BY LENA HUANG | JUNE 2, 2014
Adjuvant therapies are given after primary treatment to reduce the risk of cancer recurrence in many patients. Findings from two large-scale studies on adjuvant therapies in breast cancer were highlighted at ASCO on Sunday, signifying the importance of these treatments.
Early findings were released in a joint analysis of two phase 3 studies (TEXT and SOFT), which found Aromasin (exemestane) slightly more effective than tamoxifen when given with ovarian function suppression (OFS) in preventing recurrences in premenopausal patients with hormone receptor positive breast cancer. Researchers found about a 4 percent difference in recurrence risk over four years. However, investigators are awaiting final data from the tamoxifen only arm, which are anticipated to be presented at the San Antonio Breast Cancer Symposium in December. Currently, tamoxifen is the standard of care for this type of breast cancer in the U.S.
According to researchers, this joint analysis is the largest worldwide study assessing adjuvant aromatase inhibitor therapy with OFS in women with breast cancer. Currently, aromatase inhibitors are primarily used in postmenopausal women, but in this study, OFS mimicked the low levels that naturally occur in menopause. OFS was attained by ovarian irradiation, oophorecotomy (surgical removal of the ovaries) or with the drug triptorelin, an injection that reduces certain hormone levels in the body. OFS causes menopausal side effects, such as hot flashes. Tamoxifen has similar side effects, including hot flashes and vaginal dryness. Side effects of exemestane include osteoporosis and bone fractures.
The second phase 3 study (ALLTO) examined adding Tykerb (lapatinib) to adjuvant Herceptin (trastuzumab) for patients with early stage, HER-2 positive breast cancer. This combination did not prove more effective than the standard treatment of trastuzumab alone. Researchers found no statistically significant difference in treatments after four and a half years. Side effects of the combination were also examined and researchers found the rates of serious heart-related events were low. However, the combination treatment had higher rates of side effects, such as rash, diarrhea and liver problems.RELATED POSTS
BY LENA HUANG | MAY 31, 2014
Fertility preservation is a common concern among women undergoing chemotherapy treatment for breast cancer. New findings from a phase 3 trial reveal that adding Zoladex (goserelin), a hormone-suppressing drug, to standard chemotherapy may help preserve fertility in women with early-stage, hormone receptor-negative breast cancer. In the study, premenopausal women who were given goserelin with a cyclophosphamide-containing chemotherapy were less likely to have ovarian failure than women who received chemotherapy alone. The addition of goserelin also seemed to improve the chances of a successful pregnancy.
Goserelin is a luteinizing hormone-releasing hormone, which turns off ovarian function for a short time. Researchers hypothesize that this action protects the ovaries from chemotherapy damage. Kathy Albain of Loyola University and a senior author of the research, said in the study goserelin costs $500 to $600 per injection and patients received four injections. An unexpected finding was that women who received goserelin were also 50 percent more likely to survive four years after starting treatment compared with those who did not receive goserelin. Lead researcher Halle Moore of the Cleveland Clinic cautioned more research needs to be completed to confirm these results.
Patricia Ganz, director of cancer prevention and control research at UCLA and moderator of the session, said the research presented on the use of goserelin for fertility preservation in this group of patients may be practice changing.RELATED POSTS
BY LENA HUANG | AUGUST 1, 2013
This morning, I got a glimpse of a photo on the news that shocked me.
The New England Journal of Medicine reported this case of a 69-year-old man with skin damage on the left side of his face due to repeated sun exposure through the window of his truck. The photo shows a sharp contrast in skin texture between the exposed left side of his face to the less exposed right side of his face. The man was a truck driver for 28 years.
The photo reminded me of advice I got from my dermatologist not too long ago. I asked her about some pigmentation that was developing on the left side of my face and not on my right. Her answer: sun exposure through the window of your car. I always assumed there was some protection in my car windows but she told me that damaging rays can still penetrate the side windows. Sun damage to the skin is cumulative and can lead to skin cancers.
After our conversation, I found a good article from the Skin Cancer Foundation on "Sun Hazards in Your Car." It provides some details and quotes research about this damaging effect. For example, researchers found a parallel in countries with right side drivers. In those countries, drivers developed more sun damage on the right side of their bodies. Another study showed a higher incidence of skin cancers on the left side of the body than the right in the United States.
So, what can you do? Don't do what I did and assume your car windows are protecting you. As the article says, apply sunscreen daily and make sure you reapply it throughout the day. Wear protective clothing and sunglasses. Also, you can get UV-protective film or tint for your car windows, which will screen out a good percentage of harmful rays.RELATED POSTS
BY LENA HUANG | JULY 9, 2013
The emotional challenges of living with cancer are often overlooked in order to focus on fighting the disease itself. Recently, the American Lung Association released a video, "Navigating Lung Cancer: Stories of Support," that features three lung cancer survivors discussing their emotional journeys and how they found support.
While the video offers some advice specific to lung cancer patients, there is a lot of general information that applies to any cancer patient, survivor or caregiver. The stories from the three survivors are moving and filled with anecdotes and personal experiences that provide guidance and hope. An oncology nurse and an oncology social worker provide professional advice throughout the stories. The video is hosted by Greta Kreuz, a lung cancer survivor and news anchor for the ABC affiliate in Washington, D.C.
The video is the latest addition to the ALA's online lung cancer website, "Facing Lung Cancer: Support from Day One." The website has a lot of resources, including an interactive library with other videos, basic information on lung cancer and a section for healthcare providers. There is also support for patients and caregivers and help for making treatment decisions.
The website was launched last year with support from Lily Oncology. The ALA is responsible for all content. Check out the website and video, and maybe you will find some information and inspiration to help you on your journey.RELATED POSTS
BY LENA HUANG | SEPTEMBER 11, 2012
Want to help find ways to prevent cancer? If you are between the ages of 30 and 65, have no personal history of cancer (except basal or squamous cell skin cancer) and are willing to provide a blood sample and answer periodic surveys, here's a study you should join.
The American Cancer Society launched its third Cancer Prevention Study (CPS-3) in 2010 and is seeking more participants. The goal is to enroll 300,000 by the end of 2013. The ACS has signed up about half of that so far.
Since the 1950s, the ACS has been conducting long-term studies in which researchers collect information, such as medical and lifestyle data, from participants over a period of time. The information from these studies has resulted in major findings, such as linking cigarette smoking to lung cancer and connecting physical activity to lowering the risk of certain cancers.
As people's lifestyles and environments change, it is important to keep these studies going –- to collect current data, identify new links to cancer and find ways to prevent it. The first CPS ran from 1959 to 1972. The second CPS started in 1982 and is still going. With CPS-3, the ACS is hoping to collect even more data, especially on various ethnic and racial populations.
Cancer seems to target certain populations but we don't know why. For example, liver cancer rates are higher in Hispanics than in non-Hispanic whites, and African-American men have a higher incidence of prostate cancer compared with white men. With studies like CPS-3, we are hoping the data will help us to understand why.
The ACS is recruiting for CPS-3 around the country. Some of us on the CURE staff are going to participate. Join us, and let's support ways to fight this disease, so that future generations don't have to.
For more information about CPS-3, including finding a test site near you, click here.RELATED POSTS
BY LENA HUANG | JULY 13, 2012
The University of Michigan Health System developed a free mobile app for iPhone and iPad users to track skin changes and monitor for signs of skin cancer. UMSkinCheck lets users create a photographic baseline of skin lesions and then reminds users to check the lesion for changes over time. If a mole or lesion changes, the user can share the photo with a dermatologist to determine next steps.
The app also takes you step by step through a self-exam and will calculate your risk of developing melanoma. It also has examples of common skin lesions and takes you through the ABCDs (asymmetry, border, color, difference) of melanoma. Users can get sun safety and sunscreen tips as well.
Download the UMSkinCheck app on iTunes.RELATED POSTS
BY LENA HUANG | APRIL 27, 2012
The American Cancer Society released new guidelines that recommend good nutrition and exercise for survivors to reduce the chance of recurrence and increase the possibility of disease-free survival. The ACS formulated these recommendations after convening a group of researchers and thought leaders in nutrition, exercise and cancer survivorship to evaluate current evidence and best practices on these topics. Among the committee's recommendations:
Minimizing weight gain during treatment may be important for survivors who are overweight and also for those of normal weight.
Evidence suggests that exercise is not only safe during cancer treatment but can also improve physical functioning, quality of life, fatigue and may even increase the rate of completion of chemotherapy.
Exercise after cancer diagnosis is associated with a reduced risk of recurrence and improved mortality in many cancer survivor groups, including breast, colorectal, ovarian and prostate.
Results of observational studies suggest diet and nutrition may affect risk of recurrence, cancer progression and overall survival in those treated for cancer.
This report also specifies nutrition and exercise advice by cancer types including breast, colorectal, endometrial, ovarian, lung, prostate, head and neck, and hematologic cancers. It also includes a helpful section on common questions and answers about nutrition, exercise and cancer survivorship. Some questions covered are:
Should alcohol be avoided during treatment? (Generally yes, or kept to a minimum, based on type and stage of disease.)
Are organic foods recommended for cancer survivors? (At present it is not known if organic foods are more effective in reducing recurrence than foods produced by other farming methods.)
Does sugar feed cancer? (No, however products high in added sugar may add substantial calories, resulting in weight gain, which may affect cancer outcomes.)
Can dietary supplements reduce the risk of recurrence? (No evidence at this time suggests supplements will reduce the chances of recurrence.)
Should I exercise during cancer treatment? (Evidence suggests that exercise is safe and can improve physical functioning and quality of life, however, intensity and duration may need to be adjusted during treatment and special precautions taken for those with anemia, weak immunity, bone disease, skin sensitivity, neuropathy and other side effects of therapy.)
"While we've published previous reports outlining the evidence on the impact of nutrition and physical activity on cancer recurrence and survival, this is the first time the evidence has been strong enough to release formal guidelines for survivorship, as we've done for cancer prevention. Living a physically active lifestyle and eating a healthy diet should absolutely be top of mind for anyone who's been diagnosed with cancer," Colleen Doyle, MS, RD, ACS director of nutrition and physical activity and co-author of the guidelines, said in a press release.
To read the full report, click here.RELATED POSTS
BY LENA HUANG | JANUARY 31, 2012
The percentage of Americans getting screened for cancer is below national targets with lower rates in the Asian and Hispanic populations, says the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute in a study released last Friday.
The study revealed that in 2010 breast cancer screening rates were 72.4 percent, which is below the target of 81 percent set by Healthy People 2020, a government initiative to set benchmarks to measure the impact of prevention activities. Cervical cancer screening was at 83 percent compared with the benchmark of 93 percent; and colorectal cancer screening was at 58.6 percent lower than the target of 70.5 percent.
According to the report, screening rates in the Asian population were "significantly lower" at 64.1 percent for breast cancer, 75.4 percent for cervical cancer and 46.9 percent for colorectal cancer. Hispanics were less likely to be screened for cervical cancer (78.7 percent) and colorectal cancer (46.5 percent) compared with non-Hispanics at 83.8 percent and 59.9 percent, respectively.
In a statement accompanying the study, lead author Sallyann Coleman King, MD, said, "It is troubling to see that not all Americans are getting the recommended cancer screenings and that disparities continue to persist for certain populations. Screening can find breast, cervical, and colorectal cancers at an early stage when treatment is more effective." King, who is also an epidemic intelligence service officer in the CDC's division of cancer prevention, added, "We must continue to monitor cancer screening rates to improve the health of all Americans."
While financial costs may be a barrier to some in obtaining screening, the report also notes programs that can help. The CDC's National Breast and Cervical Cancer Early Detection Program provides access to free or low-cost screening and diagnostic services to underserved women across the country. The CDC's Colorectal Cancer Control Program offers access to screening to underserved men and women in 25 states. In addition, reducing financial barriers to preventive care is an aim of the Affordable Care Act. Under the act, breast, cervical and colorectal cancer screening is covered free under Medicare and new health insurance plans.RELATED POSTS
BY LENA HUANG | JANUARY 13, 2012
Last summer, the National Cancer Institute and the Office for the National Coordinator for Health Information Technology challenged innovators to create applications that help cancer patients, survivors and healthcare professionals. The winners were recently announced and were each awarded $20,000 to develop their technology. Although these apps are still in the early stages of development, you can test some out and see what the future may look like for technology that helps us along the cancer journey. Here are the two winners:
1. Ask Dory! was developed by Chintan Patel, PhD, and Sharib Kahn, MD, of Applied Informatics to help patients find clinical trials. It utilizes information from clinicaltrials.gov and takes you through a decision tree, or series of questions, to personalize and find the best trial for you. Dory was named after the curious fish in "Finding Nemo."
2. My Cancer Genome was developed by researchers at Vanderbilt-Ingram Cancer Center as a personalized support tool to help patients, caregivers and healthcare providers match genetic mutations to therapies, treatments and clinical trials. Developers have started with cancers that are known to have genetic links and plan to add new content as more genes and diseases are connected and as more targeted therapies emerge.
The semifinalists also had intriguing ideas. One program focuses on cancer screening and decision making, and the other plans to provide personalized strategies for reducing cancer risk. If you are interested in seeing the semifinalists, you can look here.
Congratulations to these innovators who are working to use the latest technology to make cancer more understandable and personalized!RELATED POSTS
BY LENA HUANG | NOVEMBER 10, 2011
Although President Obama issued an executive order last week to tackle the growing shortages of some medicines, the results of that order may not come fast enough for many cancer patients in need of treatments. More than 22 chemotherapy drugs, about 35 to 40 percent of the total number of approved cancer drugs, are in short supply.
To support cancer patients' concerns and provide help, Fight Colorectal Cancer is hosting a free webinar on the drug shortages called "What to do when your doc is out of 5-FU (or leucovorin or irinotecan)" on November 16 at 8:00 p.m. (EST). Dr. Lindsey Poppe, the pharmacy clinical manager of oncology for the University of North Carolina hospital system, will provide alternatives and advice for patients and discuss how to take action to get your government representatives involved in a resolution. To participate, register here.
After Nov. 16, the webinar can be accessed at fightcolorectalcancer.org.RELATED POSTS