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Childhood TB Shot May Offer Long-Term Protection from Lung Cancer

TUESDAY, Oct. 1, 2019 — A tuberculosis vaccine commonly used in other parts of the world might reduce a person’s risk of developing lung cancer if given early in childhood, a six-decade-long study reports.

The Bacille Calmette-Guerin (BCG) vaccine is the only vaccine approved for preventing tuberculosis (TB) — a potentially fatal infectious disease that typically attacks the lungs. Because TB risk is low in the United States, the vaccine isn’t often given to American children, according to the U.S. Centers for Disease Control and Prevention.

But the new study suggests the vaccine may have some positive side effects.

“BCG-vaccinated participants had a significant 2.5-fold lower rate of lung cancer,” said study senior author Dr. Naomi Aronson, director of infectious diseases at Uniformed Services University in Bethesda, Md.

She said lower lung cancer rates persisted in those who received the vaccine no matter where they lived, and whether they smoked, drank alcohol or had tuberculosis.

Aronson said BCG affects the immune system somehow and may provide even more benefit in the lungs.

The initial study was conducted in 3,000 American Indian and Alaska Native children in the 1930s. If the findings are confirmed in different groups, Aronson said the use of BCG vaccine in childhood “might be considered for risk reduction for lung cancer over a lifetime.”

Dr. Len Lichtenfeld, interim chief medical officer of the American Cancer Society, reviewed the study and called the findings fascinating. “And you rarely see this duration of follow-up,” he added. “The authors went to great lengths to validate their information.”

But, he said, it’s unlikely that BCG will be used for lung cancer prevention. While the study found a statistically significant reduction in the rate of lung cancer, the actual number of cases was very low. Just 42 people in the study were diagnosed with lung cancer.

There’s also a serious, ongoing shortage of BCG vaccine that would limit any such efforts, Lichtenfeld said. The vaccine is an effective treatment for a certain type of bladder cancer, and doctors find it hard to get enough for that purpose.

In addition, the BCG vaccine has been tested as a treatment in a number of other cancers with mixed results. In some cases, it looked as if lesions had shrunk, but the vaccine didn’t prolong survival, he explained.

Plus, Lichtenfeld said, there’s a very effective way to prevent many cases of lung cancer — don’t smoke. And, if you do, quit. “Tobacco causes most, but not all lung cancers. Not smoking helps prevent many cancers,” he said.

The initial study was conducted between 1935 and 1938. About 3,000 children from nine American Indian and Alaska Native tribes at multiple U.S. sites were randomly given the BCG vaccine or a placebo.

None of the youngsters had had tuberculosis. They were vaccinated between 5 and 11 years of age, with a median age of 8 years. Half were younger when they got the shot, half were older.

From 1992 to 1998, researchers reviewed health information from the trial participants.

There was no statistically significant differences in overall cancer rates between the vaccine and placebo groups. But the odds of lung cancer were significantly lower, the study found.

Researchers noted that lung cancer is a leading cause of death for Alaska Natives and Native Americans.

The study was published Sept. 25 in the journal JAMA Open.

More information

Read more about ways to prevent lung cancer from the American Cancer Society.

© 2019 HealthDay. All rights reserved.

Posted: October 2019

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Link Seen Between Infertility, Prostate Cancer

By Alan Mozes
HealthDay Reporter

FRIDAY, Sept. 27, 2019 (HealthDay News) — Could male infertility contribute to a higher risk for prostate cancer?

Yes, according to new Swedish research that suggests that men who become fathers through assisted reproduction treatments may be more likely to develop prostate cancer in midlife.

The conclusion follows a review of data collected by a Swedish national registry between 1994 and 2014. In all, 1 million children had been born during that time frame, mostly to men in their 30s.

Most (97%) were conceived through natural means. But 1.7% of the fathers (about 20,600 men) had undergone in vitro fertilization, while another 1.3% (nearly 15,000 men) conceived through intracytoplasmic sperm injection (ICSI) techniques.

Prostate cancer risk during the two decades following birth was less than 1% across the board. However, while just 0.28% of dads who had conceived naturally went on to develop the disease, that figure was 0.37% among those from the in vitro group.

Prostate cancer affected an even greater percentage (0.42%) of men in the sperm injection group. The team pointed out that sperm injection is usually reserved for men struggling with the most serious types of infertility.

The findings held up even after taking into account a range of factors, including age, educational background and history of prior cancer.

The team was led by researchers Yahia Al-Jebari, now at Stanford University in California, and Yvonne Lundberg Giwercman, from Lund University in Sweden. In the Sept. 25 issue of the BMJ, they concluded that “men who achieved fatherhood through assisted reproduction techniques, particularly through ICSI, are at high risk for early-onset prostate cancer and thus constitute a risk group in which testing and careful long term follow-up for prostate cancer may be beneficial.”

Still, the study authors cautioned that they only tracked prostate cancer risk up to an average age of 45, so the investigation could not assess risk across an entire lifetime. And they stressed that while they identified an association between the two, they did not prove that infertility actually causes prostate cancer.

As to what might explain the link, the study team members noted that prostate cancer and many types of infertility are both related to testosterone levels. It’s also possible that both share abnormalities on the male Y chromosome, they said.

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SOURCE:BMJ, news release, Sept. 25, 2019

Copyright © 2013-2018 HealthDay. All rights reserved.

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Doubt Over Long-Term Use of Hormone Rx for Recurrent Prostate Cancer

TUESDAY, Sept. 17, 2019 — Running contrary to current guidelines, new research suggests that use of hormone-suppressing treatment over the long term may not help some men battling recurrent prostate cancer, and may even cause harm.

In fact, the study found that long-term hormone therapy was tied to a raised risk of death from other causes for some patients who received it.

Blood levels of prostate-specific antigen (PSA) may help predict which men might benefit — and which men might not — from long-term hormone therapy following surgery, said a team led by Dr. Daniel Spratt of the University of Michigan Cancer Center, in Ann Arbor.

“We found that the lower the PSA, the more harm the patient experienced,” explained Spratt, who is research professor of radiation oncology and chair of the Genitourinary Clinical Research Program at the center. “The higher the PSA, the more likely the patient was to benefit from hormone therapy because it decreased their chances of dying from prostate cancer and resulted in improved overall survival rates.”

The study was presented Sunday at the annual meeting of the American Society for Radiation Oncology (ASTRO), in Chicago.

Because prostate tumors grow faster in the presence of hormones such as testosterone, therapies that lower hormone levels are often offered to men as a way to slow the cancer’s spread. However, these treatments can come with side effects, such as urinary incontinence or sexual dysfunction.

Still, clinical trial results first reported in 2017 found that — after surgical removal of the prostate tumor — adding two years of hormone therapy, along with radiation treatment, appeared to boost patients’ long-term survival.

Those findings led to the recommendation that men with recurrent prostate cancer be treated with both radiation and long-term hormone therapy after surgery.

Would those benefits last, however? To find out, Spratt’s team reanalyzed data from the clinical trial of 760 prostate cancer patients that spurred the new guidelines. Men in the trial were treated at centers across North America between 1998 and 2003. All had seen their cancer return after surgery, and they received radiation therapy along with either two years of hormone-suppressing therapy called bicalutamide, or a “dummy” placebo.

Looking at the data more closely, Spratt’s team found that for men with low PSA blood levels after prostate surgery, long-term hormone therapy offered no cancer survival benefit, and was associated with a doubling of the risk that these men would die from causes other than their cancer.

Patients with both low PSA and long-term hormone therapy were also three to four times more likely to experience a combination of severe heart events and neurological problems, the team reported.

“We went into this study expecting that men with low PSAs probably would derive minimal benefit from hormone therapy, but we were surprised at the magnitude of harm that these patients experienced,” Spratt said in an ASTRO news release.

“A lot of these side effects have been reported over the past few decades, but demonstrating this in a clinical trial to this extent has not been done before,” he noted.

“What we showed for the first time is that a patient’s PSA level is a predictive biomarker,” Spratt said. “That is, you can use a patient’s PSA to better select which men should receive hormone therapy, and to predict who will benefit and who will not benefit from this treatment, and who may actually be harmed by it.”

Spratt believes that, based on the new analysis, clinical guidelines for treating men with recurrent prostate cancer should be reconsidered.

“For post-operative patients with low PSAs, they do very well with just radiation therapy after surgery. They actually have very good long-term outcomes,” Spratt said.

Two experts in prostate cancer care said decisions around hormone therapy remain tough for patients and doctors, but the new study offers a bit more clarity.

Dr. Manish Vira is vice chair of urologic research at Northwell Health’s Arthur Smith Institute for Urology, in Lake Success, N.Y. He said the study “wades into the muddy waters” surrounding the risks and benefits of hormone therapy, and questions still remain.

“The results of the current study may not be generalizable to all hormonal therapy, as this study specifically used high-dose bicalutamide,” he said, and other hormone-suppressing medicines might work differently.

“That being said, the study suggests that for patients undergoing radiation therapy with lower PSA values, radiation [alone] may be more prudent,” Vira said.

Urologist Dr. Elizabeth Kavaler agreed.

“This is a very useful study, in that it gives clinicians clear guidelines on how to treat men with high-risk prostate cancer who have elevated PSA after surgery and radiation,” said Kavaler, who practices at Lenox Hill Hospital in New York City.

“Many of these patients do very well post-treatment, and do not need further hormone therapy, which will save many of them from the side effects that hormone-deprivation causes,” she added.

Because the study was presented at a medical meeting, its findings should be considered preliminary until they are published in a peer-reviewed journal.

More information

The U.S. National Cancer Institute has more on prostate cancer treatment.

© 2019 HealthDay. All rights reserved.

Posted: September 2019

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Cervical Cancer Outcomes Worse Where Clinics Close

By Robert Preidt
HealthDay Reporter

MONDAY, Sept. 16, 2019 (HealthDay News) — As government funding dried up and many women’s health clinics across America closed, cervical cancer screening rates fell and deaths from the disease rose, a new report shows.

Nearly 100 women’s health clinics in the United States closed between 2010 and 2013, researchers said — often due to the passage of more restrictive laws or the loss of Title X government funding.

In all, 37 states nationwide saw a decrease in the number of women’s health clinics during this time.

“As these clinics closed over time, it appears that fewer women were getting screened [for cervical cancer], and this trend appears to be associated with a greater number of women ultimately dying from cervical cancer,” said lead author Dr. Amar Srivastava. He’s a resident physician in radiation oncology at Washington University School of Medicine in St. Louis.

According to the American Cancer Society, each year more than 13,000 new cervical cancer cases are diagnosed in the United States, and an estimated 4,250 women die from the disease.

In the new study, Srivastava’s team analyzed 2008-2015 data from an ongoing federal health study. The investigators found that states where clinics closed had a 2% drop in cervical cancer screenings compared to states without clinic closures.

The largest declines in screenings occurred among women without insurance, Hispanic women, women aged 21 to 34 and unmarried women, the researchers reported Monday at the annual meeting of the American Society for Radiation Oncology (ASTRO).

At the same time, there was a significant rise in the risk of cervical cancer deaths for women living in states where clinics had closed, especially among urban women. In contrast, cervical cancer survival rates actually rose in states that hadn’t seen clinics shut down.

Clinic closures also seemed to affect the timing of cervical cancer diagnosis for women living in affected states. Diagnoses of cervical cancer in its early stage, when it is most curable, fell by 13% among women aged 18 to 34 in states where clinics closed, compared to women living in states with no clinic closures. Late-stage diagnoses of the disease were 8% higher in states with clinic closures than those with no clinic closures, Srivastava’s team found.

Continued

The study can’t prove that the clinic closures were behind these trends, but the speed at which these cervical cancer statistics are changing is alarming, the research team said.

“In order to see a difference in cancer survival rates, you usually need very mature, long-term follow-up data,” Srivastava noted in an ASTRO news release. “It can be 15 to 20 years in some cases. What is surprising about this study is that even though these closures occurred just a few years ago, we are already seeing clear differences in death versus survival from cervical cancer. That was both surprising and scary.”

Patients diagnosed with later stages of cancer generally have a worse prognosis and undergo more aggressive treatment, he said.

Overall, “the data are troubling,” Srivastava said. “Reducing the availability of cervical cancer screening has very real, negative consequences for women.”

The news is especially disconcerting since “cervical cancer is largely preventable because of the wide availability of the HPV [human papillomavirus] vaccine and screening that can detect precancerous lesions,” Srivastava added.

“I really do think these findings should give us some pause,” he said. “Overall, we’re seeing improved survival for cervical cancer relative to other cancers, but in the states with clinic closures we are seeing just the opposite. It should make us think — not just as medical providers and practitioners, but as people broadly — about why this is happening and what we can do to increase rather than limit access to health care.”

Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

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SOURCE: American Society for Radiation Oncology, news release, Sept. 16, 2019

Copyright © 2013-2018 HealthDay. All rights reserved.

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What Is Your Risk for Prostate Cancer?

THURSDAY, Sept. 12, 2019 — Prostate cancer is the second most common cancer in American men, so it’s important to know the risk factors and warning signs, an expert says.

The American Cancer Society estimates there will be nearly 175,000 new prostate cancer cases in the United States this year and over 31,000 deaths. One in nine men will be diagnosed with prostate cancer in their lifetime.

“The disease can be successfully treated when detected early, typically when it is still within the prostate gland,” said Dr. Alexander Kutikov, chief of urologic oncology at the Fox Chase Cancer Center in Philadelphia. “However, some types are aggressive and can spread quickly. In these cases, there may be a lesser chance of successful treatment.”

September is National Prostate Cancer Awareness month.

Men between 55 and 69 years of age should consider prostate cancer screening, according to the American Urological Association.

“Because screening has its advantages and disadvantages, not every man should be screened for prostate cancer,” Kutikov said. “Men should discuss their risk factors, screening options and preferences with their health care provider before deciding whether to be screened.”

Symptoms of prostate cancer may include trouble urinating, including a slow or weak stream or the need to urinate more often, especially at night; blood in the urine; and pain or burning during urination.

The risk for prostate cancer rises quickly after age 50. About six out of 10 prostate cancers are diagnosed in men older than 65, according to a news release from the cancer center.

Race is another risk factor. Compared to whites, blacks have a higher risk and are more than twice as likely to die from prostate cancer. Asian-American and Hispanic men have a lower risk than white men.

Having a father or brother with prostate cancer more than doubles a man’s odds for developing the disease. The risk is much higher for men with several affected relatives, particularly if they were young when diagnosed.

More information

The U.S. National Cancer Institute has more on prostate cancer.

© 2019 HealthDay. All rights reserved.

Posted: September 2019

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AHA News: Scientists Find Biological Link Between High Blood Pressure and Breast Cancer

FRIDAY, Sept. 6, 2019 (American Heart Association News) — Researchers have identified a protein that may be a risk factor for both high blood pressure and breast cancer.

Previous studies have found women with high blood pressure have about a 15% increased risk of developing breast cancer compared to women with normal blood pressure. High levels of the protein GRK4 (G-protein coupled receptor kinase 4) have been shown to cause high blood pressure, also called hypertension. The new study, presented Friday at the American Heart Association’s Hypertension Scientific Sessions in New Orleans, showed the GRK4 protein was present in breast cancer cells but not in normal breast cells.

“Cancer and hypertension share common risk factors,” said Dr. Wei Yue, the study’s lead investigator and a research scientist at the University of Virginia School of Medicine in Charlottesville. “Our laboratory’s previous research on GRK4 found that it is regulated by an oncogene called c-Myc, which plays a role in many cancers, including breast cancer. This led us to hypothesize that GRK4 could be a link.”

Nearly half of all adults with high blood pressure are women. After age 65, women are more likely than men to have high blood pressure. Pregnancy, birth control medications and menopause can all increase the risk of developing high blood pressure. If left untreated, it can cause health problems such as heart disease, stroke and vision loss.

In women, breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death.

“While previous studies have shown that breast cancer risk is increased in hypertensive women, this study adds to the current knowledge by providing the molecular mechanisms that underlie this association,” said Dr. Vesna D. Garovic, chair of the division of Nephrology and Hypertension Research at the Mayo Clinic in Rochester, Minnesota.

Garovic, who was not involved in the new research, said studies like this one that identify the molecular mechanisms and signaling pathways that cause a disease to develop can provide new insights into treatment options.

Not all breast tumors are the same. The study looked for GRK4 in two specific types of breast cancer, known as hormone-sensitive and triple-negative.

“Our conclusion may not be applicable to other types of breast cancer,” said Yue.

Garovic noted GRK4 genetic variations may not be the same in all racial groups. Studies that look for GRK4 in women with breast cancer across racial and ethnic groups, she said, may provide insights into previously reported race-based differences in tumor type, treatment response and outcomes.

GRK4 is one of seven GRK proteins. Other studies have looked for GRK2 and GRK5 in different types of cancers, but Yue said their group is the first to look for a link between GRK4, high blood pressure and breast cancer. “No one else is working on this,” she said.

Yue said this molecule is unique because it’s not normally expressed – meaning made into a protein by a gene – in breast tissues, making it a potential target for drug development.

“A drug that targeted GRK4 could potentially be used to treat the patients with hypertension and breast cancer.”

© 2019 HealthDay. All rights reserved.

Posted: September 2019

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Cancer Overtakes Heart Disease as #1 Killer of Middle-Aged in Wealthy Nations

TUESDAY, Sept. 3, 2019 — Heart disease still claims the lives of more people globally, but in more affluent nations it has now ceded its place as the leading killer to cancer, a major new report finds.

Around the world, 40% of all deaths are caused by heart disease, making it the number one global killer. That means that of the estimated 55 million people who died around the world in 2017, approximately 17.7 million succumbed to heart disease.

Cancer was the second leading killer globally, accounting for 26% of all deaths, the study authors said.

However, when middle- and lower-income countries were taken out of the calculation, a different picture emerged, according to a report published online Sept. 3 in The Lancet.

For people living in “high-income” countries such as Canada, Sweden and Saudi Arabia, heart disease represented just 23% of deaths, while cancer was to blame for 55% of deaths, the researchers said.

The findings come from a global study of more than 162,500 middle-aged people living in four high-income countries, 12 countries considered middle-income, and five low-income countries. The study was led by Dr. Gilles Dagenais, emeritus professor at Laval University in Quebec, Canada.

Speaking in a journal news release, Dagenais said that the world is undergoing a “transition” in terms of causes of death, “with cardiovascular disease no longer the leading cause of death in high-income countries.”

But as better prevention and treatment of heart disease becomes more common, and cases of the disease “continue to fall, cancer could likely become the leading cause of death worldwide, within just a few decades,” Dagenais said.

Study principal investigator Dr. Salim Yusuf, a professor of medicine at McMaster University in Canada, agreed that “long-term cardiovascular disease prevention and management strategies have proved successful in reducing the burden in high-income countries.”

But poorer nations often lack either the resources or leadership to tackle high rates of heart disease, he added, so “governments in these countries need to start by investing a greater portion of their gross domestic product in preventing and managing non-communicable diseases, including cardiovascular disease, rather than focusing largely on infectious diseases.”

A second report focused on why people around the world continue to die in great numbers from heart disease. The same team of researchers used data on almost 156,000 middle-aged people to look at the role played by 14 heart disease risk factors.

The good news: 70% of the factors driving heart disease and heart disease death are “modifiable,” meaning changes to lifestyle and environment can greatly lessen people’s risk. Some of those factors include “metabolic” ones — overweight, diabetes and the like — or high blood pressure. In poorer countries, environmental factors, such as air pollution or poor diets, play a greater role.

The study was also presented Tuesday at the annual meeting of the European Society of Cardiology, in Paris.

More information

The American Heart Association has more on heart disease.

© 2019 HealthDay. All rights reserved.

Posted: September 2019

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Justice Ruth Bader Ginsburg Treated for Pancreatic Cancer

By HealthDay staff
HealthDay Reporter

FRIDAY, Aug. 23, 2019 (HealthDay News) — Justice Ruth Bader Ginsburg has just finished treatment for pancreatic cancer, the U.S. Supreme Court announced Friday.

After the tumor was first diagnosed in late July, Ginsburg was given a three-week course of focused radiation at Memorial Sloan Kettering Cancer Center in New York City, the court said in a statement. A bile duct stent was placed and the justice tolerated treatment well, the statement added.

“The tumor was treated definitively and there is no evidence of disease elsewhere in the body,” the statement said. “Justice Ginsburg will continue to have periodic blood tests and scans. No further treatment is needed at this time.”

This is the fourth time Ginsburg has battled cancer. She had surgery in 1999 to treat colon cancer, and was treated for early-stage pancreatic cancer in 2009. Late last year, she had two cancerous nodules removed from her left lung.

A history of bouncing back from health setbacks hasn’t eased the nerves of liberals who worry about how much longer Ginsburg can serve, as the balance of the Supreme Court shifts to the right with President Donald Trump’s two recent appointees, Brett Kavanaugh and Neil Gorsuch.

Ginsburg was first appointed to the Supreme Court in 1993 by former President Bill Clinton. She is the oldest justice on the court.

Ginsburg has consistently fought for women’s rights. In 1971, she helped launch the Women’s Rights Project of the American Civil Liberties Union (ACLU). She served as the ACLU’s general counsel from 1973 to 1980.

In recent years, Ginsburg gained social media popularity with her own nickname, “Notorious R.B.G.” She was also the subject of a recent documentary, and a movie has been made about her life.

Ginsburg was born in Brooklyn, N.Y., in 1933, according to the U.S. Supreme Court website. She married Martin Ginsburg, and together they had a daughter and a son. She received her undergraduate degree from Cornell University, and attended Harvard and Columbia law schools.

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SOURCES: Aug. 23, 2019, statement,U.S. Supreme Court

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Medicare to Cover Breakthrough Cancer Gene Therapy

Aug. 8, 2019 — A breakthrough gene therapy will be covered for certain types of lymphoma and leukemia, Medicare says.

The therapy, called CAR-T, boosts a patient’s own immune cells to fight cancer and can cost hundreds of thousands of dollars, the Associated Press reported.

Studies have shown that CAR-T is effective against certain types of cancers, but can cause severe side effects. The use of the gene therapy to treat certain types of leukemia and lymphoma is approved by the U.S. Food and Drug Administration.

Medicare considered the matter for months before it announced its decision on Wednesday. The agency’s policies on coverage can influence private insurance, the AP reported.

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Finances Affect Women’s Choice of Breast Cancer Treatment: Study

FRIDAY, Aug. 2, 2019 — Cost often influences breast cancer patients’ decisions about surgery, even if they have good incomes and insurance, a new study finds.

“Eligible women with early-stage breast cancer often have choices for surgical treatments that are equally effective and result in excellent cancer outcomes,” said lead study author Dr. Rachel Greenup. She is a surgeon at Duke Cancer Institute in Durham, N.C.

“Surgeons often discuss the emotional and physical side effects of treatment, yet we rarely discuss the costs,” Greenup noted in an institute news release.

For the study, the researchers surveyed more than 600 women with stage 0 to stage 3 breast cancer. Of those, 90% were white; 70% had private health insurance; 25% had Medicare; 78% were college educated; and 56% had household incomes above $ 74,000 a year.

Even though the women were more affluent than the U.S. average, 43% said cost was a consideration when deciding on treatment, and nearly one-third said it played into the type of surgery they chose.

Among women with annual household incomes below $ 45,000, treatment cost was more important than keeping their breast or its appearance, the study findings showed.

Also, 35% said their treatment caused a financial burden, and 78% never discussed costs with their cancer care team. Even among top earners, 65% said they were financially unprepared for the cost of their cancer treatment.

Of the types of breast cancer surgeries — lumpectomy with radiation; mastectomy; and double mastectomy with or without breast reconstruction — double mastectomy was associated with higher patient debt and financial hardship.

The findings were published online July 29 in the Journal of Oncology Practice.

“Women are weighing many factors when deciding what type of surgery is best for them, including their personal desire for breast preservation, options for reconstruction, recovery time, sexuality, appearance, demands for future surveillance, and their own peace of mind,” Greenup said.

“While other side effects of surgical choice are routinely discussed with their physicians, the potential for financial harm is not explicitly addressed, including both the out-of-pocket payments and lost productivity for patients and their families,” she added. “Our study suggests this should change.”

More information

The American Cancer Society has more on breast cancer surgery.

© 2019 HealthDay. All rights reserved.

Posted: August 2019

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Childhood Cancer Steals 11 Million Years of Life: Study

By Robert Preidt
HealthDay Reporter

TUESDAY, July 30, 2019 (HealthDay News) — Researchers are closing in on the toll of childhood cancer, finding it stole 11.5 million years of healthy life lost worldwide in 2017.

Premature death took 97% of that toll, and impaired quality of life about 3%, the study found.

“Estimating the years of healthy life children have lost due to cancer allows policy makers to compare the lifelong implications of childhood cancer with other diseases, potentially helping them determine the most effective way to spend limited resources and identify high-impact cancer-control planning decisions,” said study leader Lisa Force.

Children in the poorest countries accounted for 82% of years of healthy life lost (9.5 million years) worldwide due to cancer in 2017, according to the study. The findings were published July 29 in The Lancet Oncology.

How common is childhood cancer?

The number of new cancer cases in children and teens up to age 19 was about 416,500 worldwide in 2017, the report said.

Children with cancer in high-income countries tend to have good survival, with around 80% surviving five years after diagnosis. But survival is 35% to 40% in most low- and middle-income countries, with some estimates suggesting it could be as low as 20%, the study authors noted.

Also, about 90% of children at risk of developing cancer live in low- and middle-income countries.

The study examined the years of healthy life that children and teens with cancer lose due to illness, disability and premature death, a measurement called disability-adjusted life years (DALYs). One DALY equals one year of healthy life lost.

However, the study was limited to the first 10 years after cancer diagnosis so it likely underestimates the tally, according to the researchers.

“By assessing the global burden of childhood cancer through the lens of disability-adjusted life years, we can more comprehensively understand the devastating impact of cancer on children globally,” said Force, of St. Jude Children’s Research Hospital in Memphis, Tenn.

“Our findings are an important first step in establishing that childhood cancer has a role in frameworks that address global oncology and global child health,” Force added in a journal news release.

But future progress will require much work, she explained.

“Improving childhood cancer survival will require considerable planning by policy makers to ensure well-functioning health systems capable of early diagnosis and treatment,” Force said.

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Sources

SOURCE:The Lancet Oncology, news release, July 29, 2019

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Textured Breast Implants Recalled for Cancer Risk

July 24, 2019 — Pharmaceutical giant Allergan has ordered the recall of all of its BIOCELL textured breast implants after the FDA flagged a series of reports that the implants were causing cancer in hundreds of patients worldwide.

The FDA says the textured surface, unique to Allergan’s implants, are tied to 481 cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a type of non-Hodgkin’s lymphoma. There have been 573 cases of BIA-ALCL worldwide, including 33 deaths. In 13 cases where a patient died and the manufacturer of the breast implant was known, 12 of them involved an Allergan breast implant.

Most cases of this particular cancer, which attacks the immune system, are not diagnosed for years after the original implantation.

Daniel Maman, MD, a board-certified plastic surgeon with 740 Park Plastic Surgery in New York City, says it remains unclear why these types of implants could cause cancer.

“But these rare cases are showing that the texture of the shell surrounding the implant can cause this lymphoma response in capsule tissue that surrounds the breast implant,” he says.

The FDA says anyone with an Allergan BIOCELL implant should not have it removed, unless symptoms are present. Those symptoms include persistent swelling or pain near the implant. Patients found to have BIA-ALCL would have the implants removed, along with surrounding scar tissue.

The FDA says in most cases, the cancer is limited to the scar tissue and fluid near the implant, but it can spread through the body. While the diagnosis is serious and can lead to death, the risk is considered to be low, the agency says. Some patients may need chemotherapy and/or radiation therapy.

The FDA says the risk of getting BIA-ALCL from an Allergan textured implant is roughly 6 times the risk compared to similar products from other manufacturers. Textured implants represent 10% of all breast implants sold in the United States.

“The popularity of the different types of implants is heavily dependent on the surgeon and what they prefer using, but there are pros and cons of each type of implant,” Maman says. “I personally have not put in a textured implant in over 5 years.”

The recalled products are:

Allergan Natrelle Saline-Filled Breast Implants (formerly McGhan RTV Saline-Filled Mammary Implant) approved under P990074. The following are the textured styles:

  • Style 163: BIOCELL Textured Shaped Full Height, Full Projection Saline Breast Implants
  • Style 168: BIOCELL Textured Round Moderate Profile Saline Breast Implants, also referred to as 168MP (168 Moderate Profile)
  • Style 363: BIOCELL Textured Shaped Moderate Height, Full Projection Saline Breast Implants, Allergan catalog includes 363LF, or 363 Low Height Full Projection
  • Style 468: BIOCELL Textured Shaped Full Height Moderate Projection Saline Breast Implants

Allergan Natrelle Silicone-Filled Textured Breast Implants (formerly Inamed Silicone-Filled Breast Implants) approved under P020056. The following are the textured styles:

  • Style 110: BIOCELL Textured Round Moderate Projection Gel Filled Breast Implants
  • Style 115: BIOCELL Textured Round Midrange Projection Gel Filled Breast Implants
  • Style 120: BIOCELL Textured Round High Projection Gel Filled Breast Implants
  • Style TRL: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TRLP: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TRM: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TRF: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TRX: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TCL: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TCLP: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TCM: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TCF: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TCX: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TSL: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants
  • Style TSLP: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants
  • Style TSM: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants
  • Style TSF: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants
  • Style TSX: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants

Natrelle 410 Highly Cohesive Anatomically Shaped Silicone Filled Breast Implants approved under P040046. The following are the textured styles:

  • Style 410FM
  • Style 410FF
  • Style 410MM
  • Style 410 MF
  • Style 410 FL
  • Style 410 ML
  • Style 410 LL
  • Style 410 LM
  • Style 410 LF
  • Style 410 FX
  • Style 410 MX
  • Style 410 LX

Allergan tissue expanders for the breast that have BIOCELL texturing originally cleared as:

  • Natrelle 133 Plus Tissue Expander (K143354)
  • Natrelle 133 Tissue Expander with Suture Tabs (K102806)

Sources

FDA.gov: “The FDA Takes Action to Protect Patients from Risk of Certain Textured Breast Implants; Requests Allergan Voluntarily Recall Certain Breast Implants and Tissue Expanders from the Market: FDA Safety Communication.”

Daniel Maman, MD, board-certified plastic surgeon, 740 Park Plastic Surgery, New York City.

© 2019 WebMD, LLC. All rights reserved.

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Breast Implants Tied to Rare Cancer Risk Recalled

WEDNESDAY, July 24, 2019 — Allergan’s textured breast implants will be recalled due to their link to a rare cancer, the U.S. Food and Drug Administration announced Wednesday.

Following a request from the FDA, the company will proceed with a worldwide recall of its Biocell textured breast implant products, the agency said.

The recall stems from concerns about a tumor known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

“The recall of these textured implants is a big deal in protecting women from the potential risks of developing, and dying from, this rare type of aggressive lymphoma,” explained one expert, Dr. Joshua Brody.

He directs the Lymphoma Immunotherapy Program at The Tisch Cancer Institute at Mount Sinai, in New York City.

“By preventing further use of these implants, the FDA is helping women to protect themselves from the medically serious and emotionally exhausting effects of these risks,” Brody said.

Though very rare, cases of BIA-ALCL appear to be on the rise. The FDA noted that 573 cases of BIA-ALCL, including 33 related deaths, have been reported worldwide — that’s up from the 116 cases and 24 deaths reported earlier this year.

Of the 573 cases, 481 are attributed to Allergan textured implants, the agency said. Of the 33 deaths, 12 of the 13 patients for which the maker of the implant is known had an Allergan textured breast implant at the time of their cancer diagnosis.

“Based on the currently available information, including the newly submitted data, our analysis demonstrates that the risk of BIA-ALCL with Allergan Biocell textured implants is approximately six times the risk of BIA-ALCL with textured implants from other manufacturers marketing in the U.S.,” the agency said in a news release.

“Although the overall incidence of BIA-ALCL appears to be relatively low, once the evidence indicated that a specific manufacturer’s product appeared to be directly linked to significant patient harm, including death, the FDA took action to alert the firm to new evidence indicating a recall is warranted to protect women’s health,” FDA Principal Deputy Commissioner Dr. Amy Abernethy said in the news release.

The textured implants being recalled include: Natrelle Saline-filled breast implants, Natrelle Silicone-filled breast implants, Natrelle Inspira Silicone-filled breast implants, and Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-filled breast implants.

According to Brody, “some types of implants induce inflammation, which can both increase the chance of developing cancer, and also help to ‘hide’ developing cancers from the immune system.”

He also explained that the inflammation triggered by textured implants may help foster “[gene] mutations and the expression of immune-suppressive proteins, which prevent anti-tumor immune cells from clearing the cancer.”

Also included in the new recall are so-called “tissue expanders,” used by patients before breast augmentation or reconstruction. Those products include the Natrelle 133 Plus Tissue Expander and the Natrelle 133 Tissue Expander with Suture Tabs, the FDA said.

In addition, the FDA issued a safety communication Wednesday for patients with breast implants, patients considering breast implants and their health care providers. The communication outlines the known risks and what steps patients should consider when watching for the cancer, including swelling and pain in their breasts.

“The FDA has been diligently monitoring this issue since we first identified the possible association between breast implants and ALCL in 2011 and, at that time, communicated to patients and providers that there is a risk for women with breast implants, more frequently occurring in women with textured implants, for developing this disease,” Abernethy said.

“Based on new data, our team concluded that action is necessary at this time to protect the public health,” Abernethy added.

“We will continue to monitor the incidence of BIA-ALCL across other textured and smooth breast implants and tissue expanders, as well as other devices intended for use in the breast,” Abernethy added. “If action is needed in the future, we will not hesitate to do what is necessary to protect patients.”

More information

The U.S. Food and Drug Administration has more on breast implants.

© 2019 HealthDay. All rights reserved.

Posted: July 2019

Drugs.com – Daily MedNews

Can a Broken Heart Contribute to Cancer?

WEDNESDAY, July 17, 2019 — “Broken heart syndrome” may harm more than just the heart, new research suggests.

While the extreme stress of losing a loved one has been linked to heart troubles in prior research, a new study found that one in six people with broken heart syndrome also had cancer. Even worse, they were less likely to survive their cancer five years after diagnosis.

“There seems to be a strong interplay between Takotsubo syndrome [broken heart syndrome] and malignancies,” said study senior author Dr. Christian Templin. He’s director of acute cardiac care at University Hospital Zurich in Switzerland.

“Therefore, it should be recommended for Takotsubo syndrome patients to participate in cancer screening to improve overall survival,” he said, adding that the reverse is also true. Still, the study did not prove that one causes the other.

Broken heart syndrome causes sudden intense chest pain and shortness of breath that can be mistaken for a heart attack. These symptoms are a reaction to a sudden surge in stress hormones, according to the American Heart Association (AHA).

The condition causes the heart’s main pumping chamber to enlarge, the researchers said. And that means the heart can’t pump blood effectively.

Broken heart syndrome can happen after just about any intensely emotional experience. The death of a loved one, a breakup or divorce, financial problems and even an intensely positive experience like winning the lottery can trigger broken heart syndrome, the AHA said.

Major physical stress can also trigger broken heart syndrome. A physical trauma or surgery, respiratory failure and infections are examples of physical stresses that can contribute to broken heart syndrome, the study noted.

The new study included just over 1,600 people with broken heart syndrome. The participants were recruited at 26 medical centers in nine different countries, including eight European countries and the United States.

Among those diagnosed with cancer, most were women (88%) and their average age was 70.

The incidence of cancer cases was much higher than would normally be expected, Templin said. That was true for both genders and all age groups. For example, in women aged 44 years and younger, the expected rate of cancer is 0.4%, but for those with broken heart syndrome it was 8%. In men 45 to 64 years old, the expected rate of cancer was 2%, but in those with broken heart syndrome, it was 22%. In both older men and women, the expected cancer cases were more than double what would be expected for those with broken heart syndrome.

The most common type of cancer was breast cancer. Other cancers affected areas including the digestive system, the respiratory tract, internal sex organs and the skin.

People who also had cancer were more likely to have a physical trigger for broken heart syndrome than an emotional one, the findings showed.

Templin said it’s not clear from this study exactly how these conditions are linked, though he noted that stress from a cancer diagnosis might trigger broken heart syndrome. It’s also possible that metabolic or hormonal changes caused by cancer could increase the risk of broken heart syndrome.

Dr. Guy Mintz, director of cardiovascular health and lipidology at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, N.Y., said, “Many cancer patients have both significant emotional stress and multiple medical interventions, the most common triggers found in this study.”

But he noted that “the study was too small and the cancers too variable to draw conclusions regarding a direct mechanism and the interaction of the two diagnoses on longevity.”

Mintz said it’s important for physicians to be aware of the link between broken heart syndrome and cancer so that doctors — including primary care, cancer and heart doctors — can intervene earlier in the course of either condition.

The findings were published online July 17 in the Journal of the American Heart Association.

More information

Learn more about broken heart syndrome from the American Heart Association.

© 2019 HealthDay. All rights reserved.

Posted: July 2019

Drugs.com – Daily MedNews

Sugary Sodas, Juices Tied to Higher Cancer Risk

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, July 10, 2019 (HealthDay News) — It’s long been known that sugary drinks help people pack on unwanted pounds. But new research suggests that sweetened sodas, sports drinks and even 100% fruit juice might raise your risk for some cancers.

The study couldn’t prove cause and effect, but it found that drinking as little as 3 to 4 ounces of sugary drinks each day was tied to an 18% rise in overall risk for cancer.

Among women, a similar consumption level was tied to a 22% rise in breast cancer risk, the French research team found.

A spokesperson for the American Cancer Society (ACS) said the findings should give consumers pause, because obesity is a known risk factor for cancer.

“A lot of the research on sugar-sweetened drinks and cancer has been tied to obesity,” noted Colleen Doyle, managing director of nutrition and physical activity at the ACS. “Across the board, it’s a good idea to reduce any sugar-sweetened beverage,” she advised.

The new study was led by Mathilde Touvier, research director of nutritional epidemiology at the University of Paris. Her team collected data on more than 100,000 French men and women, average age 42, who took part in a national study.

The participants answered questions about how much of 3,300 different foods and beverages they consumed each day, and were followed for up to nine years (from 2009 to 2018).

The study uncovered links between the consumption of sugary drinks and the risk of cancer in general, and for breast cancer specifically. The investigators found no association between sugary drinks and prostate or colon cancers, but the authors stressed that too few people in the study developed these cancers to make this finding definitive.

The research uncovered no links between diet sodas and other artificially sweetened beverages and cancer, although more study is needed to confirm that, the authors noted.

The connection between sugary drinks and cancer remained the same even after the team adjusted for age, sex, educational level, family history of cancer, smoking and physical activity, the researchers said.

Continued

So, why the connection? According to Touvier’s team, high-calorie drinks may raise cancer risk because sugar helps build body fat, in addition to raising blood sugar levels and inflammation — all of which are risk factors for cancer.

It’s also possible that chemicals found in these drinks might play a part in increasing cancer risk, the researchers theorized.

A group representing the beverage industry said sugary drinks can still be a part of the average diet, however.

In a statement, the American Beverage Association said: “It’s important for people to know that all beverages — either with sugar or without — are safe to consume as part of a balanced diet. America’s leading beverage companies are working together to support consumers’ efforts to reduce the sugar they consume from our beverages by providing more choices with less sugar or zero sugar, smaller package sizes and clear calorie information right up front.”

Samantha Heller is a senior clinical nutritionist at NYU Langone Medical Center in New York City. She said she wasn’t surprised by the findings.

“Do we really need more evidence that consuming sugar-sweetened beverages regularly is not healthy?” Heller said. She noted that, for decades, these drinks have been linked with diseases such as obesity, type 2 diabetes and heart disease.

On the other hand, “most of us should be drinking more water than we do,” Heller said. “Being poorly hydrated can affect us in surprising ways. It can impair our driving skills, cognitive abilities, mood, energy levels, kidneys, gastrointestinal function, appearance and more.”

Study author Touvier agreed.

“The only beverage that is recommended is water,” she said. And Touvier supports public efforts to get people away from the soda-and-juices habit.

Her team’s findings support “existing nutritional recommendations to limit sugary drinks consumption, including 100% fruit juices, as well as policy actions such as taxation and marketing restrictions targeting sugary drinks,” Touvier said.

And water doesn’t have to be boring, Heller added.

“Play around with infusing water with mint, basil, cucumber, or strawberry and lemon slices. Fill a pitcher with water and pop in your favorite herbal teas like berry, vanilla or peppermint, and chill in the refrigerator,” she suggested.

The new report was published online July 10 in the BMJ.

WebMD News from HealthDay

Sources

SOURCES: Mathilde Touvier, Ph.D., research director, nutritional epidemiology, University of Paris, France; Colleen Doyle, M.S., R.D., managing director, nutrition and physical activity, American Cancer Society; Samantha Heller, M.S., R.D., senior clinical nutritionist, NYU Langone Medical Center, New York City; July 10, 2019,BMJ, online

Copyright © 2013-2018 HealthDay. All rights reserved.

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Pagination

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