January 23, 2019
News breaks in the cancer arena all the time. Sometimes it’s big — like word that a breakthrough drug has increased survival for a hard-to-treat cancer. Sometimes it’s smaller. Any of it may matter to you and your family as you navigate the cancer journey. We do our best to keep you up-to-date with a weekly roundup of some of the most significant cancer news. Here’s what happened this week.
Obesity Doubles the Risk of Colorectal Cancer in Younger Women
What’s new Obesity is associated with a doubled risk of early-onset colorectal cancer (colorectal cancer diagnosed in women younger than 50), according to a study published in the January issue of JAMA Oncology.
The study, led by researchers at Massachusetts General Hospital and Harvard Medical School in Boston, examined the medical records of 85,256 women who were part of the Nurses Health Study II. The women were cancer free upon enrollment of the study. The analysis showed those who were obese (a body mass index of 30 or higher) had double the risk of developing colorectal cancer before age 50 compared with women with normal BMI.
Why it matters Colorectal cancer rates are rising in people age 50 and younger in the United States. The study suggests a link to obesity. The authors called for additional research on men and on how obesity may be contributing to the risk of the disease.
RELATED: People Who Are Obese Respond Better to Some Cancer Immunotherapy Drugs
Which Hepatitis B Drug You Take May Affect Your Liver Cancer Risk
What’s new Treatment with the hepatitis B antiviral medication Viread (tenofovir, or TDF) was linked to a significantly lower risk of liver cancer and liver cancer death compared with treatment with the antiviral drug Baraclude (entecavir, or ETV), according to a study published in the January issue of JAMA Oncology.
The study examined 24,156 adult patients in Korea with chronic hepatitis B (CHB) infection. Researchers found those treated with Viread had a 35 percent lower risk of developing liver cancer. The results were confirmed in a second study of 2,701 patients.
Why it matters The incidence of liver cancer is rising in the United States, in part because of a growing number of hepatitis B infections. Both Viread and Baraclude are equally recommended for the treatment of hepatitis B infection. But it has been unclear whether the drugs influence the later risk of liver cancer. Given that liver cancer has a poor prognosis, the study has implications for preventing liver cancer in patients with hepatitis B infection, said the authors, from University of Ulsan College of Medicine, Seoul, Republic of Korea. An editorial accompanying the paper noted: “These striking findings raise the question of whether the current CHB guidelines should be updated to reflect this observed superior anticancer benefit of TDF over ETV.”
RELATED: Deaths From Alcohol-Related Liver Disease and Liver Cancer Are on the Rise Among Young Americans
Cancer Patients With Other Illnesses Less Likely to Join Clinical Trials
What’s new Cancer patients with other illnesses, such as asthma or hypertension, are less likely to discuss cancer clinical trial participation with their doctors and are less likely to be offered clinical trial participation or join a trial, according to research published January 10 in JAMA Oncology.
Investigators from the SWOG Cancer Research Network (originally the Southwest Cancer Chemotherapy Study Group), surveyed 5,499 patients and found that 66 percent of patients reported having one or more secondary illnesses, or comorbidities, such as hypertension, vision loss, arthritis, asthma, hearing loss or a previous cancer. They had far fewer discussions with their healthcare providers about clinical trials, compared with cancer patients with no secondary illnesses, and were less likely to enroll in trials.
Why it matters Cancer clinical trials sometimes offer patients with challenging prognoses the best chances of survival because trials typically compare the standard-of-care treatment with a potentially better treatment. Many studies may limit enrollment of patients with certain comorbidities. Several cancer professional associations, along with the FDA, are working to change clinical trial eligibility requirements to allow more people with manageable comorbidities to join trials, the authors noted. The authors of an editorial accompanying the article noted: “Modernizing eligibility criteria by removing restrictions on comorbid conditions represents an important step forward in our efforts to enhance clinical trial participation across the population.”
RELATED: 7 Myths About Clinical Trials for Advanced Breast Cancer
Low-Dose CT Lung Cancer Screening May Have Higher Risks and Costs Than First Thought
What’s new A new study suggests that low-dose CT screening for people at high risk for lung cancer may ultimately lead to higher rates of complications and higher costs than suggested by a major clinical trial, called the National Lung Screening Trial (NLST), that initially assessed the screening technique. The report was published January 14 in the journal JAMA Internal Medicine.
Researchers looked at 174,702 people ages 55 to 77 who had invasive diagnostic procedures to check for lung cancer and compared them with a similar number of people who did not have those procedures. They found that, among younger individuals (ages 55 to 64), postprocedural complication rates were 22.2 percent compared with just 9.8 percent in the NLST. For older individuals (ages 65 to 77), complication rates were 23.8 percent in the current study and 8.5 percent in the NLST.
The researchers also performed an analysis of costs related to postprocedural complications and found they ranged from $6,320 for minor complications to $56,845 for major complications.
Why it matters The study shows that real-world costs and complications arising from low-dose CT lung cancer screening may be different from what was found in the NLST trial. But the authors, from the University of Texas MD Anderson Cancer Center, point out that only a small percentage of people screened for lung cancer end up needing invasive diagnostic procedures and that lung cancer screening still appears to benefit people who meet the criteria for screening (such as heavy, long-term current or former smokers). Nevertheless, the authors said, doctors should share the potential harms and benefits of screening with their patients who are considering screening.
RELATED: Lung Cancer Risk: Should You Get Screened?
States With the Highest Incidence of Melanoma Skin Cancer Have the Best Survival Rates
What’s new The incidence and chances of surviving melanoma skin cancer varies widely across states, according to a new study. States with a higher incidence of melanoma have better survival rates, while states with a lower incidence of the disease have lower survival rates. The paper was published online January 16 in the Journal of the American Academy of Dermatology.
Researchers at University of Utah Health studied melanoma incidence and deaths per state, and looked at the number of doctors practicing in a region and the percentage of whites in the population (white people have a higher incidence of the disease). They found the highest survival rates in Oregon, Washington, Utah, Minnesota, Vermont, and New Hampshire, and the lowest survival rates in Texas, Louisiana, Alabama, Indiana, Illinois, and Nevada. Regions with more practicing doctors had lower survival rates.
Why it matters The study provides information that can be used to improve melanoma survival rates and determine how healthcare systems respond to melanoma, the authors said. The link between more physicians and a higher death rate is surprising, they said, and may be explained by sicker patients going to larger medical facilities where there are more doctors who report disease statistics. “The analysis is telling us that two people with similar melanomas could have very different outcomes based on where they live and the care they receive,” said Aaron Secrest, MD, PhD, an assistant professor at the University of Utah Health in Salt Lake City and the senior author of the paper. “We can use this information to improve care to help more people survive.”
RELATED: Melanoma Signs and Symptoms: Early Detection Is Key
Acupressure Helps Breast Cancer Survivors Who Have Lingering Side Effects
What’s new Self-administered acupressure helps breast cancer survivors with post-treatment symptoms such as pain, anxiety, depression, and poor sleep, according to a study published January 16 in JNCI Cancer Spectrum.
Researchers at the University of Michigan in Ann Arbor enrolled 288 breast cancersurvivors into a study in which they were randomized into three groups: those who applied relaxing acupressure (a type of acupressure using body points designed to treat insomnia), those who applied stimulating acupressure (a type of acupressure using body points designed to increase energy) and those who received standard care, which included things like sleep management advice. The women in the acupressure groups were taught how to find and stimulate acupressure points, and then did so at home once a day for six weeks. The study showed women who had relaxing acupressure experienced the most relief from depression and pain. The women who had stimulating acupressure also experienced reductions in those symptoms — not as much as the relaxing acupressure group but more than the standard-care group.
Why it matters It’s common for breast cancer survivors to experience some lingering effects from treatment, the authors said. Acupressure could be a low-cost, at-home solution to curb those effects. The researchers plan to gather more information using neuroimaging to understand the brain pathways involved in the treatment.
RELATED: Sleep Apnea Increases the Risk for Gout, Study Suggests
Breast Cancer More Likely to Metastasize in Young Women in Years Following Childbirth
What’s new Breast cancers diagnosed in young women within 10 years of giving birth are much more likely to metastasize compared with breast cancers in women who gave birth less recently or not all, say the authors of a study published January 11 in the Journal of the American Medical Association Network.
Researchers looked at data from 701 breast cancer patients, ages 45 and below, included in the Colorado Young Women’s Breast Cancer Cohort and compared them according to their childbirth histories. The increased risk for metastasis was highest in the women up to 10 years postpartum and was most pronounced in women with stage 1 or 2 breast cancer, with a 3.5 to 5 times higher risk than women with similar, nonpregnancy associated breast cancers. For estrogen-receptor positive tumors, an increased risk of metastasis was present up to 15 years following diagnosis.
Why it matters “This is the first study to demonstrate that a postpartum breast cancer diagnosed up to 10 years after last childbirth can independently increase a woman’s risk for developing metastasis to other parts of the body,” says the lead author, Virginia Borges, MD, the director of the breast cancer research program and young women’s breast cancer translational program at the University of Colorado Cancer Center in Aurora.
It’s possible that, after childbirth, conditions in surrounding breast tissue may influence the development of metastases, the authors said. These changes include the formation of new lymph channels in breast tissue and nursing.