Tuesday, December 11, 2018

American Cancer Society vs. U.S. advisory group

Agency and task force disagree on when people should start screening for colon cancer 

Whether U.S. adults should start colon cancer screening at age 45 or 50 is still in doubt.

The most recent guidelines from the American Cancer Society advocate the former, but an influential government advisory group, the U.S. Preventive Services Task Force, still believes the latter age is perfectly okay.

According to an Associated Press story by Mike Stobbe a while back, the cancer society admits its recommendation of the earlier age "could cause confusion for doctors and patients." 

Both groups, however, apparently recommend six other kinds of screening exams, "from inexpensive take-home stool tests performed every year to colonoscopies done every 10."
Dr. Rich Wender
The best test, the cancer society's Dr. Rich Wender is quoted as saying, "is the test that gets done. All of these tests are good tests, and the choice should be offered to patients."

Most colon cancer occurs, according to the story, "in adults 55 and older, and the good news is rates of cases and deaths have been falling for decades."

Colon cancer, combined with rectal cancer, is the second leading cause of cancer deaths in the United States — the top cause being lung cancer.

Some 140,000 Americans were expected to be diagnosed with colon cancer this year, "and about 50,000 will die from it," Stobbe's piece reports.

Only "about two-thirds of people 50 and older have been following screening guidelines," the article notes, quoting Dr. Marcus Plescia of the Association of State and Territorial Health Officials as saying that "it's hard enough to get people to do it at all."

But Dr. Andrew Wolf, lead author of the American Cancer Society study, reportedly said his agency had considered and rejected that reasoning.

More information about conflicting research and findings 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

Sunday, December 2, 2018

Can laparoscopic surgery spread cancer cells?

New data shows less invasive operation causes more deaths for women with cervical cancer

In news that may appear counter-intuitive, two studies have shown a higher death rate for a less invasive version of a cancer operation in women.

According to a recent Associate Press story by Carla K. Johnson, the new evidence challenges standard practice "and the 'less is more' approach to treating cervical cancer."

The article notes that the unexpected findings already "are prompting changes at some hospitals that perform radical hysterectomies for early-stage disease."
Dr. Pedro Ramirez
Dr. Pedro Ramirez of the University of Texas MD Anderson Cancer Center in Houston, who led the more rigorous study, says that after the results became known "we immediately as a department changed our practice and changed completely to the open approach."

Findings from his study, which was conducted at more than 30 sites in a dozen countries and were published in the New England Journal of Medicine, showed "women who had the less invasive surgery were four times more likely to see their cancer return compared to women who had traditional surgery."

Dr. Jason Wright of New York-Presbyterian Hospital, a co-author of the other study, says "we're rethinking how we approach patients. There's a lot of surprise around these findings."

And Dr. Amanda Fader of Johns Hopkins Kimmel Cancer Center, explaining that the Baltimore hospital "has stopped doing less invasive hysterectomies for cervical cancer until there is more data," is quoted as saying the new research "is 'a great blow' to the [newer] technique and the findings are 'alarming.'"

Surgeons, she adds, ""should proceed cautiously."

In both studies, Johnson's story says, "researchers compared two methods for radical hysterectomy, an operation to remove the uterus, cervix and part of the vagina. The surgery cost around $9,000 to $12,000 with the minimally invasive version at the higher end."

Traditional surgery involves a cut in the lower abdomen; in the newer method, laparoscopic surgery, from which patients recover more rapidly, small incisions are made for a camera and instruments.

Some experts believe the reason for the higher death rate is because "there may be something about the tools or technique that spreads the cancer cells from the tumor to the abdominal cavity," AP's article reports.

More information on research into cancer for both men and women 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.