Drug added to hormone treatment gets support

Younger women with advanced breast cancer can find hope in new targeted therapy, N.Y. Times says 

A new drug has brought new hope for younger women with advanced breast cancer.

According to a recent story by by Denise Grady in The New York Times, "adding a newer medicine to the standard hormonal treatment helped women who had not reached menopause or were still going through it."

Seventy percent of the women in a clinical test, the article says, "were still alive three and a half years [after taking the drug], compared with only 46 percent of those given the standard treatment alone."

Grady's piece explains that the "standard treatment uses drugs to block the hormone estrogen or stop the body from making it, because estrogen feeds the growth of breast cancer in many patients."

The new findings apply only to women "whose tumors are sensitive to estrogen but lack a protein called HER2."

Dr. Debu Tripathy

Dr. Debu Tripathy, an author of the study and chair of breast medical oncology at the M.D. Anderson Cancer Center in Houston, is quoted by Grady as follows: "I think there's a lot of optimism now that were have pushed the survival boundary, that we can go farther. Once you break a boundary, you learn how to break more boundaries."

The Times also quotes Dr. Sylva Adams, a breast cancer specialist and researcher at NYU Langone Health's Perlmuter Cancer Center but not a part of the study, as saying "this is wonderful news. It's a trial worth highlighting."

She also notes that — while citing the study as "a very important milestone" — "there have been very few studies in advanced breast cancer…showing a clear survival benefit."

The pill used in the trial, ribociclib, is, The Times reports, "a so-called targeted therapy, which blocks an enzyme that helps cancer grow. It was first approved by the Food and Drug Administration in 2017 for postmenopausal women with advanced breast cancer, and then in 2018 for younger women."

Ribociclib, which women may take for months (or even several years), costs $12,553 a month. Its usage must be monitored closely, Grady writes, "because it can cause dangerous abnormalities in heart rhythm, as well as liver and kidney problems and lowered blood counts that can increase the risk of infection."

Like all targeted therapies, the article adds, "it may stop working as the cancer developed resistance to it."

The results of the study, which were slated to be presented at the annual meeting of the American Society of Clinical Oncology, in Chicago, were published in The New England Journal of Medicine.

The study included 672 women aged 18 to 59. All had advanced breast cancer, "meaning it had recurred after treatment or had begun to spread, and was no longer considered curable."

More information about new drugs can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Help possible for some breast, prostate diseases

Common dietary supplement might be the remedy for a rare genetic mutation that can lead to cancer

Although a rare genetic mutation leads to cancer, a fix may already be available.

According to a recent story by Gina Kolata in The New York Times, "a common dietary supplement may help overcome mutations in the Pten gene."

The real question, the Times asks, is, "Should patients take it?"

And the paper's answer, based on medical personnel that were interviewed, is a qualified yes.

Kolata's article says that the mutation "markedly raises the risk for several cancers, including prostate and breast cancer…as well as autism and schizophrenia in some individuals."

The lifetime risk in carriers, it indicates, is an astoundingly high 85 percent.

In theory, those at risk could help themselves by eating brussels sprouts, broccoli or other cruciferous veggies. The problem is, Kolata reports, to get enough to be of real use, "they'd have to eat a lot: six pounds of brussels sprouts a day — raw."

Instead, a healing compound "is widely available as a dietary supplement" found in local drugstores.

Experts, Kolata adds, "are debating whether to embark on a clinical trial with it."

The Times specifically cites a study published in the journal Science in which "researchers found evidence that a compound called indole-3-cabinol (i3c) blocks an enzyme that inhibits the activity of Pten. With the gene more active, patients with the mutation may be better protected against cancer."

The study, Kolata notes, "was done only in mice and in human cancer cells grown  in petrie dishes."

She explains, further, that although the findings do apply to Pten gene activity, "there is little evidence for most of the other wild claims made for i3c by supplement makers."

Although inherited Pten mutations are rare, striking one in 200,000, the gene also spontaneously mutates in many tumors. "When that happens," the Times piece maintains, "the patient's prognosis is poor."

Dr. Mustafa Sahin

The article quotes Dr. Mustafa Sahin, an expert on the gene at Boston Children's Hospital (who wasn't involved in the work at Beth Israel Deaconess Medical Center in Boston that was the basis for the Journal report), called the research a "tour de force study" whose result was "a paradigm shift in the field [that is] very exciting in terms of its therapeutic implications."

The Times also quotes Dr. Pier Paolo Pandolfi, director of the center who's been trying to find a way to restore Pten activity for years and is the senior author of the paper, as saying about the findings: "We got lucky — or smart."

More information about mutations, especially the BRCA1 and BRCA2 gene, can be found in "Rollercoaster: How a man can survive his partner's breast cancer" a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Once you hit 80, odds say you'll live past 90

Risk factors for another cancer jump up if you've already had one kind — or if one of your kin has

Is it possible to live cancer-free?

The answer is a resounding yes, at least according to a recent non-bylined article in the AARP Magazine, whose subhead reads in part, "Age is a risk factor for cancer, but the chances of developing a fatal cancer may actually begin to decline at age 70."

It also contends that "once you hit 80, our chance of living to 90 and beyond goes way up."

The article isn't totally positive, however.

It says, for instance, that "women who have had breast cancer are more at risk for another type of breast cancer, and other cancers."

And it notes that "a Stanford University study showed that people diagnosed with six or more basal cell carcinomas have more than three times the odds for developing future cancers, such as breast, colon and prostate cancer as well as leukemia and lymphoma — likely due to an underlying  problem in genes that repair DNA."

In short, having one kind of cancer makes a woman or man prone to other kinds. 

And if you smoked, it says, "you're at increased risk for not only lung cancer but also a dozen other cancers, including oral, cervical, bladder and pancreatic."

Your family medical history can also increase your risk.

Heather Hampel

The AARP piece quotes Heather Hampel, associate director of the Ohio State University Comprehensive Cancer Center, as saying that if you have a family history of cancer you should coordinate with a genetic counselor who can put your results in perspective and recommend an action plan.

"Women who carry the BRCA1 or BRCA2 gene, for example, have up to a 72% chance of developing breast cancer and 44% chance of ovarian cancer by age 80," the article states.

But, even though in the general population women have only about a 12% lifetime risk of breast cancer, and "though those statistics sound scary, genetic testing can help doctors guide you on the best ways to prevent cancers, or diagnose this earlier, when they are treatable," the AARP mag further   quotes Hampel.

More information about risks can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at caregivers.

Diet change can slice chance of death by 21%

Cutting down on fat while eating more veggies and fruits might save you from dying of breast cancer

Eating more fruits and veggies, and less fat, can cut women's risk of dying from breast cancer, a new study says.

According to a recent story by Marilynn Marchione of the Associated Press, a test involving 49,000 breast cancer-free women between the ages of 50 and 79 over two decades shows that those "who modified their diets for at least eight years and who later developed the cancer had a 21% lower risk of dying of the disease compared to others who continued to eat as usual."

Marchione's piece explains that results of the large, rigorous experiment are notable because, for the first time, researchers didn't merely "try to draw health conclusions from observation about how people eat."

But because the "risk was small to start with and diet's effect was not huge…it took 20 years for the difference between the groups to appear."

The diet change, the AP story continues, "also did not lower the risk of developing breast cancer, which was the study's main goal."

Dr. Rowan Chlebowski

Results, which stemmed from the Women's Health Initiative, a major federally funded study that previously overturned longtime advice on hormone therapy for menopause symptoms, were announced by Dr. Rowan Chlebowski of Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center in a telephone news conference held by the American Society of Clinical Oncology prior to its annual meeting.

Chlebowski, the AP story reports, "is working on another study to see whether women who are obese or have certain other health risks get the biggest benefit from trimming dietary fat. Results from this study suggest they might."

Marchione's article adds that Dr. Lidia Schapira, a breast cancer expert at Stanford University and a spokeswoman for the oncology society, says that because of the quality of the study, "we need to take this very seriously. What we eat matters." 

More information about research into possible disease preventions can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Medical risks expanding along with waistlines

Cancer dangers from obesity are growing exponentially, article in The Washington Post indicates

Obesity may overtake smoking as the No. 1 preventable cause of cancer.

According to a story by Laurie McKinley in The Washington Post a while back, the change is due to waistlines continuing "to expand while tobacco use plummets."

McKinley notes that Dr. Otis Brawley, ex-American Cancer Society (ACS) chief medical officer who's now a Johns Hopkins oncologist, says the switch may take five to 10 years.

Dr. Jennifer Ligibel

What's happening, she quotes Dr. Jennifer Ligibel, a breast oncologist at the Dana-Farber Cancer Institute, as saying, is that "a complex interplay of metabolism, inflammation and immunity…creates an environment that is more permissive for cancer."

The Post also quotes Dr. Jonathan Wright, a urologist at Fred Hutchinson Cancer Research, to the effect that "it does appear that the risk is greater the more obese you are."

Only about half the American public purportedly is aware of the link between excess weight and cancer. 

The deadly combo has long been known to increase the risk of heart disease and diabetes — and now is being associated, according to the Post, "with an increased risk of getting at least 13 types of cancer, including stomach, pancreatic, colorectal and liver malignancies, as well as postmenopausal breast cancer."

ACS researchers contend that "excess body weight is linked to about 8 percent of all cancers in the United States and about 7 percent of cancer deaths," McKinley reports.

She also writes that "compared with people of normal weight, obese patients are more likely to see their cancer come back and have a lower likelihood of survival. Perhaps more alarming, young people, who as a group are heavier than their parents, are developing weight-related malignancies, including colorectal cancer, at earlier ages than previous generations, experts say."

An article in JAMA Internal Medicine (the journal of the American Medical Association) several years ago maintained that "seven in 10 Americans are overweight or obese." But the obesity rate has been rising exponentially since that piece was published.

The type of cancer most associated with obesity, McKinley writes, "is endometrial, which develops in the lining of the uterus. Obese and overweight women are two to four times as likely to develop the disease as women of normal weight, and the risk rises with increased weight gain, according to the National Institutes of Health."

Statistics from that source also indicate that "people who are overweight or obese are twice as likely to develop liver and kidney cancer, and about 1.5 times as likely to develop pancreatic cancer than normal-weight people, according to NIH."

Several researchers, McKinley says, "are running clinical trials to prove what many already believe — that losing weight reduces the odds of developing cancer or having a recurrence." 

If studies show that to be true, she adds, "doctors could prescribe a weight-loss program as standard therapy for breast cancer patients — much as cardiac rehabilitation is urged for heart-attack patients. That could pave the way for insurance coverage."

More details on health risks can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Breast cancer split into 11 separate diseases

'Molecular wiring' of tumors might forecast survival or relapse, new study shows

Can the so-called "internal wiring" of breast cancer predict whether you will survive or face a relapse?

The answer is a definite maybe.

As reported recently by the BBC News website, a new study published in the journal Nature indicates that the malady is actually 11 separate diseases with each having "a different risk of coming back [and] each with a different cause and needing different treatment." 

The article by health and science correspondent James Gallagher says that scientists at Stanford Universities and the University of Cambridge "looked in incredible detail at nearly 2,000 women's breast cancers" and analyzed the genetic mutations inside the tumors so they could "create a new way of classifying them."

Doctors, the piece notes, "currently classify breast cancers based on whether they respond to the hormone estrogen or targeting therapies like Herceptin."

Professor Carlos Caldas

Gallagher's story quotes Professor Carlos Caldas of the Department of Oncology at Cambridge Institute to the effect that the findings — which focus on the "molecular wiring" of the tumors — are "a very significant step to more precision-type medicine.

The study also "showed that triple negative breast cancers — one of the hardest to treat — were not all one class of cancer, but two."

The first group, according to the story, is "one where if women have not relapsed by five years they are probably cured" but a second subgroup is one in which women "are still at significant risk of later relapse."

Four subgroups, the article continued, "were both driven by estrogen and had a 'marked increased' risk of recurrence" — situations where patients "may benefit from a longer course of hormone therapy drugs like tamoxifen."

More information on research regarding the disease can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

U.S. eyes label warning for Allergen devices

FDA pressure results in breast implants that cause rare cancer of the immune system being recalled

Allergen is recalling its textured breast implants worldwide that have been linked to anaplastic large-cell lymphoma, a rare cancer of the immune system.

The company has responded to belated pressure from the Federal Drug Administration.

According to a recent story by Denise Grady in The New York Times, however, the FDA reports that women who have the implants but no symptoms don't need to remove them.

Yet the article does note "the recall means that doctors and hospitals should not implant any more of the devices and should return any on their shelves to Allergen."

The disease is not breast cancer but developed in tissues around the implant. "In most cases," Grady's story says, "removing the implant and the scar tissue around it cures the cancer, but if it is not detected early it can spread and kill the patient."

The condition, it continues, "has occurred with implants placed for cosmetic breast enlargement and with those used for reconstruction after mastectomy for breast cancer."

Thirty-three deaths and 573 cases have been reported from implants, Grady's piece reports, with a dozen deaths and 481 of them attributed to Allergen Biocell, according to the FDA, which dragged its heels after first recognizing the link to breast implants in 2011.

The Times story, which notes that the devices were banned months ago in Europe, contends that the "Biocell textured implants carry a risk that is about six times that of other textured implants sold in the United States."

Dr. Binita Ashar

It also reports that Dr. Binita Ashar, director of the FDA's Office of Surgical and Infection Control Devices, said at a news briefing…about the recall" that "hundreds of thousands of women in the United States have Biocell implants." 

The article also quotes Dr. Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health, as saying that "the data regarding deaths was particularly informative of our decisions."

Main symptoms of the disease "are usually swelling and fluid accumulation around the implant," Brady writes.

FDA officials reportedly are considering "adding a black-box warning [to the labeling of the breast implants] to draw attention to the risks, and requiring doctors and patients considering the surgery to go over as checklist to help women understand the benefits and risks of the devices."

More information about implants can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

'Gaping hole' is found in U.S. health system

N.Y. Times article exposes major economic hardships that some cancer caregivers are facing

America's health system is badly flawed because it's making caregivers of patients with cancer and other diseases work much too hard to negotiate it — especially economically.

Aaron E. Carroll

That's the basic conclusion of a recent The New York Times article by Aaron E. Carroll, a professor at Indiana University School of Medicine.

In the piece, Carroll says his friend, international fraternity CEO Jim Fleischer's story about a rare cancer taught him about the problem in our health system.

Despite his friend having "great insurance" and "enough money" and getting "excellent care," he discovered the "impossibility and hardship faced by…friends and family members who are caregivers."

The situation, Carroll writes, is "hugely disrupting and expensive. There's no system for it. It's a gaping hole." 

The writer cites as an example that following his surgery and chemotherapy, his friend's wife, mother-in-law, friends and co-workers needed to take lots of time off to care for him and take him to appointments.

Carroll also suggests that "if it was this hard for [Jim], it's probably unbearable for many others with fewer resources. People can be financially ruined by illness — and health insurance won't fix that."

Last year, the Times piece notes, "it's estimated that more than 1.7 million people faced a cancer diagnosis. The year before, America spent more than $147 billion caring for people with cancer. But that doesn't include the costs outside of health care."

This year, the article continues, "the National Cancer Institute will spend more than $5.7 billion on cancer research. Almost none of that will investigate how to support the families of those who have the disease."

Researchers in the past have estimated the "economic burden for caregivers for patients with lung and colorectal cancer," Carroll says. "They reported that the average cost to a caregiver in the initial phase of treatment was more than $7,000," with an additional $20,000 spent after treatment on so-called continuing care.

Another study cited caregiving costs for breast cancer at $38,000, lung cancer at $72,000, for ovarian cancer $66,000, for lymphoma $59,000.

Carroll concludes that it's crucial to recognize "that the efforts of caregivers are probably just as important to health as the drugs and procedures the medical system provides."

More details about the issues that helpmates have can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.