Saturday, November 23, 2019

HPV shots might save thousands of lives

Vaccines, screenings, treatments could severely cut deaths from cervical cancer, N.Y. Times says

Cervical cancer last year killed more than 311,000 women, one every two minutes, but early detection might have prevented thousands of those deaths around the world.

Such detection, it's believed, could have resulted in expanded screenings and treatments.

In addition, an increase in HPV vaccinations for teenage girls may have helped a great deal.

At least those are the conclusion drawn by Mia Armstrong in a recent story in The New York Times. 

Dr. Kirsten Austad
Armstrong quotes Dr. Kirsten Austad, director of women's health for the Maya Health Alliance, as saying, "Almost no one needs to die of cervical cancer."

Of the more than 300,000 annual deaths from cervical cancer, the fourth most common cancer for women globally, the Times piece notes, more than 85 percent were in low- and middle-income countries.

The story also mentions a World Health Organization estimate of 570,000 new cases in 2018, the same year that Dr. Tedros Adhanom Ghebreyesus, director general of WHO, "called for coordinated global action" to eliminate the disease.

Armstrong cites, too, the words of Dr. Silvia de Sanjosé, director of women's cancer for PATH, a nonprofit focused on global health, to the effect that such a coordinated effort "was crucial to elevating the issue," which had previously received little attention.

"I would not say that that's enough," she said, the story continues. "But it's clearly a turning point." 

She also told the Times about a couple of big challenges: The vaccine needs to be given after age nine, which is later than most routine vaccines, and the price tag, which in the lowest-income countries costs approximately $4.50, jumps to $150 in some places.

WHO recommends that 9- to 14-year-old girls receive two does of the [HPV vaccine, which protects] against HPV infections responsible for 70 to 90 percent of cervical cancers."

The difficulty is, however, that, according to the story, WHO estimates indicate that "only around 25 percent of 10-year-olds live in counties that have introduced the HPV vaccine."

Other calls to action about diseases can be found in "Rollercoaster: How a man can survive his wife's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Tuesday, November 12, 2019

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.

Sunday, November 3, 2019

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.