'Single-shot' treatment excites cancer experts

• By Sam Lister in London Monday March 29 2010 Courtesy Irish Independent

PIONEERING treatment for breast cancer that cuts a six-week course of tumour-destroying therapy to a single half-hour "shot" is showing success in early trials in patients, according to British doctors.The radiotherapy treatment, which is for use in patients with early breast cancer after they have undergone surgery on the tumour, is designed to kill cancerous cells with a concentrated beam of radiation.

Please click on this link for full article www.independent.ie/health/latest-news/singleshot-treatment-excites-cancer-experts-2115618.html

Breast cancer - many overestimate future risk

[Posted: Mon 29/03/2010 by Deborah Condon]

Women who have been diagnosed with breast cancer often significantly over-estimate the risk of the disease developing in their unaffected breast, the results of a new study indicate.
As a result of this, some are choosing to have prophylactic mastectomies based on a false perception of increased risk. A prophylactic mastectomy is surgery to remove one or both breasts to reduce the risk of developing breast cancer.
Speaking at a major European conference recently, Mr Ajay Sahu, a consultant breast surgeon at the Frenchay Hospital in the UK, explained that women who have been diagnosed with breast cancer believe the risk of the disease occurring in their unaffected breast is as much as ten times higher than it actually is.
Mr Sahu reached his conclusions after conducting a study of 27 consecutive patients, aged between 31 and 65, who were diagnosed with breast cancer between April 2007 and October 2009. All were having surgery on one breast, but were requesting that the other breast be removed too.
He said he carried out the study because he realised that the incidence of contralateral prophylactic mastectomy was increasing in his unit. This is when the other unaffected breast is removed to reduce the risk of developing cancer.
“I felt that the time of diagnosis was a moment of increased stress and not the right time to make such a decision,” Mr Sahu explained.
He pointed out that there is no evidence that women who have a single, small breast tumour or who are at low to moderate risk of developing a further breast cancer, gain any survival benefit from a mastectomy or a contralateral prophylactic mastectomy.
“Yet these procedures are increasingly being accepted as patient choice and offered by clinicians who do not address the possibility of an inaccurate perception of risk as the reason behind their patient’s request.
“The incidence of contralateral prophylactic mastectomy has almost doubled in recent times without any evidence of survival benefit and the reasons for this need to be addressed and alternative strategies considered,” Mr Sahu said.
He noted that the reasons given by the 27 Frenchay patients for requesting a contralateral prophylactic mastectomy included young age, but without a family history (three patients), family history, which was deemed low risk by the surgeon (12 patients), a bad experience of treatment outcome among family or friends (four patients) and a desire to avoid radiotherapy (one patient).
All the patients thought that they would not live longer than five years, and all overestimated their risk of contralateral breast cancer by a factor of five to ten.
Mr Sahu asked about the patients’ perception of risk and the reason behind a request for prophylactic mastectomy at the time of diagnosis and then the operation was deferred.
Breast care nurses counselled the patients at the time of diagnosis and when the post-operative results and plans for adjuvant treatment were discussed. The patients received adjuvant chemotherapy and/or radiotherapy and were followed up at six months by the breast care nurses and at 12 months by the surgeon.
 the end of 12 months, those who still requested prophylactic surgery were offered the operation.However, Mr Sahu found that at the end of the 12 months, all the patients were less anxious about their risk. Just four patients still asked for prophylactic surgery. The remaining 23 were pleased to have had the opportunity to rethink their decision and chose not to have the surgery.
Mr Sahu said that the 12 months delay before any prophylactic surgery did not make the women more anxious.
“The ‘cooling off period’ actually helped to reduce anxiety and helped the women to be comfortable with the decision they made in the end. Patients were happy with the alternative strategy to prophylactic surgery - in other words, they had an understanding of actual risk of bilateral breast cancer, an understanding that the risk can be reduced by treatment and surveillance by annual mammography, and that no survival benefit is conferred by the operation,” Mr Sahu explained.
He said that while the study was small and should be treated with caution, ‘the important message is that the patient’s choice may be based on inaccurate overestimation of risk at the time of diagnosis and given time, they may not have the same risk perception later on’.
“Healthcare professionals should be aware of this and offer a ‘cooling off’ period to facilitate appropriate decision-making. The study is continuing and when we have recruited more patients we hope to be able to make more definite recommendations,” Mr Sahu added.
He is continuing his research by studying the psychological aspects of patients’ decision-making processes.
Details of these findings were presented at the 7th European Breast Cancer Conference in Barcelon

Study disputes cancer scanning success

• By Sam Lister Wednesday March 24 2010 Courtesy Irish Indepenent

ROUTINE breast cancer screening may have little effect on reducing deaths from the disease and the value of national programmes should be questioned, according to a report.A study by the Nordic Cochrane Centre in Copenhagen, published today in the 'British Medical Journal', concludes that national screening programmes bring no benefit in terms of lives saved.The study, based on the Danish programme, is the latest work to raise questions about the efficacy of population-wide mammographies. It comes as the world's leading disease experts gather at the European Breast Cancer Conference in Barcelona, Spain.The findings, based on analysis of data over a 20-year period covering the introduction of regional screening in Denmark, found that breast cancer mortality fell by 1pc per year in the screened areas and by 2pc per year in non-screened areas.The research authors, from the University of Copenhagen and the Norwegian Institute of Public Health, concluded they could find no effect of the Danish programme on death rates. (© The Times, London)

Page last updated at 00:01 GMT, Monday, 22 March 2010 Courtesy of BBC News

 Lung cancer gene found in non-smokers 
 
Most lung cancers are caused by smoking
A gene that could help explain why some non-smokers develop lung cancer has been pinpointed by US researchers.
It is hoped that further research into the GPC5 gene could open the way for new targeted treatments as well as picking out those at high risk.
But Cancer Research UK said more work was needed to work out the exact reason for the link.
A quarter of lung cancers globally occur in people who have never smoked, The Lancet Oncology reports.
Smoking causes 90% of lung cancers, but there is still a significant number of non-smokers who develop the disease
Dr Kat Arney, Cancer Research UK
In the UK, 10% of lung cancers develop in people who do not smoke.
The researchers said lung cancer in non-smokers was an increasing problem but the causes were not well understood.
DNA samples from 754 people who had smoked fewer than 100 cigarettes in their lifetime were scanned to find the genetic differences that seemed most likely to affect the risk of lung cancer.
When chronic respiratory disease, exposure to second-hand smoke and family history of lung cancer were taken into account, two sections of the genome seemed to be key.
Confirmation
The team then took the 44 most common genetic alterations seen in the first part of the study and studied them in two other groups of non-smokers - half of whom had been diagnosed with lung cancer.
The same two genetic marks were significant.
A third study of 530 patients confirmed the result.
Closer analysis showed that these two bits of the genome were responsible for switching on and off the GPC5 gene.
Further tests showed that activity of the GPC5 gene was 50% lower in adenocarcinoma - the most common form of lung cancer - than in normal lung tissue.
The researchers believe that this lower activity of the gene could contribute to the development of cancer in people who do not smoke.
In a comment piece published alongside the study, Dr Ramaswamy Govindan, from Washington University School of Medicine, said "it is far from clear" how the finding could predispose people to lung cancer.
"More studies are needed to confirm these preliminary observations in the tumour samples from those with no history of tobacco smoking."
Dr Kat Arney, Cancer Research UK's science information manager, said: "Smoking causes 90% of lung cancers, but there is still a significant number of non-smokers who develop the disease.
"These new results could help to explain why, but much more work needs to be done to understand exactly how these gene variations are linked to lung cancer risk."

Page last updated at 05:44 GMT, Monday, 22 March 2010
 Courtesys of BBC News
Infertility clue to prostate cancer 
By Helen Briggs Health reporter, BBC News 

Studies on fatherhood and prostate cancer have produced mixed results
Infertile men may have a higher risk of developing prostate cancer, US data suggests.
Researchers looked at the cancer records of men attending infertility clinics in California.
They found men unable to father a child were nearly three times more likely to be diagnosed with prostate cancer than normal.
The authors of the study, published in the journal Cancer, say more work must be done to confirm the possible link.
If confirmed, it might be appropriate for infertile men to be given early prostate cancer screening, they say.
It's unlikely that being infertile directly leads to prostate cancer.
Ed Yong, Cancer Research UK
Study leader, Dr Thomas Walsh of the University of Washington in Seattle said: "These are some of the first data to suggest that male reproductive health in early life may be a risk factor for serious malignant disease in later life.
"It is important for investigators and physicians to do further research to find out what might be the common underlying cause that may lead to both infertility and later the development of prostate cancer."

Risk factors
Prostate cancer is the most common cancer in men. Risk factors include age, family history and ethnicity.
 SIGNS OF PROSTATE CANCER
Having to rush to the toilet to pass urine
Difficulty in passing urine
Passing urine more often than usual
Pain on passing urine
Blood in the urine or semen
More recently, it has been suggested that fatherhood status might be linked with prostate cancer but studies have shown conflicting results.
The new study looked at the risk of prostate cancer in 22,562 men checked for infertility in 15 clinics in California between 1967 to 1998.
About 4,500 of these men were found to have male infertility - and 19 went on to develop the most aggressive form of prostate cancer.
In a similar sample of men in the general population, 16 men were diagnosed with the high risk form of the disease.
Overall, infertile men were found to be 2.6 times more likely to be diagnosed with the most aggressive form of prostate cancer.
Genetic clues
But Dr Helen Rippon, head of research management at The Prostate Cancer Charity, said with such small numbers of men affected, it is difficult to draw any firm conclusions about whether the suggested link does exist.
She said: "This potential new risk factor would need to be backed up by further, large scale studies before any recommendations can be made about targeting early screening for prostate cancer at men with fertility problems."
Ed Yong, head of health evidence and information at Cancer Research UK, said: "It's unlikely that being infertile directly leads to prostate cancer.
"Instead, both infertility and a higher risk of prostate cancer might stem from a common genetic fault, or some aspect of our lifestyle or environment."

Page last updated at 00:01 GMT, Saturday, 20 March 2010
Courtesy of BBC News
Setback for cervical cancer test hopes 
By Helen Briggs Health reporter, BBC News 

Minor abnormalities in smear tests are very common
Testing for human papillomavirus during cervical screening does not help doctors identify women at risk of cancer, a study suggests.A positive HPV test does not accurately predict which women need an urgent follow-up, say doctors.
Each year, millions of UK women have a cervical screening test as part of the national programme.
The NHS is piloting add-on tests for the virus linked to cervical cancer at several UK centres.
Other studies have shown this could be a useful tool for identifying women at high risk of developing cervical cancer.
The most important thing is to attend for cervical cancer screening - the most effective way of preventing cervical cancer.
Dr Maggie Cruickshank, University of Aberdeen
Around six out of 100 women who have a test receive a borderline or mild abnormality result.
But only a tiny minority of these will go on to develop cervical cancer.
The study, funded by the Medical Research Council, looked at 4,439 women undergoing cervical screening in Grampian, Tayside and Nottingham.
Those with mild abnormalities were tested to see if they were positive for HPV, a sexually-transmitted infection linked to most cases of cervical cancer.
Early signs
But the researchers found 70% of women testing positive for HPV after a mild abnormality result did not develop early signs of cancer during a three-year follow-up.
Cervical cancer
Around 2,800 women are diagnosed with it each year in the UK
May not cause any symptoms at all until it has reached an advanced stage
Abnormal bleeding is the most common symptom
Dr Maggie Cruickshank, from the Department of Obstetrics and Gynaecology at the University of Aberdeen, led the study.
She said: "The most important thing is to attend for cervical cancer screening - the most effective way of preventing cervical cancer.
"This new additional test may not add any value.
"Our study is showing that HPV is such a common infection in younger women that testing for it doesn't help decide which is the best action to take."
But in women over 40, HPV testing might be useful for ruling out further investigations, she added.
Contradictory research
Professor Jack Cuzick is an epidemiologist for Cancer Research UK.
He said other studies have shown that HPV testing is good at detecting abnormalities in women with low-grade tests and can reduce the number who need to be referred for treatment, especially in the over 35s.
He added: "The results of this study are surprising, as they're very much out of line with most other studies in the field.
"One thing to note is that the type of test used isn't commercially available, so we need to be careful when considering these results in the context of our national screening programme."
Julietta Patnick, director of the NHS Cancer Screening Programmes, said the results of the study would be reviewed.
Full details of the research are published in the British Journal of Obstetrics and Gynaecology.
 

Doctors get top-up fees to treat 1,300 patients on waiting lists

• By Eilish O'Regan Health Correspondent Thursday March 18 2010

MORE than 1,300 patients on waiting lists were treated privately after public hospitals and doctors were paid top-up fees, the Irish Independent has learned.Every year public hospitals across the country are unable to treat hundreds of patients during normal hours, blaming pressure on beds, staff and other services.However, a total of 1,346 of these patients were treated, mostly at weekends, in the same public hospital last year after the National Treatment Purchase Fund (NTPF) paid the private fee, which is split between the hospital and doctors. Both the hospitals, which receive an annual financial budget, and the doctors, who receive generous salaries of over €110,000, are funded to treat these public patients.But under this arrangement they end up being paid "on the double" for the out of hours work. The NTPF pays for most of the procedures in private hospitals for public patients who have waited longest. However, a spokesman confirmed that 6pc of its work was done in public hospitals last year and 7pc in 2008.

Treatments

Figures obtained by the Irish Independent show the highest number of public patients were treated in this manner in hospitals in the south east, where 238 underwent procedures such as joint replacements and hernia repair. The Royal Victoria Eye and Ear Hospital carried out 203 treatments on public patients for the private fee, including care of cataracts and squints.There were also significant numbers of patients treated in busy hospitals such as the Mater Hospital in Dublin (173) for procedures such as hysterectomies.\In Beaumont Hospital, 45 patients were treated for a range of procedures including hip replacement, squint and breast reconstruction.A spokesman for Beaumont last night claimed some treatments were of a specialist nature and could not be carried out in a private hospital. In other instances there were patient complications which meant they could not be transferred elsewhere, he added.High numbers of patients ended up being treated with private fees in our Lady's Hospital for Sick Children in Crumlin (103) and in the South Infirmary Victoria Hospital in Cork (162).A spokesman for the NTPF last night told the Irish Independent: "At this time and as a matter of policy the NTPF is permitted to purchase up to 10pc of its surgical capacity from within the public hospital system on the strict understanding that it does not interfere with normal core hospital activity." However, Stephen McMahon of the Irish Patients' Association last night said a question mark hangs over whether productivity is greater if there is a private fee involved.

Funding

"We have to be sure that it is spare capacity that is being used. Are hospitals treating the same amount of patients during normal hours as when the money is following the patient?" he asked.Labour health spokeswoman Jan O' Sullivan said she could not see why public hospitals could not receive enough funding to treat the patients in the first place. "I am also concerned because the NTPF has consistently refused to disclose its payments for this work to Oireachtas committees. We should be able to compare the cost of this work with that provided by public hospitals during normal hours," she added.Doctors' organisations have also voiced their objections to the NTPF, claiming its funding should be directed towards public hospital budgets instead.

'Freezing' treatment found to kill breast cancer

• By Rebecca Smith in London Wednesday March 17 2010

Breast cancer sufferers could avoid the need for surgery in the future after doctors discovered a way of destroying tumours by freezing them.The scientists adapted a technique used to treat prostate cancer to successfully destroy breast cancer tumours in 13 patients, a conference was told.Small needles were inserted into the tumours, guided by imaging scanners, under local anaesthetic to deliver temperatures of minus 30C. This, in effect, froze the tumour and killed it.Previous attempts to use the treatment, known as cryotherapy, on breast cancer did not achieve sufficiently low temperatures to make it work.Other studies used cryotherapy to treat tumours, but only during open surgery. The new technique resulted in only small nicks to the skin and researchers claimed there was minimal pain and excellent healing.Biopsies taken immediately after treatment showed that no cancer remained and there was no sign of it returning after five years, researchers said. The study by a team at the Barbara Ann Karmanos Cancer Institute in Detroit, Michigan, was presented at the Society of Interventional Radiology annual scientific meeting in Florida.Dr Peter Littrup, the lead author, said: "Minimally invasive cryotherapy opens the door for a potential new treatment for breast cancer and needs to be further tested.

Potential

"When used for local control and/or potential cure of breast cancer, it provided safe and effective breast conservation with minimal discomfort for a group of women who refused invasive surgery."Doctors said surgery to cut out breast cancer was still the most effective chance of a cure, but minimally invasive techniques such as cryotherapy could be used for women who could not have an operation or did not want to.Breast cancer is the most common form of the disease in Britain with around 45,500 women and 300 men diagnosed each year.Dr Caitlin Palframan, from Breakthrough Breast Cancer, said surgery remained the gold standard. Dr Kat Arney, from Cancer Research UK, said: "This new technique has only been tested in a very small number of women. Larger trials will be needed before we know whether it is a safe and effective alternative to surgery." (© Daily Telegraph, London)

It's dearer than the Ritz, your €889-a-day public hospital bed

• By Eilish O'Regan Health Correspondent Tuesday March 16 2010 Courtesy of the Irish Independent

THE average cost of a bed in a public hospital is now €889 a day -- more expensive than a room in some of the top hotels in the world.A night at the Ritz in Paris will set you back €870, while an executive suite at Trump Tower Hotel in New York will place you in the lap of luxury for €651.And although patients in one of Ireland's public hospitals will not be treated to chocolates on their pillows at night or be able to sink into Egyptian cotton sheets, they are "cosseted" by the presence of doctors, nurses and hi-tech medical machinery instead.The taxpayer picks up most of the bill for the nightly cost of a public hospital bed, and if the patient does not have a medical card, he or she pays no more than €75 a day.

Overheads

The maximum amount a public patient will pay for a hospital stay in a year is €750 but it is free for medical card holders.A spokesman for the Health Service Executive (HSE) said the average of €889 was based on figures from 39 hospitals that submitted costings."The average cost quoted relates to the in-patient stay only and excludes outpatient, emergency department and day-case costs."It also excludes depreciation and capital costs," he explained."The average cost is a full cost and includes all pay, non-pay and overhead costs covering all services that could be used by an in-patient."It would thus include medical pay, nursing pay, blood, medicines, medical and surgical supplies, theatre, intensive care units, radiology, laboratories and other areas and other support staff."The costing process does not provide a pay or non-pay breakdown of the €889."However, based on the total annual financial statement (AFS) costs going into the costing process, pay would account for approximately 70pc of the total,'' the spokesman added.The HSE does get some return for the use of a public bed by a patient who has private health insurance.The insurance company can be levied between €655 to €910 for a bed depending on whether it is for day care, private or semi-private in one of the major teaching hospitals.The cost for health insurance companies is lower for a bed in a county or voluntary non-teaching hospital. It varies from €434 to €607.

Overcrowding

The high cost of a public bed shows how the closure of a bed can lead to considerable cost saving for a hospital.Hundreds of hospital beds are set to be closed this year, despite evidence of ongoing overcrowding in some of the major hospitals.There are also hundreds of patients who should be discharged because they no longer need acute care. But they are occupying beds when they could be transferred elsewhere if the facilities were available.Beaumont Hospital in Dublin has given 23 patients until Friday week to fill out a form for transfer to a nursing home, failing which they will each be charged €1,365 a week.The patients had been assessed as needing nursing home care but refused to complete the form, which would see them financially assessed to determine what level of contribution, if any, they make to their care.

Opening up new front on the prostate cancer battlefield

By Lisa Smyth
Friday, 12 March 2010 Courtesy of The Belfast Telegraph

Scientists are developing a revolutionary way to administer radiation to prostate cancer patients. Radiotherapy treats cancer by using high-energy X-rays to destroy the cancer cells, while doing as little harm as possible to normal cells in the surrounding area such as the bladder or rectum. But the treatment can cause complications for patients, including difficulty passing urine. Seven out of every 10 men may no longer be able to get an erection after external radiotherapy treatment for prostate cancer. Researchers at the Experimental Cancer Medicine Centre (ECMC) in Belfast — funded by Cancer Research UK and the Department of Health — are looking at ways of improving the process so that only the tumour, not surrounding cells, are targeted. It is a unique approach, brought to the ECMC by Kevin Prise, Professor of Radiation Biology, and could lead to an advancement in the use of radiation in treating patients with prostate cancer.

“We collaborate with Dr Joe |O’Sullivan and our colleagues in the radiotherapy department,” said Professor Prise. “We are involved in an experimental lab-based programme looking at how to improve the delivery of radiation into prostate cells.” Prof Prise said the research is at an early stage and scientists are trying to understand basic mechanisms which they hope will allow them to develop the technology. He said: “We are looking at how radiation interacts with the tumours in order to improve its use. There are some very big changes in how radiation is being delivered. Previously, it was shone on the tumour from one direction but now it is given in a much more complicated way from a series of directions to gradually build up dose and try to protect the normal cells. This is a fairly new approach in terms of trying to deliver clinical radiation. This is work we started almost two years ago when I came to Queen’s in 2007 and it relates to previous work I have done. “It is a very, very precise way of targeting radiation. We can hit single cells with radiation. It is pretty excellent technology we have here that no other lab in the UK has. I brought that expertise from my previous lab. It really is groundbreaking stuff.” Scientists are monitoring and analysing the results of studies to gain a better understanding of the disease. “We are trying to improve the effectiveness of existing treatments and see how to optimise them and make them even better that they already are,” continued Prof Prise. “We want to maximise the effect that radiation has on the tumour and minimise the effects on surrounding structures.” The cells used in the study have been developed from tumours removed from patients in the past — showing the benefits of clinical trials. Prof Prise said this allows scientists to work in a more controlled way. “Some of them are from patients a long time ago but essentially we can mimic in the lab what is going on in the body,” he explained.
 

Page last updated at 00:02 GMT, Friday, 12 March 2010
Courtesy of BBC News
Home cervical cancer testing kit boosts diagnosis 
 
Smear tests are less sensitive than HPV tests, say researchers
At-home screening tests for the virus responsible for most cervical cancers could detect many more cases of the disease, say Dutch researchers.
Although cervical screening programmes have cut deaths, not all women take up the invite from the GP.
But self-test kits for human papillomavirus (HPV) could double the number of women diagnosed, the British Medical Journal reported.
Trials of self-testing for HPV are currently being done in the UK.
There are more than 100 types of HPV, which is sexually transmitted, but only 13 of them are known to cause cancer.
While it's important for women to attend cervical screening appointments, some find it difficult to do so for cultural or other reasons
Professor Stephen Duffy, Cancer Research UK
Although most HPV infections clear up by themselves, in some women it persists and cause damage to cells which may eventually develop into cervical cancer.
A vaccine against the two main types of HPV was introduced in the UK in 2008 for schoolgirls.
But the NHS has also been piloting HPV testing as an "add-on" to traditional screening - to pick out those most at risk.

Test kit

In the latest study almost 28,000 Dutch women who had not responded to two invites to attend the regular screening programme were sent an at-home screening kit for HPV.
A smaller group were sent a third invitation for routine screening.
More than a quarter of those sent kits returned a completed test kit, compared with only one in seven who responded in the recall group.
Those who self-tested and had a positive result were then referred for further tests.
Importantly, those women who had also not taken up the offer of the previous round of screening had a higher risk of abnormal changes in their cervix.
The researchers said more than half of cervical cancers in countries with screening programmes are diagnosed in women who have not attended routine testing.
Stephen Duffy, Cancer Research UK's professor of cancer screening, said: "While it's important for women to attend cervical screening appointments, some find it difficult to do so for cultural or other reasons.
"For these women, self-sampling for HPV may be an option.
"Its acceptability and effectiveness are currently being researched here in the UK."
 

Research team gives leukaemia patients real hope

Wednesday, 10 March 2010 Courtesy of Belfast Telegraph

Northern Ireland scientists at very forefront of the battle against the deadly disease, Lisa Smyth speaks to a doctor involved in medical trials A doctor involved in the trial looking at the effectiveness of a drug for Chronic Myeloid Leukaemia (CML) has said early findings are positive. Professor Mary Frances McMullin, professor of clinical haematology, said medical research into the disease has already achieved great success and revealed the survival rate for people with the disease has risen dramatically as a result of studying the genetic make-up of the tumours. In 2000, 20 patients a year would be treated at Belfast City Hospital but this has risen to about 80 due to the life-prolonging effects of the new drugs, Prof McMullin said.

And the research team at the Experimental Cancer Medicine Centre in Belfast is now working to build on this success in conjunction with other scientists around the world. They are studying the effects of a second generation drug called nilotinib, which blocks a protein made by CML cells that have an abnormal chromosome — 95% of people with CML have this abnormal chromosome — which in turn stops the leukaemia cells from growing. Researchers are currently looking at nilotinib as a first treatment for CML before imatinib — the current standard treatment for people with the disease. Prof McMullin said: “People are not dying of the disease anymore. Before all this came along the only certain treatment was a bone marrow transplant.

“First of all there is the issue of mortality associated with this procedure and secondly you can only do a bone marrow transplant if you can find a donor and the patient is young and fit enough.” Prof McMullin said a bone marrow transplant would almost never be done in patients over 60, meaning the new treatments have brought hope to older people, such as Maureen Mack, who are diagnosed with CML. She said: “We would have given patients drugs to control blood count but it didn’t do anything to get rid of the disease. These treatments have totally changed the disease. We can’t talk about survival rates anymore as it looks like they are going to survive for many years and nilotinib looks like it’s even better.

“The initial results of the first patients were presented to the American Society of Haematology in December and the findings showed the vast majority of patients had gone into cytogenic remission at three months. “With the older treatments you would not have gone into remission at that stage and that’s why I can be positive about it.”

Read more: http://www.belfasttelegraph.co.uk/news/health/research-team-gives-leukaemia-patients-real-hope-14713034.html#ixzz0hlD9URxn
 

Radiotherapy wait linked to cancer recurrence

[Posted: Wed 03/03/2010 by Deborah Condon] Courtesy of Irish Health

The longer a woman is left waiting for radiotherapy after breast cancer surgery, the more chance there is that the disease will recur, the results of a new study indicate.

Four to six weeks is generally accepted as a reasonable interval between cancer surgery and radiotherapy, however until now, the evidence relating to waiting times in patients with breast cancer has been mixed.

Researchers from the US, Canada and Japan set out to examine the link between waiting for radiotherapy and breast cancer recurrence.They analysed cancer records for over 18,000 women who had been diagnosed with early stage breast cancer between 1991 and 2002 when they were aged 65 or older. All of the participants had received cancer-related surgery and radiotherapy, but not chemotherapy. They were followed up for an average of five years.The study found that women who started radiotherapy more than six weeks after surgery were at an increased risk of having the disease return. Some 30% of the participants started radiotherapy after six weeks and 734 (4%) experienced a local recurrence of the disease at five years.A further analysis meanwhile showed a continuous relation between time to radiotherapy and local recurrence. According to the researchers, this suggests that initiating radiation therapy as soon as possible after surgery could minimise the risk of recurrence.

“The implication of a continuous relationship between start of radiotherapy and local recurrence is that there is no ‘safe’ threshold in terms of waiting time and that radiotherapy should therefore be started as soon as possible,” they said.They added that the cost of increasing capacity to ensure uniformly short waiting times could be substantial and would need to be weighed against the small absolute benefit in local recurrence.“But given the known negative impact of local recurrence on overall survival and the large numbers of women treated with radiotherapy for breast cancer, it seems appropriate to consider whether this is a price we should be prepared to pay.”

Details of these findings are published in the British Medical Journal.

Campaign to 'Get Men Talking' about health

[Posted: Tue 02/03/2010 by Deborah Condon] Courtesy o Irish Healthf

A new campaign aimed at getting men talking about their health has been launched by the Marie Keating Foundation.

The campaign has been launched as part of the Foundation’s annual Men’s Health Month, which takes place every March. Currently in Ireland, one in nine Irish men is at risk of developing prostate cancer, one in 19 is at risk of developing bowel cancer and one in 205 is at risk in relation to testicular cancer.As part of the ‘Get Men Talking’ campaign, a new website, http://www.getmentalking.ie, has been developed to specifically focus on cancer. Tools on the site include an ‘ask the expert’ section, a discussions area and general information on different types of cancer.According to Lillian McGovern of the foundation, it is hoped that men will use the site to tell their stories in ‘a safe and non-threatening way’.

“The power of this channel of communication cannot be underestimated and our hope is that many men will engage with us using this method,” she said.

Diet link to ovarian cancer survival

[Posted: Mon 01/03/2010 by Deborah Condon] Courtesy of Irish Health

Healthy eating in the years preceding a diagnosis appear to increase the chances of survival from ovarian cancer, the results of a new study indicate.
Ovarian cancer is the fourth most frequently diagnosed cancer in women in Ireland. More than 200 women die from the disease here each year and approximately 330 new cases are diagnosed annually.
Irish women diagnosed with the disease only have a 15% chance of surviving beyond the first five years if the cancer is detected at an advanced stage. If it is detected at an early stage, the five-year survival rate jumps to 80%, however initially, the disease can be asymptomatic (no symptoms appearing) and when they do show, symptoms are often similar to other more common conditions, such as digestive and bladder disorders.
According to US researchers, this marks one of the first studies to evaluate possible diet associations with ovarian cancer survival. They said that because of the asymptomatic onset and relatively low five-year survival rate from the disease, research linked to survivorship is essential.
They looked at 351 women diagnosed with the disease. Details about the women’s lives were collected, including details about their lifestyle and diet.
Each participant completed a food frequency questionnaire where they were asked to report their usual dietary intake over the three to five years prior to their diagnosis.
The foods were divided into groups such as fruits, vegetables, grains, meats, dairy, fats and oils, sweets and alcohol.
The researchers from the University of Illinois found that higher total fruit and vegetable consumption, and higher vegetable consumption alone led to a survival advantage. Likewise, a statistically significant improvement in survival was observed for the healthier grains.
However higher intakes of less healthy meats were associated with a survival time disadvantage.
“The study findings suggest that food patterns three to five years prior to a diagnosis of ovarian cancer have the potential to influence survival time. The pre-diagnosis food patterns observed to afford a survival advantage after an ovarian cancer diagnosis reflect characteristics commonly found in plant-based or low fat diets.
“These diets generally contain high levels of constituents that would be expected to protect against cancer and minimise ingestion of known carcinogens found in foods,” the researchers said.
Details of these findings are published in the Journal of the American Dietetic Association.

70-day wait for tests is breached

• \Monday March 01 2010 Courtesy of Irish Independent

If you are a public patient without health insurance, you can face considerable delays for diagnostic tests.

In Cork University Hospital all patients for routine diagnostics should be seen within 70 days but its own internal figures show this is being breached and the waiting time is well over 80 days.

In Galway University Hospital the 70-day target is also not being met for patients needing ultrasound and the delay extends to over 90 days. Delays for ultrasound in Tallaght Hospital, meanwhile, extend to over 160 days.

Irish Independent

Page last updated at 00:21 GMT, Monday, 1 March 2010
 Courtesy of BCCNews
 Gene test aid to cancer treatment
 
Tests to direct treatment strategies could prevent unnecessary treatment
Scientists have developed a gene test which predicts how well chemotherapy will work in cancer patients.
Starting with 829 genes in breast cancer cells, the team whittled down the possibilities to six genes which had an impact on whether a drug worked.
They then showed that these genes could be used to predict the effectiveness of a drug called paclitaxel in patients.
It is hoped the approach, reported in The Lancet Oncology, can be replicated for other cancers and treatments.
The international project, including researchers from Cancer Research UK's London Research Institute, opens the way for breast cancer treatment to be targeted to those who will benefit the most.
To find which genes, if missing or faulty, could prevent the drug from working, they deleted them one by one from cancer cells in the laboratory.
They eventually highlighted the six genes which if absent or not working prevent paclitaxel from properly killing breast cancer cells.

Spare treatment
More than 45,500 women are diagnosed with breast cancer in the UK each year - and it is estimated that around 15% of these women will be prescribed paclitaxel.
The researchers estimate they could potentially spare half of the patients currently receiving this drug from treatment which would not be effective.
Study leader, Dr Charles Swanton, head of translational cancer therapeutics at the Institute, said one of the great challenges in cancer medicine is determining which patients will benefit from particular cancer drugs, which are in themselves toxic and carry severe side effects.
The challenge is to apply these methods to other drugs in cancer medicine

Dr Charles Swanton, study leader
"Our research shows it is now possible to rapidly pinpoint genes which prevent cancer cells from being destroyed by anti-cancer drugs and use these same genes to predict which patients will benefit from specific types of treatment."
Further studies will now be done to see if the technique can be developed into a simple diagnostic test to be given to patients to help inform doctors about whether or not to prescribe paclitaxel.
He said the challenge will be to apply these methods to other drugs in cancer medicine.
"These could include treatments that are currently deemed too expensive to fund on the NHS - however, in the future, treating only the patients that will benefit from certain treatments will save the NHS money in the long term."
Dr Lesley Walker, Cancer Research UK's director of cancer information, said: "New techniques such as these can enable drugs to be tailored to individual patients, and this could potentially improve cancer survival in the long term.
"Health professionals may in the future be able to use this information to direct treatment to patients most likely to benefit, and avoid giving treatment that is less likely to be effective to patients with drug resistant cancers."
 
 

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