as the NHLBI-funded Cardiovascular Inflammation Reduction Trial, to further refine the best therapeutic strategies for preventing cardiovascular disease."
Aug 24th 2017
A woman has shared a warning in which she claims that finding a black line down your nail could be a sign of cancer
According to Jean Skinner, who claims to be a beauty technician from Uckfield, East Sussex, a client came in asking for a nail colour dark enough to cover the black line on her nail.
Skinner urged her to visit the doctor about it, and she claims the woman then found out she had melanoma.
Writing on Facebook, Skinner describes the client as having “a straight dark vertical stripe down her nail,” which, she says, many people had told her was due to lack of calcium, hereditary or a blood blister.
“This is melanoma!!!” Skinner wrote. “I did not want to frighten her but I told her she needed to see her doctor immediately! She called me today to tell me that yes it was a very aggressive melanoma that has already spread to her lymph nodes!! Her prognosis is not good!”
Skinner is now urging people to pay attention to abnormalities in their nail beds, even though, she points out, “odd changes in your nails can very likely be nothing to worry about.”
The Facebook post has been widely shared, with people commenting on how scary the warning is.
But according to official NHS guidelines, “dark stripes running down the nails (linear melanonychia) are fairly common in black people over 20 years of age, and in most cases it's perfectly normal.”
They do advise, however, that dark stripes on nails shouldn't be ignored because they could in fact be a sign of subungal melanoma, a form of skin cancer that affects the nail bed. If you find a dark line, you should see your doctor to check it isn’t melanoma.
“Subungual melanoma usually only affects one nail,” the NHS explains. “It will also cause the stripe to change in appearance – for example, it may become wider or darker over time and the pigmentation may also affect the surrounding skin (the nail fold).”
Melanoma makes up four per cent of total cancers in the UK and it has become 119 per cent more common since the early 1990s, according to Cancer Research UK.
Symptoms can occur in various places of the body, including under fingernails, between your toes or on your scalp.
“Symptoms of melanoma under your nails include dark areas or marks,” Professor Sanchia Aranda, CEO of Cancer Council Australia, told 7 News.
“Elsewhere on your skin, as well as keeping an eye out for new moles or spots, look for moles or spots that change colour, have a variety of colours, are getting bigger or have an uneven border or develop a lump within them.”
Aug 15th 2017
New low-cost cancer blood test could transform how cancer is monitored
Researchers from Stanford University have described a test that has the possibility to 'transform' a cancer diagnosis through detecting genetic mutations in miniscule amounts of DNA released from cancer cells in to someone's blood.
The report in The Journal of Molecular Diagnostics, describes how the cancer test – called a single colour digital PCR – only needs a fraction of a tube of blood and can detect at least three mutation-bearing molecules in a single reaction. It is thought the test is highly sensitive and has the potential for personalisation, meaning it could recognise mutations unique to individual cancers.
Lead investigator Hanlee P. Ji, MD, Associate Professor in the Department of Medicine at Stanford University and Senior Associate Director of the Stanford Genome Technology Center explained:
"For monitoring patient tumors, only a handful of blood tests are available which are limited to only several types of cancers. Nearly all cancer patients require monitoring by whole body imaging, which can be costly, complex, and time-consuming. In contrast, molecular tests like the one we have developed will enable patients to be monitored at every visit, and thus have the potential for quickly tracking cancer growth and spread. Moreover, the test's rapid turnaround and relatively low cost, especially compared to next-generation DNA sequencing, provide a potential opportunity for universal monitoring of more patients than is currently done."
The report explains the test was used to analyse samples from six patients, five of which were previously diagnosed with bowel cancer and one with cholangiocarcinoma – a bile duct cancer.
After customised mutation detection assays (an assay is an investigative, analytic procedure in laboratory medicine) researchers identified tumour-derived circulating DNA in three of the patients. In one of the patients, the assay showed the presence of three different mutations. The three patients whose samples didn't show elevated cancer DNA, were undergoing active treatment at the time, Medical Xpress report.
Lead author Christina Wood Bouwens said of the test:
"This test is simple enough to set up and analyze without extensive training, and therefore, it can be implemented by anyone, making it highly accessible to any laboratory. It has been truly motivating to work with a technology that will help transform the way that we monitor and treat individuals with cancer. I am excited to share our findings with the cancer research community."
Aug 3rd 2017
A sunscreen that uses DNA to act as a 'second skin' is on the horizon, potentially offering better protection from ultraviolet light throughout the day without the laborious task of constant re-application.
Scientists in the US used DNA samples taken from salmon to develop a product which gets better at shielding the skin from harmful UV exposure the longer it is in direct sunlight. It also helps lock in the moisture beneath the skin's surface – promising a longer-lasting tan.
Instead of damaging our own skin's DNA (resulting in sunburn), the UV light instead only affects the alternative applied layer of salmon DNA. Dr Guy German, assistant professor of biomedical engineering at Binghampton university, where the research was conducted, explained: "We thought, let's flip it. What happens instead if we actually used DNA as a sacrificial layer? So instead of damaging DNA within the skin, we damage a layer on top of the skin."
In tests, the research team found that the thin, optically transparent crystalline DNA films that they had developed became better at absorbing UV light the more they were exposed to it. German added: "If you translate that, it means to me that if you use this as a topical cream or sunscreen, the longer that you stay out on the beach, the better it gets at being a sunscreen."
As it stands, current sunscreens need to be applied roughly 30 minutes before sun exposure and then reapplied every couple of hours throughout the day – unless you go swimming or sweat profusely, in which case you need to reapply more often. However, the development of this DNA film means that a single application would suffice for beachgoers, holidaymakers or anyone who spends a significant amount of time in the sun.
The potential of DNA films isn't just limited to sunscreen. The moisture-locking properties of such a product promises a potential treatment or prevention method for dry, flaky or pigmented skin, as well as injuries. Commenting on the versatility of the material, German said: "Not only do we think this might have applications for sunscreen and moisturisers directly, but if it's optically transparent and prevents tissue damage from the sun and it's good at keeping the skin hydrated, we think this might be potentially exploitable as a wound covering for extreme environments."
For now, however, the research is still in the early stages, and a lot more tests will have to be done before anything of this kind appears on the market. So, as far as summer 2017 is concerned, keep applying that sun lotion.
July 27th 2017
When a shop assistant told Jenny Murphy her beloved son Billy had "freaky" and "scary eyes" the young mum was shocked at his obvious cruelty.
The mum-of-five had taken her seven-month-old tot toy shopping and soon found herself walking out of the store upset.
She left without complaining, not wanting to cause a fuss for fear of ruining a much-needed family holiday .
For months Jenny had been concerned about Billy as he appeared to have little strength as he walked, and had been vomiting all his milk as they attempted to get him onto solid food.
But doctors dismissed her worries, and said it was just a problem with weaning.
The shop worker's cruel comment about Billy stuck in Jenny's mind and it was not until she mentioned it to a health visitor that the jibe ended up saving the tot's life, as he was finally diagnosed with a lethal brain tumour.
“Over the past few weeks, we’d noticed he looked like he was staring, but I never dreamt it could be a sign of anything sinister," said Jenny, 37.
The family had been out Christmas shopping when a male shop assistant started looking awkwardly at Billy.
Jenny said: “He just stared and then blurted out: 'Your baby’s eyes are freaking me out! They’re scary'.
"I was shocked and couldn’t believe he’d say something so cruel about my baby. Craig and I just looked at each other lost for words. Isla and Poppy were with us, too and we didn’t want to spoil a family day out."
Jenny lives in the Wirral, Merseyside with partner Craig Moss, 31, who is Billy and three-year- old Isla’s dad, as well as Molly, 17, Jake, 13, and Poppy, nine from her ex-husband.
At the time Billy had been looking downwards and you could see the whites of his eyes, but his family never thought this could be an indication of a life threatening tumour that gave him just a one in four chance of survival.
When her health visitor came round a few days later, Jenny showed her Billy’s eyes.
“She took one look at him and said he had ‘sunset’ eyes, which was a sign of build-up of fluid on the brain,” added Jenny.
“Then she told me I needed to get it checked out urgently.”
The health visitor rang the Wirral’s Arrowe Park hospital, who said to bring Billy in.
Later that day, Billy had a CT scan which revealed he had a “mass” on his brain and he was taken to Alder Hey Children’s Hospital in Liverpool. An MRI scan at the hospital confirmed the devastating news that Billy - at just seven months old - had a brain tumour.
“I felt numb,” said Jenny.
“I think we were in shock. I even asked if we could take Billy home before his operation.”
Jenny then remembered some of the previous warning signs that she had been told to ignore.
A few months before Billy had been difficult to wake up at home. They called for an ambulance and he was checked out at hospital.
“But he was fine by then and we came home. I thought nothing of it,” said Jenny.
"Then in the November, I mentioned to a health visitor Billy didn’t seem to have much strength in his legs, she told me not to worry as his sister Isla had been weak for a while, so it might be a family trait.”
Later that month, they started weaning Billy and he vomited whole bottles up as soon as he drank them.
Jenny added: "Craig took him to the local walk in centre. They said his sickness was down to weaning and told us to lay off it for a week. That just didn’t ring true with me – it was my fifth time weaning a baby and I knew what I was doing by then. But the vomiting only lasted 24 hours.
“When we were told our beautiful boy had a brain tumour, those other symptoms flashed through my mind.”
Six days after his devastating diagnosis, on December 16, 2015, Billy had a five-hour operation.
Surgeons were able to remove the whole tumour and a biopsy revealed it was cancerous – a grade three choroid plexus carcinoma.
“He came home on Christmas Eve, but it wasn’t much of a first Christmas for him as he was poorly after surgery,” said Jenny.
On December 30, he started six months’ chemotherapy and was only given a 25 per cent chance of survival.
But Billy amazed everyone with his recovery.
“He is a remarkable little boy – despite being in pain after surgery, he never stopped smiling,” added Jenny.
“We count our blessings he made such a good recovery as so many children with brain tumours have far more problems and disabilities caused by their tumours and surgery."
Billy has been able to play with his brothers and sisters after successfully undergoing his
“A key part of that is to make sure more parents and healthcare professionals are aware of the warning signs of a brain tumour in children.
“It is devastating to be told your child has a brain tumour and we so grateful to Billy’s family for sharing his story to help us raise awareness and thrilled he is doing so well.”
World Aquatics Championships gold medallist, Tom Daley, who lost his dad, Rob, to a brain tumour in 2011, presented BBC 1 Lifeline appeal on Sunday to fund world-first research to analyse the symptoms.
“We’ve noticed he’s got a few concentration problems and he’s got a slight gait to his walk at times, which may be side effects, so we’ll keep an eye on that,” said Jenny.
“But generally, he’s had a remarkable recovery and is thriving. He’s mad about Peppa Pig and loves his food. He’s talking and being the little lively boy that he should be."
The family are backing The Brain Tumour Charity's HeadSmart campaign and their bid for a National Lottery Award.
Hayley Epps, campaign manager for The Brain Tumour Charity, said: “Brain tumours kill more children and people under 40 in the UK than any other form of cancer.
“HeadSmart has two aims: to save lives and reduce long-term disability by bringing down diagnosis times.
“The kids all absolutely adore their little brother,” said Jenny.
“And Molly is like a second mum to him, I don’t know what I’d do without her.”
In November last year, the family were treated to a visit to the X Factor studios in London, arranged by The Brain Tumour Charity, which supports the family. They met Simon Cowell and other judges Louis Walsh and Sharon Osbourne, as well as the contestants, including 2016 winner Matt Terry and controversial Honey G.
But Billy blanked Simon Cowell as he refused to high five him and blurted out “Oh no!” as he listened to Honey G at the sound check.
Now Billy's last four-monthly scan has come back clear and he’s looking forward to starting nursery in September.
July 27th 2017
A brave mum who was diagnosed with breast cancer just days ago has shared an intimate photo to warn others about unfamiliar symptoms of the disease.
While most of us associate a lump, swelling or a change in size or shape with breast cancer, it doesn’t always present itself that way.
This was the case for Sherrie Rhodes, a mother-of-three whose diagnosis started with a dimple.
After seeing a post on Facebook that named dimples as a sign of breast cancer, Rhodes decided to visist her GP upon discovering two dents in the side of her right breast, the Hull Daily Mail reports.
She was then referred to a breast clinic where she was given the devastating news that she had breast cancer on Monday.
But despite the shock, Rhodes knew that she had to warn other women and took to Facebook to share a picture of the dimples.
“Yesterday I was diagnosed with breast cancer,” the brave mum wrote.
“It came as a total shock as this dimpling (in the pic) is the only symptom I had. I wasn't too worried as there was no lump or anything. Unfortunately it came back as breast cancer.
“Please check your breast regularly and don't ignore anything that is different. If I hadn't seen a post like this previously I wouldn't have known that this dimpling was a sign of cancer. Please share and raise awareness.”
The Facebook post has since been shared more than 400 times with an abundance of women praising her for raising awareness while others have also come forward saying that they had no idea dimples were an indication of breast cancer.
“Yesterday I touched my breasts for the first time in years and it was because I saw this heartbreaking status from my friend Sherrie,” one person wrote.
“Thank you Sherrie for raising awareness so soon after your diagnosis. You've already inspired me more than you know.”
“Early detection means better treatment outcomes. Well done Sherrie,” another said.
Other possible symptoms of breast cancer include a lump or area of thickened tissue in a breast; a change in the size or shape of one or both breasts; discharge from a nipple; a lump or swelling in an armpit; dimpling on the skin of the breast; a rash on or around a nipple; or a change in the appearance of a nipple, such as becoming sunken.
July 8th 2017
Each year, over 50,000 women are diagnosed with breast cancer in the UK – one in eight worldwide. The good news, though, is that survival rates from this terrible disease are continuing to creep up, meaning that the majority of people diagnosed with breast cancer have a fighting chance of survival.
But breast cancer recovery is about more than just surviving, it's about thriving; reconnecting with your body, celebrating what it can do and watching it flourish as you return to full health – factors that can be enhanced through exercise. So, for those of you who are looking to get moving again post-cancer, no matter where you are in your journey, we got in touch with Rachel Rawson, Senior Clinical Nurse Specialist at Breast Cancer Care, for some expert advice.
Regular physical activity can help maintain or improve both physical and mental health during and after treatment, Rachel says. Here's how:
"For individuals who are undergoing chemo or other forms of therapy, it's worth noting that exercise can help avoid or reduce some side effects of cancer treatment. There is good evidence that it can help with fatigue and the management of lymphedema, but also weight gain and osteoporosis."
However, Rachel cautions that exercising during and after treatment for breast cancer can sometimes be difficult, as some side effects – such as fatigue or feeling sick – can get in the way. However, even doing a small amount of activity has benefits.
"If a person is new to exercise or is trying out a new form of exercise then starting slowly and building up activity gradually is advised. Checking with a health care professional first may also helpful in making the decision about which exercise is best."
Maintaining some form of physical activity can also improve long-term health, reducing the risk of heart attacks and strokes – and there is also some evidence to suggest that exercise may reduce the risk of the cancer coming back.
"It can also help with your mental wellbeing by reducing anxiety, stress, depression and improving your overall mood. In addition, exercise can prevent or reduce the loss of muscle tone and aerobic fitness that can happen during treatment."
What to do
The key to exercise is finding something that you enjoy and that you can easily introduce into your day or week. For example, if you enjoy walking, try to increase the amount of time you walk for and the number of times you walk each day. You could also try increasing your pace as your energy returns. A pedometer (or phone app) can help you monitor your progress.
Rachel adds: "If you drive to work or the shops, park your car a little further away and walk the rest, or get off the bus a stop earlier than you need to and walk. Even something as simple as energetic housework can help increase your daily activity levels."
Other small changes that can make a big difference include using the stairs instead of talking the lift, sitting less and standing more, for example when talking on the phone.
"Setting realistic goals and keeping a record of how much activity you do may also help you stay motivated," says Rachel. "For some people a goal is key to starting to exercise. It gives a sense of achievement and friends and family can join in."
If you, a family member or friend are up for a challenge in the name of defeating cancer, why not use a charity event as your ultimate exercise goal? Breast Cancer Care has loads of fundraising events that you can get involved in, such as the Shock Absorber WomenOnly Triathlon which is taking place this weekend - look out for team NetDoctor on the way round!
"Exercise really does help in so many different ways but one of the good things about it is that it can be a way to connect with people. Joining walking groups, learning to dance or going to a local gym can all be ways that a person can meet others so that it's a social event. Equally, exercising alone can be just as beneficial and can give time for reflection or working towards new goals."
July 8th 2017
Hasini Jayatilaka was a sophomore at the Johns Hopkins University working in a lab studying cancer cells when she noticed that when the cells become too densely packed, some would break off and start spreading.
She wasn't sure what to make of it, until she attended an academic conference and heard a speaker talking about bacterial cells behaving the same way. Yet when she went through the academic literature to see if anyone had written about similar behavior in cancer cells, she found nothing.
Seven years later, the theory Jayatilaka developed early in college is now a bona fide discovery that offers significant promise for cancer treatment.
Jayatilaka and a team at Johns Hopkins discovered the biochemical mechanism that tells cancer cells to break off from the primary tumor and spread throughout the body, a process called metastasis. Some 90 percent of cancer deaths are caused when cancer metastasizes. The team also found that two existing, FDA-approved drugs can slow metastasis significantly.
"A female patient with breast cancer doesn't succumb to the disease just because she has a mass on her breast; she succumbs to the disease because [when] it spreads either to the lungs, the liver, the brain, it becomes untreatable," said Jayatilaka, who earned her doctorate in chemical and biomolecular engineering this spring in addition to her earlier undergraduate degree at Hopkins.
"There are really no therapeutics out there right now that directly target the spread of cancer. So what we came up with through our studies was this drug cocktail that could potentially inhibit the spread of cancer."
The study was published online May 26 in the journal Nature Communications. The next step for the team is to test the effectiveness of the drugs in human subjects.
Typically, cancer research and treatment has focused on shrinking the primary tumor through chemotherapy or other methods. But, the team said, by attacking the deadly process of metastasis, more patients could survive.
"It's not this primary tumor that's going to kill you typically," said Denis Wirtz, Johns Hopkins' vice provost for research and director of its Physical Sciences-Oncology Center, who was a senior author on the paper.
Jayatilaka began by studying how cancer cells behave and communicate with each other, using a three-dimensional model that mimics human tissue rather than looking at them in a petri dish. Many researchers believe metastasis happens after the primary tumor reaches a certain size, but Jayatilaka found it was the tumor's density that determined when it would metastasize.
"If you look at the human population, once we become too dense in an area, we move out to the suburbs or wherever, and we decide to set up shop there," Jayatilaka said. "I think the cancer cells are doing the same thing."
When the tumor reaches a certain density, the study found, it releases two proteins called Interleukin 6 and Interleukin 8, signaling to cancer cells that things had grown too crowded and it was time to break off and head into other parts of the body.
Previously, Wirtz said, the act of a tumor growing and the act of cancer cells spreading were thought to be very separate activities, because that's how it appeared by studying cancer cells in a petri dish, rather than the 3-D model the Hopkins team used. Many researchers study only cancer cell growth or its spread, and don't communicate with each other often, he said.
Once the cancer cells start to sense the presence of too many other cancer cells around them, they start secreting the Interleukin proteins, Wirtz said. If those proteins are added to a tumor that hasn't yet metastasized, that process would begin, he said.
The team then tested two drugs known to work on the Interleukin receptors to see if they would block or slow metastasis in mice. They found that using the two drugs together would block the signals from the Interleukin proteins that told the cancer cells to break off and spread, slowing — though not completely stopping — metastasis.
The drugs the team used were Tocilizumab, a rheumatoid arthritis treatment, and Reparixin, which is being evaluated for cancer treatment.
The drugs bind to the Interleukin receptors and block their signals, slowing metastasis.
Though metastasis was not completely stopped, Jayatilaka said, the mice given the drug cocktail fared well and survived through the experiment. She said adding another, yet-to-be-determined drug or tweaking the dose might stop metastasis entirely.
Contrary to the hair loss, nausea and other negative side effects patients undergoing chemotherapy suffer, Wirtz said the side effects from the drugs used in the study would be minimal.
Anirban Maitra, co-director of a pancreatic cancer research center at the MD Anderson Cancer Center at the University of Texas, cautioned that clinical trials in humans are needed to prove the theory.
"There's a risk that something that looks so great in an animal model won't pan out in a human," he said.
But Maitra said the study looked promising, in particular because the researchers had used drugs already on the market. It can take a decade to identify a drug that would perform similarly and get it approved, and many similar observations don't advance because of the time and expense it can take to get drug approval, he said.
Muhammad Zaman, a professor and cancer expert at Boston University, called the Hopkins discovery "exciting."
"This paper gives you a very specific target to design drugs against," he said. "That's really quite spectacular from the point of view of drug design and creating therapies."
Zaman said it was important for cancer researchers to use engineering to better understand cancer, as the Hopkins team did.
"This really brings cancer and engineering together in a very unique way, and it really takes an approach that is quantitative and rigorous," he said. "We have to think of cancer as a complex system, not just a disease."
Wirtz predicted a future where cancer would be fought with a mix of chemotherapy to shrink the primary tumor and drug cocktails like the one the Hopkins team developed to ensure it would not metastasize. He compared such a treatment to how HIV/AIDS is treated today.
"We're not going to cure cancer with one therapy or even two therapies; it's going to be drug cocktails," Wirtz said. "That's what saved the day with HIV/AIDS."
Immunotherapy, which uses the body's immune system to fight cancer, also could play a role in a combined method, Wirtz added.
"We're, in research, sometimes incentivized to look at one pathway at a time, one type of cancer at a time," Wirtz said. "I think oncology has started realizing we're going to need more than one approach."
June 15th 2017
A woman has shared a photo of her breast in the hope it’ll educate others of the warning signs of inflammatory breast cancer.
Jennifer Cordts noticed a red rash on her left breast in 2015. After a mammogram came back all clear, she didn’t think anything of it.
“I was told, crazy enough, that my bra was too small,” she told WFAA Dallas.
But when the rash didn’t disappear, Cordts started Googling her symptoms and inflammatory breast cancer came up.
“It was late at night, everybody was asleep, and I was terrified. I just had a bad feeling,” she recalled.
One year after she first noticed the rash, a biopsy confirmed the worst - Cordts had stage four inflammatory breast cancer.
Inflammatory breast cancer is a rare type of breast cancer that grows along the lymph vessels in the skin of the breast, according to Macmillan Cancer Support.
Cancer cells may not form a lump, but they do block the vessels.
Symptoms of the disease include: redness, swelling or pain in the breast; the breast feeling hot to touch; skin of the breast looking pitted (like orange peel); ridges or raised marks on the skin of the breast and pain in, or discharge from, the nipple.
Discussing the day she was diagnosed, Cordts revealed: “I remember him [the doctor] saying ‘inflammatory breast cancer’ and all I could think about was what I’d Googled.
“Because what I’d Googled said that everybody dies, nobody survives.
“I knew my fate right then.”
Cordts has been given three to five years to live. She is also receiving treatment to slow down the growth of her cancer.
The mum-of-two is now making as many memories as she can with her family.
She has spoken out about her diagnosis in the hope that it will prompt others to get a faster diagnosis if they spot any unusual symptoms.
She said: “I really want someone to go, ‘oh my gosh I have redness in my breast, I better push past the mammogram and ask for more tests’.”
Related: Cancer myths debunked
April 27th 2017
A young dad who had never taken a sick day in his life, died after a tragic battle with bowel cancer .
John Hewitt, just 34, ran tough mudders, played football and cycled regularly.
He was described by his wife Katie as the "healthiest person" she'd ever met and had never needed to stay off work due to illness.
The couple, from Bristol, thought little of his change in bowel movements and a slight bleed due to his active lifestyle and healthy past.
But as pregnant Katie went for her 12 weeks scan on their unborn baby, John was given the devastating test results that confirmed he had bowel cancer .
Their first child was only a year old.
Speaking about the heartache of losing her husband, Katie, 32, said: "We had one week of feeling like we had everything we could have ever wanted before we were told his diagnosis.
“That was before we found out it was terminal, so things quickly became a lot a worse, reports the Bristol Post .
"'Devastating' doesn't even come close in describing the way we both felt. It was the most unimaginable news and something we, of course, weren't prepared for.
“He had one year with our second child before he died – not nearly enough time.
“During that time his condition became progressively worse and he became very unwell.”
John, who worked as engineer, continued to receive palliative chemotherapy in an attempt to slow down the progression the disease but his tumour was too aggressive and he did not respond to treatment and died on New Year’s Eve.
Katie said: “We were a young couple, we’d only been married for four years and we had two babies .
"St Peter’s Hospice was so respectful of this and special little touches, like allowing me to stay overnight and moving our beds together, so that we could sleep next to each other, made our last days together that little bit easier.
“It was moments like that which meant so much and which we wouldn’t have been able to share in a hospital.
“His dying wish was for me to raise money for the hospice. Unfortunately we wont be the last couple who need to use the hospice.
“It’s such an amazing service and it’s offered for free, which is so important.
"When you’re in your 30s, you don’t expect to be involved with a hospice. We didn’t envisage our lives taking this course.
"However the hospice ended up being the best place.
"What we didn’t realise initially about St Peter’s Hospice, is that it’s not just about death.
"They helped manage John’s symptoms and made him more comfortable from as early as four months before his death.
"It was obviously still awful and the worst thing imaginable, but we would have been lost without the help of the hospice and I know I’d still be struggling more now without the bereavement support.”
Katie hopes to create a lasting legacy for John by raising £19,000 for the charity - which would pay for one day of treatment at the hospice.
And to help her reach the goal, Katie and group of friends, including one of John’s sisters, Anne Mark, will be taking part in Bristol’s 10k challenge in 11 days' time
Katie said: “It’s definitely going to be a challenge. I’ve never run 10k before in my life.
"We’re all training as much as we can around childcare but none of us are doing it for a good time, it’s about raising money for St Peter’s Hospice.”
The Great Bristol 10k is taking place on Sunday May 7 and registration is still open for those who would like to sign up in aid of the hospice.
The charity is also inviting people to come along and support their runners on the day.
Dubbed “Cheer Champions” these supporters would represent St Peter’s Hospice and cheer the runners on. They will receive a branded St Peter’s Hospice t-shirt to wear on the day.
March 23rd 2017
Former Beverly Hills, 90210 star Luke Perry suffered a health scare in 2015 when his doctor found precancerous growths during a routine colonoscopy.
The actor, now 50, promptly had the growths removed, but he was lucky medics made the discovery in his colon before they developed into colorectal cancer - and now he is using his experience to urge others to get tested on a regular basis.
"Right now, there are 23 million Americans who haven't been screened who need to be screened," he told Fox News. "If I had waited, it could have been a whole different scenario."
Colorectal cancer is typically associated with people over 55, but researchers at the American Cancer Society recently discovered that millennials now face double the risk of developing the illness compared to the baby boomer generation, which refers to people born between 1946 and 1964.
Perry has since joined forces with bosses at advocacy group Fight Colorectal Cancer to support its Strong Arm Selfie national campaign, which encourages social media users to share a snap of themselves flexing a bicep and using the hashtag "#StrongArmSelfie". Pharmaceutical executives at Bayer Healthcare have pledged to donate $1 (£0.80) to the charity for every photo shared.
The actor's close call with cancer emerges weeks after his former Beverly Hills, 90210 co-star Shannen Doherty completed chemotherapy treatment for breast cancer, which she was diagnosed with in 2015.
March 22nd 2017
Women who have taken the contraceptive pill are protected from some types of cancer for as long as 30 years, according to new research.
Those who have used the pill are less likely to have bowel cancer, endometrial cancer or ovarian cancer than women who had never taken it, a study at the University of Aberdeen found.
Researchers also looked at the risk of all types of cancer in women who have taken the pill during their reproductive years and found it does not lead to new cancer risks later in life.
The results are the latest published from the longest-running study in the world into the effects of taking the contraceptive pill.
Established by the Royal College of General Practitioners' in 1968, the Oral Contraception Study was set up to look at the long-term health effects of oral contraceptives.
The latest study, led by Dr Lisa Iversen, relates to 46,000 women followed for up to 44 years.
Dr Iversen, research fellow in the Institute of Applied Health Sciences at the university, said: "Because the study has been going for such a long time we are able to look at the very long-term effects, if there are any, associated with the pill.
"What we found from looking at up to 44 years' worth of data was that having ever used the pill, women are less likely to get colorectal, endometrial and ovarian cancer.
"So, the protective benefits from using the pill during their reproductive years are lasting for at least 30 years after women have stopped using the pill.
"We were also interested in what the overall balance of all types of cancer is amongst women who have used the pill as they enter the later stages of their life.
"We did not find any evidence of new cancer risks appearing later in life as women get older.
"These results from the longest-running study in the world into oral contraceptive use are reassuring.
"Specifically, pill users don't have an overall increased risk of cancer over their lifetime and that the protective effects of some specific cancers last for at least 30 years. "
The study, which has received funding from bodies including the Medical Research Council, Imperial Cancer Research Fund and the British Heart Foundation, published its latest findings in the American Journal of Obstetrics and Gynaecology.
Dec 31st 2016
Thousands of women may be needlessly having their breasts removed to prevent cancer because of the ‘Angelina Jolie’ effect, researchers have warned.
Around 4,000 women in Britain a year now opt for a double mastectomy in the belief that it will prevent cancer returning in the healthy breast, a figure that has increased since actress Jolie publicly announced she had the procedure in 2013.
Yet there is no evidence that it prevents cancer from spreading in women who do not have an underlying risk of cancer, as Jolie has.
A new survey by researchers in America found that when women are not advised by their physicians one in five will opt for a double mastectomy.
The procedure can lead to major complications - including depression, and breast cancer specialist Dr Reshma Jagsi urged surgeons to advise patients not to have the operations when they did not need them.
Dr Jagsi, of Michigan University, said: "When patients do not perceive a surgeon's recommendation against it, even patients without a high genetic risk for a second primary breast cancer choose a double mastectomy at an alarmingly high rate.
"Our findings should motivate surgeons to broach these difficult conversations with their patients, to make their recommendations clear, and to promote patients' peace of mind by emphasising how other treatments complement surgery to reduce the risk of both tumor recurrence and subsequent cancer development.
"These findings should also motivate efforts to inform and support surgeons in this challenging communication context.”
Jolie had both her breasts removed after being told she had an 87 per cent risk of developing breast cancer due to a defective BRCA1 gene and family history.
Her mother, maternal grandmother and aunt all died from breast or ovarian cancer in their late 40s or in their 50s. The actress later also had her ovaries removed.
Other stars who have undergone it include X-Factor judge Sharon Osbourne and Oscar-winning actress Kathy Bates.
Breast cancer is the most common cancer among women with more than 50,000 being diagnosed in the UK each year.
Many women opt for the surgery not only for peace of mind, but because they feel they would look out of balance with one breast - although there has been an increase in the amount of plastic surgery done to reconstruct breasts following the operation.
The researchers carried out the study because little is known about treatment decision making or physician interactions in diverse patient populations.
They questioned 2,402 patients who underwent recent treatment for breast cancer to evaluate motivations, knowledge and decisions as well as the impact of surgeon recommendations.
They found that fewer than four-in-ten women knew that a double mastectomy does not improve survival for all women with breast cancer.
The research was published in JAMA Surgery.
23rd Dec 2016
Bursting cancer cells
A research team of Naraesuan University has successfully extracted chemicals from the latex of Rak plant (Calotropis gigantea) which are capable of inhibiting the function of a protein which is essential for the growth of cancerous cells, said Dr Supawadee Pahera, a lecturer at the faculty of pharmacy of the university.
She added that the chemicals were found to be capable of resisting H1N1 flu virus in the early stage of infection and stopping enzyme which causes tissue inflammation.
Dr Supawadee said that this research work would pave the way for the search of new medicines for the treatment of certain ailments.
The research work has been patented and also published in three international academic publications, she said, adding that the university recently signed an MOU for research cooperation with Macau University of Science and Technology in search of an anti-cancer medicine and anti-flu virus.
The research work on latex of the Rak plant has won the Macau Scientific and Technological R&D Post-graduates Award 2016.
Sep 13th 2016
Failure of cancer surgery to intraoperatively detect and eliminate microscopic residual disease (MRD) causes lethal recurrence and metastases, and the removal of important normal tissues causes excessive morbidity. Here, we show that a plasmonic nanobubble (PNB), a non-stationary laser pulse-activated nanoevent, intraoperatively detects and eliminates MRD in the surgical bed. PNBs were generated in vivo in head and neck cancer cells by systemically targeting tumours with gold colloids and locally applying near-infrared, low-energy short laser pulses, and were simultaneously detected with an acoustic probe. In mouse models, between 3 and 30 residual cancer cells and MRD (undetectable with current methods) were non-invasively detected up to 4 mm deep in the surgical bed within 1 ms. In resectable MRD, PNB-guided surgery prevented local recurrence and delivered 100% tumour-free survival. In unresectable MRD, PNB nanosurgery improved survival twofold compared with standard surgery. Our results show that PNB-guided surgery and nanosurgery can rapidly and precisely detect and remove MRD in simple intraoperative procedures.
A new cancer research breakthrough has recently been developed thanks to researchers from McGill University, Université de Montréal and Polytechnique Montréal. The new nanorobots can travel down the bloodstream to administer drugs precisely by targeting a tumor’s cancer cells. This is the best way to inject medication since the integrity of the healthy tissues and organs won’t be jeopardized. This means that the dosage of the drug could be reduced, which is significant because the drug is very toxic for humans.
According to Professor Sylvain Martel, director and the head of the research team at Polytechnique Montréal Nanorobotics Laboratory and the holder of the Medical Nanorobotics Canada Research Chair, these nanorobotic agents hold no less than 100 million bacteria, which are flagellated and self-propelled. These bacteria are full of drugs and take a direct path from the injection site to the part of the body that needs to be cured. The propelling force of the drug is strong enough to enter the tumors deeply and to travel efficiently.
When the nanorobotic agents enter a specific tumor they can automatically detect the tumor areas that have been depleted of oxygen, which are called hypoxic zones, in order to deliver the medicine to them. Tumor cells that are rapidly proliferative create a hypoxic zone by substantially consuming oxygen. Up until now these hypoxic zones have been resistant to the majority of therapy methods including radiotherapy. It is difficult to access these tumors even with a small blood cell path because physiological complex microenvironments need to be crossed. For this reason, Prof. Martel along with his team of researchers decided to use nanotechnology to see results.
There are 2 natural systems that the bacteria rely on for movement. They are
drawn towards a magnetic field through the synthesis created by a magnetic
nanoparticles chain and they are able to get to the active regions in the tumor
and remain there with an oxygen concentration measuring sensor. When these 2
systems of transportation are used together and when the bacteria are exposed
to a magnetic field that is computer-controlled, these bacteria are able to
replicate perfectly these task-oriented artificialnanorobots.
Prof. Martel goes on to say that more advanced intervention methods and engineering concepts will be created as a result of the innovative use of these nanorobots. As well, the synthesis of new transportation methods for diagnosing, imaging and therapeutic agents can be further researched. Chemotherapy is a toxic form of therapy for the human body and as a result of the research the side effects could be eliminated while the therapeutic effectiveness is increased by using nanorobots to directly transport the drugs to the targeted area.
The research paper has been published in the journal of Nature Nanotechnology in a study titled “Magneto-aerotactic bacteria deliver drug-containing nanoliposomes to tumour hypoxic regions.” The research marks the results of the study done on mice and shows how they successfully directed nanorobotic agents into colorectal tumors.
Macmillan chief executive Lynda Thomas said: “What we are seeing is that a lot of people are coming in and out of treatment, so all of that does put pressure on the NHS.”
Around 625,000 people in the UK are estimated to be facing poor health or disability after treatment.
With the numbers living with cancer in the UK set to rise from 2.5 million to four million by 2030, more will need support.
Mrs Thomas said the challenge for medical professionals is to “keep up to speed” with the potential side-effects as new treatments emerge.
Tattoos can cause cancer and mutations - and one colour is potentially more toxic than others, according to scientists.
Research by the European Chemicals Agency to be published imminently is investigating possible risks associated with being inked.
The agency said: “Many reports show significant concerns for public health stemming from the composition of inks used for tattooing.
“The most severe concerns are allergies caused by the substances in the inks and possible carcinogenic, mutagenic or reproductively toxic effects.
Inks are not currently regulated in the EU. If any particular chemicals are found to be harmful as thought, they will be banned.
An agency spokesman said : "If it is found that a restriction is needed, a formal proposal to restrict the substances will be submitted within one year to initiate the process."
Red ink has been linked to dermatitis - swelling and soreness - due to it containing mercury sulphide while.
Meanwhile red, blue, green and purple ones are more likely to cause granulomas – little ridges of bumps on the skin.
The public will be asked to contribute to the research. The NHS has also warned of the dangers of ‘black’ or ‘neutral’ henna.
Different to authentic henna, which is orange in colour, this darker substance it may contain levels of a chemical dye ‘so powerful and toxic that it is illegal to use it on the skin’.
The NHS warned: “If you see a shop or stall offering to paint black tattoos onto your skin, don’t be tempted to get one. It could leave you scarred for life and put you at risk of a life-threatening allergic reaction.”
Anyone suffering an allergic reaction should contact a doctor as soon as possible.
A new study suggests that alcohol is a direct cause of cancer in several areas of the body.
The study, published Thursday in the scientific journal Addiction, consists of a major review of 10 years’ worth of studies from several organizations, including the World Cancer Research Fund, the American Institute for Cancer Research and the International Agency for Research on Cancer.
And its conclusions are dire.
Nearly 6 percent of cancer deaths worldwide can be linked to alcohol, including in people who drink light to moderate amounts of alcohol, the study concludes. “From a public health perspective, alcohol is estimated to have caused approximately half a million deaths from cancer in 2012,” wrote study author Jennie Connor, a professor of epidemiology at the University of Otago in New Zealand.
The study determined that there is a strong link between alcohol consumption and cancer in specific areas of the body, such as the liver, colon, esophagus and female breast. There are also causal contributions in other areas such as the prostate, pancreas and skin.
How alcohol causes cancer is not deeply understood, according to the study, but it is thought to depend on the “target organ.” For example, cancers of the throat, mouth and liver can be largely attributed to a carcinogenic compound called acetaldehyde. Salivary acetaldehyde levels have been found to reach high levels when drinking.
Breast tissue is another area that seems to be particularly susceptible to alcohol.
Connor noted the United Kingdom’s Million Women Cohort study, which found that women who drank 70 to 140 grams of alcohol per week experienced a 13 percent increase in breast cancer and a 5 percent increase in total cancer compared to those who drank less than 20 grams per week.
Unfortunately, the amount you drink might not matter all that much. While heavy drinkers have a higher risk of liver, colon and laryngeal cancer than light drinkers, all drinkers have the same risk of mouth, esophagus, breast and pharynx cancer.
Connor also acknowledges that some of the studies she reviewed show that those who drink light to moderate of alcohol have a reduced risk of developing cardiovascular disease than abstainers.
But many epidemiologists agree that research confirms alcohol actually causes cancer, Connor wrote, while the relationship between drinking and heart disease is not as conclusive.
For example, other lifestyle factors beyond alcohol consumption ― such as a person’s healthy behavior and demographic conditions ― typically put abstainers at a higher risk than those who moderately drink. Connor cites a 2005 study that showed 27 out of 30 risk factors for cardiovascular disease were more prevalent in abstainers than moderate drinkers.
“Promotion of health benefits from drinking at moderate levels is seen increasingly as disingenuous or irrelevant in comparison to the increase in risk of a range of cancers,” she wrote in the study.
As a solution to alcohol-attributed cancer, Connor suggests everyone should reduce their alcohol consumption, not just heavy drinkers.
“Population-wide reduction in alcohol consumption will have an important effect on the incidence of [cancer], while targeting the heaviest drinkers alone has limited potential,” she wrote in the study.
However, most people
today are hesitant to adapt to the facts. While the majority of the population
readily accepts that smoking causes lung cancer, “alcohol’s causal role is
perceived to be more complex than tobacco’s,”
About 1.7 million people in England could be living with undiagnosed lung cancer, lung disease or heart disease, which are among the country’s biggest killers, a government agency has warned.
Public Health England (PHE) is urging anyone with a persistent cough, or who gets breathless doing everyday tasks that never previously troubled them, to see their GP in case they have one of the conditions.
Launching its latest “Be Clear on Cancer” campaign on Thursday, it said that the conditions together kill more than 100,000 people a year, but finding them early makes them more treatable.
PHE estimates that there are about 80,000 undiagnosed cases of lung cancer, 1 million cases of chronic obstructive pulmonary disease (COPD) – which includes emphysema and chronic bronchitis – and 600,000 undiagnosed cases of coronary heart disease.
Prof Kevin Fenton, PHE national director for health and wellbeing, said: “The estimated number of people with undiagnosed lung cancer, lung disease or heart disease is deeply concerning. If diagnosed early, these diseases can be managed and treated successfully. This campaign will help people recognise the symptoms and encourage them to seek help, potentially saving lives from what are three of the biggest causes of death in England.”
The campaign is aimed at men and women aged 50 and over, who are most at risk. It says that a persistent cough or shortness of breath mowing the lawn, vacuuming or doing other tasks that did not used to prove difficult could be a sign of lung cancer or other lung disease. Breathlessness could be a sign of heart disease as well.
Coronary heart disease is the single biggest cause of death in England, accounting for more than 56,000 deaths every year, and lung cancer is the biggest cancer killer, causing around 28,400 deaths a year. COPD is the cause of a further 24,000 deaths.
Public health minister Jane Ellisonsaid: “Sadly, diagnosis often comes too late, which can have a devastating impact on those living with any of these conditions, as well as those close to them. The more people we can encourage to get their symptoms checked, the more likely they are to be diagnosed earlier and treated successfully.”
Around 36,500 people in England are diagnosed with lung cancer each year. There are currently approximately one million people who have been diagnosed with COPD and around 1.8 million who have been diagnosed with coronary heart disease.
Breast Cancer one of the worst being Triple negative breast cancer has shown excellent results when treated with a cocktail of two approved drugs.
Using Pemetrexed and sorafenib together causes cancer cells to eat themselves from the inside out
Reports the journal Oncotarget
EHA 2016: Restoring effective anti-tumour response in Hodgkin lymphoma with nivolumab
Adding to a growing list of disease applications, nivolumab is efficacious against primary Hodgkin lymphoma.
This is according to research presented at the European Haematology Association 21st congress in Copenhagen
Hodgkin lymphoma typically affects young men and women in their 30s.
Although it is highly curable with the current combination of chemo and radiation therapy, approximately 20% of patients will not be cured with first line regimens.
(AP) — A 64-year-old cancer patient has received the nation's first penis
transplant, a groundbreaking operation that may also help accident victims and
some of the many U.S. veterans maimed by roadside bombs.
In a case that represents the latest frontier in the growing field of reconstructive transplants, Thomas Manning of Halifax, Massachusetts, is faring well after the 15-hour operation last week, Massachusetts General Hospital said Monday.
His doctors said they are cautiously optimistic that Manning eventually will be able to urinate normally and function sexually again for the first time since aggressive penile cancer led to the amputation of the former bank courier's genitals in 2012. They said his psychological state will play a big role in his recovery.
"Emotionally he's doing amazing. I'm really impressed with how he's handling things. He's just a positive person," Dr. Curtis Cetrulo, who was among the lead surgeons on a team of more than 50, said at a news conference. "He wants to be whole again. He does not want to be in the shadows."
Manning, who is single and has no children, did not appear at the news conference but said in a statement: "Today I begin a new chapter filled with personal hope and hope for others who have suffered genital injuries. In sharing this success with all of you, it is my hope we can usher in a bright future for this type of transplantation."
The identity of the deceased donor was not released.
The operation is highly experimental — only one other patient, in South Africa, has a transplanted penis. But four additional hospitals around the country have permission from the United Network for Organ Sharing, which oversees the nation's transplant system, to attempt the delicate surgery.
The loss of a penis, whether from cancer, accident or war injury, is emotionally traumatic, affecting urination, sexual intimacy and the ability to conceive a child. Many patients suffer in silence because of the stigma their injuries sometimes carry; Cetrulo said many become isolated and despondent.
Unlike traditional life-saving transplants of hearts, kidneys or livers, reconstructive transplants are done to improve quality of life. And while a penis transplant may sound radical, it follows transplants of faces, hands and even the uterus.
"This is a logical next step," said Dr. W. P. Andrew Lee, chairman of plastic and reconstructive surgery at Johns Hopkins University School of Medicine.
His hospital is preparing for a penis transplant in a wounded veteran soon, and Lee said this new field is important for "people who want to feel whole again after the loss of important body parts."
Still, candidates face some serious risks: rejection of the tissue, and side effects from the anti-rejection drugs that must be taken for life. Doctors are working to reduce the medication needed.
Penis transplants have generated intense interest among veterans from Iraq and Afghanistan, but they will require more extensive surgery since their injuries, often from roadside bombs, tend to be more extensive, with damage to blood vessels, nerves and pelvic tissue that also will need repair, Lee noted.
The Department of Defense Trauma Registry has recorded 1,367 male service members who survived with genitourinary injuries between 2001 and 2013. It's not clear how many victims lost all or part of the penis.
A man in China received a penis transplant in 2005. But doctors said he asked them to remove his new organ two weeks later because he and his wife were having psychological problems.
In December 2014, a 21-year-old man in South Africa whose penis had been amputated following complications from circumcision in his late teens received a transplant.
Dr. Andre van der Merwe of the University of Stellenbosch told The Associated Press that the man is healthy, has normal sexual function and was able to conceive, although the baby was stillborn. But his recovery was difficult, with blood clots and infections, the doctor said.
For congenital abnormalities or transgender surgery, doctors can fashion the form of a penis from a patient's own skin, using implants to achieve erection. But transplanting a functional penis requires connecting tiny blood vessels and nerves.
A bigger challenge than the surgery itself is finding donor organs.
"People are still reluctant to donate," van der Merwe said. "There are huge psychological issues about donating your relative's penis."
In the U.S., people or their families who agree to donate organs such as the heart or lung must be asked separately about also donating a penis, hand or other body part, said Dr. Scott Levin, a hand transplant surgeon at the University of Pennsylvania and vice chairman of UNOS' committee on reconstructive transplants.
In Boston, Cetrulo said the transplanted penis has good blood flow and so far shows no signs of rejection. He said that Manning should be released from the hospital soon, and that the surgery had three aims: ensuring the transplanted penis looks natural, is capable of normal urination — which he hopes will resume in a few weeks — and eventually normal sexual function.
The news on cancer just gets better and better. I remember 35 years ago wondering when a cure would come – then 25 years ago thinking a cure could be 10 to 15 years away.
And now we live in an age when a cure is just around the corner. British scientists claim they’re on the brink of being able to treat cancer, and possibly even cure it, with a single jab. It’s taking personalised cancer treatment to new levels.
A Cancer Research UK spokesman said that if this treatment lives up to its promise, “it could prove a revolutionary way to treat or even cure cancer”.
Cancer claims more than 160,000 lives a year in the UK and even the newest wonder drugs give many patients only a few extra years of life.
With existing drugs focusing on just one type of cancer, a medicine that initially helps will stop working if the cancer mutates.
Some immunotherapies – treatments that use the immune system and its white blood cells to beat cancer – are already available and are producing some stunning results, although they don’t work for everyone.
Experts from University College , London, are studying how a tumour grows and mutates over time.
The study leader, Professor Charles Swanton, said: “This takes personalised medicine to its limit, where each patient would get a unique, bespoke treatment.
“It offers the hope that we might just be able to turn the tide against advanced cancer. In a few years, we will be using immunotherapy for cancer just as much as chemotherapy today.
“I’ll be disappointed if we haven’t treated a patient within two years. If this doesn’t work, I’ll probably hang up my hat and do something else.”
Crucially, the UCL researchers have found a way of identifying the mutations found on every cancer cell in a tumour that allows them to escape treatment and regrow.
They’ve also discovered that some lung cancer patients have disease-fighting white blood cells that are a perfect match for these mutations. So these cells could be taken from patients, grown in the lab and then put back to kill every cell of the cancer.
It would also be possible to create a vaccine in the form of a drug that commands the immune system to fight the cancer. It could even be a single jab.
Professor Peter Johnson of Cancer Research UK said: “This fascinating research gives us vital clues about how to specifically tailor treatment for a patient using their immune system. It will impinge in a huge way on how we treat cancer in the future.”
Aspirin for cancer
Scientists made the discovery after looking through a huge number of studies that looked at bowel, breast and prostate cancers.
Taking a low-dose medication alongside normal treatment appears to reduce the likelihood of dying from cancer by 15 per cent to 20 per cent, according to the new study.
Professor Peter Elwood, from the University of Cardiff, who led the research published in the journal Public Library of Science ONE, said: "There is a growing body of evidence that taking aspirin is of significant benefit in reducing some cancers.
"Whilst we know a low dose of aspirin has been shown to reduce the incidence of cancer, its role in the treatment of cancer remains uncertain. As a result, we set out to conduct a systematic search of all the scientific literature."
The team pooled together data from five randomised trials and 42 observational studies.
As well as improving survival, aspirin appeared to reduce the risk of cancer spreading.
Although a known risk associated with taking aspirin is bleeding in the gut, the researchers found no evidence of this being serious or life-threatening.
The study highlights the need for trials to establish whether low-dose aspirin really should be considered an additional treatment for cancer, said the researchers.
Professor Elwood added: "While there is a desperate need for more detailed research to verify our review and to obtain evidence on less common cancers, we'd urge patients diagnosed with cancer to speak to their doctor about our findings so they can make an informed decision as to whether or not they should take a low-dose aspirin as part of their cancer treatment."
Studies of six other cancers also suggested an aspirin benefit, but in these cases patient numbers were too low to allow confident interpretation of the data
May 9th 2016
A ‘neutron bomb’ antibody, which kills Cancer cells but leaves healthy ones unscathed, could be used to treat the disease. Researchers have developed an antibody from the body’s own immune system that homes in on cancer cells. The antibody targets a natural defence mechanism that cancer tumours exploit. Special proteins guard the surface of cells to prevent the body’s own immune system attacking them. Researchers say they are “excited” by the findings, which could provide a whole new way of treating cancer.
In a study published in cell reports, researchers developed and tested the cancer-fighting antibody. The human-derived antibody dismantles a specific part of the cancer cell’s defence system, before launching an attack. Scientists began their research after observing that some lung cancer patients have early-stage tumours that never progress to advanced stages. The patients with the slower-progressing tumours had antibodies against a specific protein, called complement factor H, or CFH, which protects cells from an immune system attack. CFH prevents an important immune system response from activating. It does this by preventing a deposit of complement C3b protein on the cell surface. When complement C3b reaches the cell, it can cause the membrane to deteriorate and, ultimately, the cell to die. After identifying the antibody for CFH, researchers from Duke university North Carolina, then sought to find a way of producing antibodies that recognised the same part of the CFH as the autoantibodies made by the early-stage cancer patients. The researchers then pooled the white blood cells from the CFH antibody-producing cancer patients, before isolating and cloning the antibody genes from single immune cells. These mature antibodies recognised the same region of CFH targeted by the original patient’s immune systems, so healthy cells were left unharmed. The team went on to test the new treatment on multiple cancer cell lines, including lung, gastric and breast cancers, both in lab dishes and on living mice. Author Dr Edward Patz, from Duke University, said: “This is the first completely human-derived antibody developed as an anti-cancer therapy, which is very different from other immunotherapy approaches. “We believe it might be this additional cellular response that could potentially have the most profound impact on cancer outcomes long-term.” While researchers say further tests are needed, the team are excited about the new findings. Dr Patz added: “This could represent a whole new approach to treating cancer, and it’s exciting because the antibody selectively kills tumour cells, so we don’t have significant side effects to achieve tumour control. “We believe we can modulate the immune response and let the body’s own immune system take over to either kill the tumour or keep it from growing.”
More than half of all British people ignore "red flag" symptoms that may show they have cancer, studies have revealed - so what are the dangers and how do you recognise them?
Some of the potential early warning signs of cancer include:
surveys have shown people may be in danger of ignoring some of the hidden signs
of cancer out of fear that they're wasting their doctor's time.
More than 50 per cent of British people had experienced at least one "red flag" symptom – such as a persistent cough, a sore that doesn't heal or a lump – but only two per cent thought cancer could be the cause, Cancer Research has found.
Some people said they failed to see a doctor because they were worried that their GP would view it as trivial , while others said they feared a cancer diagnosis or believed in maintaining a "stiff upper lip".
Others reported feeling a lack of confidence in the health system or assumed their symptoms were down to ageing.
And many believed their symptoms would simply go away of their own accord, according to the survey of more than 1,700 people over the age of 50.
Dr Richard Roope, of Cancer Research UK, told The Independent: “The advice we give is: if in doubt, check it out – this would not be wasting your GP’s time.
“Often your symptoms won’t be caused by cancer, but if they are, the quicker the diagnosis, the better the outcome.”
The most common cancers are prostate cancer, breast cancer, bowel and lung cancer - but the UK’s cancer survival rates lag behind the European average and delays in diagnosing the disease are believed to be a major factor.
February 4 2016 was World Cancer Day, a campaign which started in 2000 to promote research, improve treatment and raise awareness of the devastating disease which affects 14.1m people across the world each year.
I'm sure it was a great success but don't let that put you off doing your best to make next year even better.
Thanks to scientists working under the auspices of the World Health Organization, you can be fairly sure your toothbrush won't give you cancer. Over four decades, a WHO research agency has assessed 989 substances and activities, ranging from arsenic to hairdressing, and found only one was "probably not" likely to cause cancer in humans. It was an ingredient in nylon used in stretchy yoga pants and toothbrush bristles.
All the other 988 substances, however, pose some level of risk or need further research, according to the International Agency for Research on Cancer (IARC), which is an arm of the WHO. Some things in IARC's top category of carcinogens are pretty obvious nasties, such as plutonium, mustard gas and smoking tobacco. Others are more surprising: Also ranked as "Group 1 Carcinogens" are wood dust and Chinese salted fish.
IARC has said that working as a painter causes cancer, using a mobile phone possibly does, and working shifts as a pilot or a nurse, for example - is "probably carcinogenic." Last October, it ranked processed meats in its top category of known carcinogens, alongside plutonium.
The findings have caused consternation, not least for non-scientists puzzled by what IARC's rankings mean.
As a global authority on cancer - a disease that kills more than 8 million people a year worldwide, with more than 14 million new cases appearing annually - IARC has enormous influence and commands much respect, even among its critics. Yet experts from academia, industry and public health say IARC confuses the public and policymakers. Some critics say the way IARC considers and communicates whether substances are carcinogenic is flawed and needs reform.
Even the WHO, which oversees IARC, was caught off guard by the agency's announcement that red and processed meat should be classified respectively as probable and known carcinogens. The WHO's official spokesman, Gregory Hartl, issued a statement saying WHO's Geneva headquarters had been flooded with queries and requests for clarification. IARC's ruling did not mean people should stop eating meat, he said.
Asked about the relationship between IARC and the WHO, Hartl told Reuters: "WHO works closely and continually with IARC to improve the way the two bodies collaborate and communicate on the knowledge of potential and real hazards and risks to the public."
At stake are judgments that can affect the lives of millions of people and the economic activities of states and multinational companies. IARC's rulings influence many things, from whether chemicals are licensed for use in industry to whether consumers choose or spurn certain products or lifestyles.
But its methods are poorly understood and do not serve the public well, according to Bob Tarone, a statistician formerly at America's National Cancer Institute and now Biostatistics Director at the International Epidemiology Institute. He said of the way IARC works: "It's not good for science, it's not good for regulatory agencies. And for people? Well, they are just being confused."
Paolo Boffetta worked at IARC for 19 years, rising to become head of the genetics and epidemiology team, and describes himself as "still a strong supporter" of the agency. Nevertheless, Boffetta, now at the Mount Sinai School of Medicine in the United States, said IARC's approach sometimes lacks "scientific rigour" because its judgments can involve experts reviewing their own research or that of colleagues.
Some institutions have also clashed with IARC. The agency is currently embroiled in an acrimonious dispute with the European Food Safety Authority (EFSA) over glyphosate, an ingredient of widely-used pesticides. IARC says glyphosate is "probably carcinogenic." EFSA says it isn't. The glyphosate row has thrown up concerns about potential conflicts of interest at IARC: It involves an adviser to the agency who is closely linked to the Environmental Defense Fund, a U.S. campaign group opposed to pesticides. (See ).
In the face of its critics, IARC steadfastly defends its methods and aims. "This is really the strongest possible process," Kurt Straif, the head of IARC's classification programme, told Reuters when asked about the way his agency evaluates possible causes of cancer.
IARC's director, Chris Wild, has also defended the agency against criticism in scientific journals. In a letter to one of the journals, he said the scientists involved in its classification decisions "are motivated by a desire to improve public health by identifying the causes of human cancer and thereby contributing to disease prevention."
Richard Sullivan, a professor of cancer policy and global health at King's College London, says any confusion is due to a widespread misunderstanding of IARC's role.
"IARC is purely there to do the science. And the science is absolutely fine," he told Reuters. "But there is a disjunction between the pure science and the policy and public health messaging. That's where problems arise."
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