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AHA News: Regular Low-Level Radiation Exposure Raises High Blood Pressure Risk

FRIDAY, May 3, 2019 (American Heart Association News) — Prolonged exposure to low-dose radiation — like the type emitted by X-ray machines and CT scanners — can increase the risk of developing high blood pressure, a key contributor to heart disease and stroke, a new study has found.

Researchers examined the health records of more than 22,300 workers at the Mayak Production Association, a large-scale nuclear facility in Russia. The employees were hired between 1948 and 1982 and worked an average 18 years at the facility. More than half in the study had been employees for at least a decade.

All the plant employees received at least one comprehensive health exam, including a complete set of lab screenings, each year.

Researchers discovered that 8,425 employees — or about 38% of the group — had blood pressure readings at or above 140/90, and the incidence of high blood pressure was significantly associated with the cumulative radiation dose. The current high blood pressure threshold in the United States is 130/80.

The rate in the new study is higher than the incidence of high blood pressure found among Japanese survivors of the atomic bombs dropped in Hiroshima and Nagasaki in 1945. But it’s lower than the risk estimated among cleanup crew members who spent days or months at the Chernobyl nuclear plant following the 1986 explosion at that Ukraine facility.

Ionizing radiation is a form of energy that a growing number of people find themselves exposed to every day, particularly when they undergo diagnostic exams using X-rays and CTs, or computed tomography scans.

Radiation exposure is commonly associated with the development of cancer, but its link to developing heart disease and stroke is not as well known, said Dr. Tamara Azizova, lead author of the study, which published Friday in the American Heart Association journal Hypertension.

“It is necessary to inform the public that not only high doses of radiation, but low to moderate doses also increase the risk of hypertension and other circulatory system diseases, which today contribute significantly to death and disability,” Azizova said in a news release. She is a researcher with the Southern Urals Biophysics Institute in Ozersk, Russia.

“As a result, all radiological protection principles and dose limits should be strictly followed for workers and the general public.”

The study did not explain how exposure to low-dose radiation contributed to a rise in blood pressure and Azizova said, “so far, the mechanisms remain unclear.”

But the study adds to a body of evidence that even low doses of ionizing radiation can increase the risk of developing heart disease and stroke, said Richard Wakeford, an epidemiology professor at the Centre for Occupational and Environmental Health at the University of Manchester in the United Kingdom.

“Low-level exposure to radiation is experienced in everyday life. CT scans, X-rays, natural background radiation, occupational exposure, medical workers, aircrew,” he said.

Yet the system of radiological protection is “against the presumed cancer and hereditary risks of exposure to radiation,” he said, and not against preventing heart disease and stroke.

“But potentially,” Wakeford wrote in an editorial that accompanied the study, “this (cardiovascular) risk is a substantial component of the overall risk to health from low levels of exposure.”

© 2019 HealthDay. All rights reserved.

Posted: May 2019

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Radiation Helps Some Hormone-Driven Breast Cancer

By Serena Gordon

HealthDay Reporter

FRIDAY, April 26, 2019 (HealthDay News) — For women with hormone-driven breast cancer, adding radiation to hormone therapy might keep their cancer from coming back for up to a decade, a new study finds.

Breast cancer didn’t come back in the same breast for 97.5% of women who had radiation therapy plus hormone therapy compared to just over 92% of women who had hormone therapy alone, the researchers said.

In addition, over the study’s 10-year follow-up period, 94.5% of the women in the radiation therapy group were still alive without a cancer recurrence, compared to just over 88% of women who only had hormone therapy.

Study author Dr. Gerd Fastner, from Paracelsus Medical University in Salzburg, Austria, said the study shows that adding radiation therapy can increase disease-free survival and improve the odds a cancer won’t come back over the long term.

Dr. Alice Police, regional director of breast surgery at Northwell Health Breast Care Centers Westchester in Sleepy Hollow, N.Y., said the findings are important because “there have been a lot of studies trying to prove that in small cancers in postmenopausal women, there may be a group of women who can skip radiation. This study shows it’s still not safe to omit radiation therapy in women who have had breast-conserving surgery.”

Police added that while women with these specific cancers might think they can choose one treatment or another, a combination yields the best results.

The study included nearly 900 postmenopausal women. Fastner said they were between 46 and 80 years old, with an average age of 66. All of the women were from Austria, and most were white.

The women in the study all had breast cancer that was considered low risk for spreading. Their tumors were small in size (under 3 centimeters).

All of the women had breast-conserving surgery. That means rather than removing the entire breast (mastectomy), surgeons remove the tumor and a bit of the healthy tissue around the tumor.

The study patients all had hormone receptor-positive cancers, which means that hormones such as estrogen and progesterone fueled the cancer’s growth, according to the U.S. National Cancer Institute. About two of three breast cancers are hormone receptor-positive, according to the American Cancer Society.

Continued

After surgery, the women in the study were all treated with hormone therapies such as tamoxifen or anastrozole. These therapies either remove hormones or block their action, according to the cancer institute.

Some women — 439 — received radiation therapy for just over a month within six weeks of their surgery. The remaining 430 women took hormone therapy alone.

A decade later, 10 women in the radiation group had a recurrence of cancer in the same breast. In the hormone therapy-only group, 31 women had a cancer recurrence, the researchers found.

The findings are to be presented Sunday at the European Society for Radiotherapy and Oncology (ESTRO) meeting, in Milan. Findings presented at meetings are typically viewed as preliminary until they’ve been published in a peer-reviewed journal.

Fastner said it’s still a matter of some debate if all women with these low-risk cancers should be given radiation therapy after breast-conserving surgery, largely because of newer techniques, such as partial breast radiation and brachytherapy.

And, in a small, select group of women, it might be better to forgo radiation.

“The total omission of radiotherapy should only be considered in frail, elderly patients who would not be able to tolerate such treatment,” Fastner said in a meeting news release.

Funding for the study was provided by Astra Zeneca, a pharmaceutical company that produces hormone therapies.

WebMD News from HealthDay

Sources

SOURCES: Gerd Fastner, M.D., associate professor, Paracelsus Medical University, Salzburg, Austria; Alice Police, M.D., regional director, breast surgery, Northwell Health Breast Care Centers Westchester, Sleepy Hollow, N.Y.; April 28, 2019, presentation, ESTRO meeting, Milan

Copyright © 2013-2018 HealthDay. All rights reserved.

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Pagination

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Breast Cancer Radiation Not as Bad as Many Fear

MONDAY, Feb. 26, 2018 — Many breast cancer patients say they’ve heard scary stories about radiation therapy, but their actual experience is usually better, new research finds.

The study of more than 300 women who underwent breast radiation found that almost half had heard “frightening” stories going into treatment. But only 2 percent ultimately agreed that the stories were true.

And over 80 percent of all patients said their experience with radiation therapy was actually “less scary” than they’d expected.

Researchers said the findings show that the public still has misconceptions about “modern” radiation therapy.

“The word ‘radiation’ itself sounds frightening, and it’s associated with many negative news stories,” said senior study author Dr. Susan McCloskey.

But over the past 20 years, there have been key advances in how breast radiation is given, explained McCloskey, an assistant professor of radiation oncology at the University of California, Los Angeles.

It’s more precise and shorter in duration — which has helped limit short-term side effects like skin burning and breast pain.

Doctors can also now create individualized radiation plans for each patient, and give the treatment in “more convenient” schedules, McCloskey noted.

Dr. Beryl McCormick is a radiation oncologist at Memorial Sloan Kettering Cancer Center in New York City.

She said that in her experience, it’s “extremely common” for patients to go into treatment having heard scary stories.

The side effects of any cancer treatment will vary from one person to another. But McCormick said it’s possible to predict what women can typically expect.

For example, skin symptoms vary based on whether a woman had only the breast tumor removed (a lumpectomy), or breast-removal surgery (a mastectomy).

With lumpectomy patients, McCormick said she usually tells them the skin effects will be similar to what would happen if they were out in the sun for two hours without sunscreen.

Those skin symptoms typically go away a few weeks after treatment ends, she noted.

With mastectomy patients, the effects would typically be more pronounced and lasting, because the radiation therapy is actually, in part, targeting the skin, McCormick said.

What’s important, she added, is that women have a thorough discussion of the benefits and risks of radiation therapy when making treatment decisions.

“That discussion should start with their surgeon, who is usually the first [doctor] a woman will see,” McCormick said.

If a woman finds the surgeon cannot answer all her questions, she can ask to talk to a radiation oncologist, McCormick suggested.

The study findings were based on 327 women who’d been treated for breast cancer within the past several years. They’d had surgery, followed by radiation — usually a lumpectomy, though 17 percent had undergone a mastectomy.

Overall, 47 percent said that before starting treatment, they’d read or heard “scary” stories about the effects of breast radiation. And many went into treatment worried about risks like skin burning and damage to the internal organs.

In hindsight, though, few women felt their experience matched the stories they’d heard.

Instead, 84 percent said their side effects — including skin symptoms, pain and fatigue — had been less serious than they’d expected. Similar percentages also said their treatment had been less disruptive to their work and family life than they’d feared.

The long-term outlook was better than most women had thought, too. Of women who’d gotten a lumpectomy, 89 percent said the appearance of their irradiated breast was better than they’d expected.

Similarly, 67 percent of mastectomy patients said the appearance of the radiation-treated area was better than they’d anticipated, according to the report.

Finally, the vast majority of women agreed with the statement, “If future patients knew the real truth about radiation therapy, they would be less scared about treatment.”

The study was published Feb. 26 in the journal Cancer.

McCloskey said she hopes the findings will offer future patients a “better idea of the breast radiation experience when making treatment decisions.”

McCormick agreed. “Almost everyone in the study went through [radiation] therapy and said it wasn’t as scary as they’d thought,” she said. “I think that’s pretty powerful.”

In the longer term, chest radiation carries a risk of heart or lung disease, since it can damage those organs. But recent research shows that among nonsmoking women who receive breast radiation, less than 1 percent ultimately die of heart disease or lung cancer, according to McCloskey’s team.

More information

The U.S. National Cancer Institute has more on radiation therapy.

© 2018 HealthDay. All rights reserved.

Posted: February 2018

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Radiation, Chemo Mix Boosting Lung Cancer Survival

By Dennis Thompson

HealthDay Reporter

TUESDAY, Sept. 26, 2017 (HealthDay News) — Combining radiation therapy with chemotherapy has substantially extended survival for many people with lung cancer, two new studies report.

About 32 percent of non-small cell lung cancer patients who received chemoradiation therapy were still alive five years following treatment, a survival rate double that of previous estimates, according to results from a long-term clinical trial.

Further, a small second clinical trial of people with lung cancer that had already spread to other parts of the body showed that radiation therapy added to chemo dramatically slowed the time until these cancers progressed further.

The two studies show that radiation therapy and chemotherapy work well together, and that radiation also might help patients who are undergoing newer forms of cancer treatment like targeted therapy and immunotherapy, said Dr. Benjamin Movsas, a radiation oncologist with the Henry Ford Hospital in Detroit.

“Instead of becoming less important, radiation therapy is becoming more important,” Movsas said.

Both studies were presented Sunday at the American Society of Radiation Oncology’s annual meeting, in San Diego. Findings presented at meetings are typically viewed as preliminary until they’ve been published in a peer-reviewed journal.

Chemotherapy’s advantage is that it can attack cancer anywhere in the body, even cancer cells doctors haven’t found, Movsas said.

“It goes around the entire body through the bloodstream,” he said. “If there are residual cancer cells that may have spread from the initial site, this is a way to address those.”

But chemotherapy often can’t kill off a solid tumor completely. Focused radiation can step in and destroy those clumps of cancer cells, acting in conjunction with chemo, explained Movsas, who was not involved with the studies.

The first presentation involved long-term results from a major chemoradiation therapy trial that started in 2006. The study involved more than 500 patients treated at 185 hospitals in the United States and Canada. They all had inoperable stage 3 lung cancer that had not spread to other parts of the body.

The researchers reported that the overall five-year survival rate from this combination therapy was 32 percent, more than twice as high as previous estimates.

Continued

“That’s the new benchmark for stage 3 lung cancer. About one-third of patients are alive at five years,” said principal investigator Dr. Jeffrey Bradley. He’s director of the S.L. King Center for Proton Therapy at the Washington University School of Medicine in St. Louis.

“A third of patients are alive at five years — that’s as close to cure as you can get,” Movsas said. “For me, that’s a real step forward and a very, very promising result.”

The second study looked into whether radiation therapy could be added to chemo to control cancer that had spread into other parts of the body such as the brain, liver, bone and pancreas.

For this clinical trial, researchers used radiation therapy on 14 patients whose lung cancer had spread to six or fewer sites elsewhere in the body. Beam radiation targeted both the main tumor and the new cancer sites.

Patients were recruited between April 2014 and July 2016. Thirty-one cancerous lesions were treated with radiation in the 14 patients.

People who received chemoradiation experienced a remission nearly triple that of a 15-person control group who got just chemotherapy — 9.7 months compared with 3.5 months, said lead researcher Dr. Puneeth Iyengar.

Only four of those who received radiation therapy have had renewed progression of their cancer, compared with 10 out of 15 patients in the chemo-only group, Iyengar said.

He’s an assistant professor of radiation oncology at the University of Texas Southwestern Medical Center in Dallas.

The chemoradiation patients didn’t have any cancer recurrences (failures) “within the areas that were irradiated, whereas a multitude of patients [in the control group] failed in areas that would have gotten radiation had they been in that arm of the trial,” Iyengar said.

“Clearly, local [radiation] treatment improved the control of the disease and also delayed the time to progression,” Iyengar concluded.

Movsas called these results a “paradigm shift” in the way radiation therapy can help treat patients with advanced lung cancer.

“This is really changing the way we are thinking about patients with lung cancer that has spread to certain areas,” Movsas said.

Continued

In both clinical trials, chemoradiation therapy had side effects similar to those produced by chemotherapy alone, Movsas added.

“Overall, it was pretty well-tolerated,” he said.

WebMD News from HealthDay

Sources

SOURCES: Benjamin Movsas, M.D., radiation oncologist, Henry Ford Hospital, Detroit; Jeffrey Bradley, M.D., director, S.L. King Center for Proton Therapy, Washington University School of Medicine in St. Louis; Puneeth Iyengar, M.D., Ph.D., assistant professor, radiation oncology, University of Texas Southwestern Medical Center, Dallas; Sept. 24, 2017 presentations, American Society of Radiation Oncology meeting, San Diego

Copyright © 2013-2017 HealthDay. All rights reserved.

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Childhood Cancer Radiation May Cause Gene Mutation

By Robert Preidt

HealthDay Reporter

FRIDAY, Aug. 4, 2017 (HealthDay News) — Some adult survivors of childhood cancer go on to develop brain tumors, and now researchers say they’ve found a gene mutation that seems to increase that risk.

The researchers said their findings could lead to ways to prevent these brain tumors.

Adults who had radiation to their head and spine to treat childhood cancer have a greater risk of meningiomas. These tumors, which are often benign, are the most common type of brain tumor in adults, according to the American Brain Tumor Association.

In this study, Canadian researchers looked at 31 radiation-induced meningiomas in patients who underwent head and spine radiation during childhood. Most of them (74 percent) had survived either leukemia or pediatric brain cancer.

These brain tumors were compared with 30 meningiomas among people in the general population.

Gelareh Zadeh, the study’s co-principal investigator, said that radiation-induced meningiomas appear to be the same as those that just occur sporadically. They look the same on MRI scans and under a microscope. And, they feel the same during surgery, Zadeh said.

“What’s different is [that radiation-induced tumors] are more aggressive, tend to recur in multiples and invade the brain, causing significant morbidity and limitations (or impairments) for individuals who survive following childhood radiation,” Zadeh said.

Zadeh is a brain tumor researcher and associate professor in the neurology division at the University of Toronto.

Ken Aldape is a co-principal investigator on the study. He said the research team found a specific rearrangement involving the NF2 gene in radiation-induced meningiomas. He said there are likely other genetic rearrangements caused by radiation-induced DNA damage.

“So one of the next steps is to identify what the radiation is doing to the DNA of the meninges,” Aldape said in a University Health Network news release. Aldape is a professor of laboratory medicine and pathobiology at the University of Toronto.

Figuring out which group of childhood cancer patients have the highest risk of these radiation-induced tumors is critical. These patients could be followed closely for early detection and management, Aldape explained.

The study was published online Aug. 4 in the journal Nature Communications.

WebMD News from HealthDay

Sources

SOURCE: University Health Network, news release, Aug. 4, 2017

Copyright © 2013-2017 HealthDay. All rights reserved.

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Is One Round of Radiation Enough for Spine Pain in Cancer Patients?

By Robert Preidt

HealthDay Reporter

FRIDAY, June 2, 2017 (HealthDay News) — Just one dose of radiation works as well as a full week of treatment to ease debilitating spinal pain in patients with advanced cancer, a new study shows.

Known as spinal cord compression, the condition happens when a tumor presses against the spine. It can cause pain, numbness, tingling and difficulty walking.

Radiation is often used to relieve these symptoms of spinal compression, but there is no standard recommended length of treatment, the study authors said.

They assessed 688 patients with prostate, lung, breast and gastrointestinal cancers that had spread and found that a single radiation treatment was as effective as five radiation sessions.

The patients were assessed by how well they could walk and move. The researchers found that both short-course and longer-course radiation treatments helped patients stay mobile.

The study was to be presented Friday at the annual meeting of the American Society of Clinical Oncology (ASCO), in Chicago. Research presented at meetings is viewed as preliminary until published in a peer-reviewed journal.

“Our findings establish single-dose radiotherapy as the standard of care… at least for patients with a short life expectancy,” said study author Dr. Peter Hoskin, an oncologist at the Mount Vernon Cancer Centre in Middlesex, England.

“For patients, this means fewer hospital visits and more time with family,” he said in an ASCO news release.

“Longer radiation may be more effective for preventing regrowth of [cancer spread] in the spine than single-dose radiation. Therefore, a longer course of radiation may still be better for patients with a longer life expectancy, but we need more research to confirm this,” Hoskin said.

WebMD News from HealthDay

Sources

SOURCE: American Society of Clinical Oncology, news release, June 2, 2017

Copyright © 2013-2017 HealthDay. All rights reserved.

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Is One Round of Radiation Enough for Spine Pain in Cancer Patients?

FRIDAY, June 2, 2017 — Just one dose of radiation works as well as a full week of treatment to ease debilitating spinal pain in patients with advanced cancer, a new study shows.

Known as spinal cord compression, the condition happens when a tumor presses against the spine. It can cause pain, numbness, tingling and difficulty walking.

Radiation is often used to relieve these symptoms of spinal compression, but there is no standard recommended length of treatment, the study authors said.

They assessed 688 patients with prostate, lung, breast and gastrointestinal cancers that had spread and found that a single radiation treatment was as effective as five radiation sessions.

The patients were assessed by how well they could walk and move. The researchers found that both short-course and longer-course radiation treatments helped patients stay mobile.

The study was to be presented Friday at the annual meeting of the American Society of Clinical Oncology (ASCO), in Chicago. Research presented at meetings is viewed as preliminary until published in a peer-reviewed journal.

“Our findings establish single-dose radiotherapy as the standard of care… at least for patients with a short life expectancy,” said study author Dr. Peter Hoskin, an oncologist at the Mount Vernon Cancer Centre in Middlesex, England.

“For patients, this means fewer hospital visits and more time with family,” he said in an ASCO news release.

“Longer radiation may be more effective for preventing regrowth of [cancer spread] in the spine than single-dose radiation. Therefore, a longer course of radiation may still be better for patients with a longer life expectancy, but we need more research to confirm this,” Hoskin said.

More information

The Canadian Cancer Society has more on spinal cord compression.

Posted: June 2017

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A Movie Instead of Anesthesia for Kids’ Radiation Therapy

TUESDAY, May 9, 2017 — For children with cancer, watching movies during radiation therapy might eliminate their need for general anesthesia, a new study suggests.

Kid-friendly movies such as “SpongeBob SquarePants” and “Cars” helped reduce the risks, trauma and costs of treatment for kids evaluated in the small European study.

Cancer is rare in children, but those who develop tumors in their brain, bone and other soft tissues may require radiation therapy.

“Being treated with radiotherapy means coming in for a treatment every weekday for four to six weeks. The children need to remain motionless during treatment and, on the whole, that means a general anesthesia. That, in turn, means they have to keep their stomach empty for six hours before the treatment,” said study author and radiation therapist Catia Aguas.

“We wanted to see if installing a projector and letting children watch a video of their choice would allow them to keep still enough so that we would not need to give them anesthesia,” said Aguas, who is with the Cliniques Universitaires Saint-Luc in Brussels, Belgium.

Based on this small study, a good movie has a valuable sedating effect.

Twelve children between 18 months and 6 years old underwent radiation treatment for cancer at the Belgian hospital. Half were treated after a video projector was installed in the radiation therapy room.

The researchers noted that 83 percent of the children treated before the video projector was installed needed general anesthesia for their treatment.

After the projector was installed, only 33 percent needed general anesthesia, the study found.

“Since we started using videos, children are a lot less anxious… And once the movie starts it’s as though they travel to another world,” Aguas said in a news release from the European Society for Radiotherapy & Oncology.

“‘SpongeBob,’ ‘Cars’ and ‘Barbie’ have been popular movie choices with our patients. Now in our clinic, video has almost completely replaced anesthesia, resulting in reduced treatment times and reduction of stress for the young patients and their families,” she added.

Treatments that previously took one hour or more now take around 15 to 20 minutes. The researchers said this is partly because of timed saved by not administering anesthesia, and also because kids who know they’ll see videos are more cooperative.

The findings were scheduled for presentation May 8 at the annual meeting of the European Society for Radiotherapy & Oncology, in Vienna, Austria. Studies presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Cancer Institute provides more on radiation therapy.

Posted: May 2017

Drugs.com – Daily MedNews

Hemp Consumes Radiation, Mitigates Heavy Metals From Soil

It would appear as though the industrial applications of the hemp plant are seemingly infinite.

While it’s long been understood that hemp can produce a plethora of every day products– such as fuel, textiles, construction material, clothing, food and paper –hemp can also apparently draw toxins from the soil.

According to an online report, hemp can help erase some of the nastier environmental mistakes made in mankind’s recent past. Not only can humans benefit from consuming hemp protein, wearing hemp clothing, and writing on hemp paper, hemp is known to be extremely useful in the elimination of cadmium and other toxic metals from the Earth’s valuable soil, including radiation.

“Hemp is proving to be one of the best phyto-remediative plants we have been able to find,” said Slavik Dushenkov, a research scienst with PHYTOTECH.”

Thanks to the hemp plants overwhelming success in removing radiation from soil surrounding Russia’s Chernobyl disaster, hemp is now high on the list for consideration in drawing out radiation from the soil surrounding Japan’s Fukushima nuclear facility.

Thanks to Phytoremediation, the rather complicated manner by which hemp cleans up our polluted soil and allows plants to tidy up the environment or “remediate” toxic soil, the process of cleaning up our precious resources contaminated by human activity has just gotten a little bit healthier for the planet.

Read the full text on, “How Hemp Can Clean up Radiation From Fukushima Nuclear Disasterhere.

(Photo Courtesy of Cannabis Culture)

Marijuana

Higher-Dose, Short-Duration Radiation Better for Early Breast Cancer: Study


This Treatment Better for Early Breast Cancer

Treatment offers fewer side effects and better quality of life, researchers say

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

THURSDAY, Aug. 6, 2015 (HealthDay News) — A shorter course of radiation therapy is better for women with early stage breast cancer, according to a new study.

Specifically, it found that those who received higher doses of whole breast radiation over a shorter period of time had fewer side effects and a better quality of life than those who received smaller doses of radiation over a longer period of time.

“Patients who received the shorter course reported less difficulty in caring for their families’ needs. This is a major priority for women undergoing breast cancer radiation,” study first author Dr. Simona Shaitelman, from the University of Texas MD Anderson Cancer Center, said in a center news release.

“Most are busy working mothers, working inside or outside the home, and are juggling a number of priorities. It’s paramount that we address this need,” explained Shaitelman, who is an assistant professor of radiation oncology.

The study was published Aug. 6 in the journal JAMA Oncology.

Doctors should use this higher-dose approach — called hypofractionated whole breast irradiation — as a starting point when discussing treatment options with breast cancer patients, researchers said.

Radiation therapy for breast cancer in the United States is generally given in smaller doses over a longer period of time. This method is called conventionally fractionated whole breast irradiation.

Only one-third of patients who should undergo the new, higher-dose treatment according to American Society of Radiation Oncology guidelines actually receive it, the researchers said.

Their study included nearly 300 women with early breast cancer (stages 0-2). The women were all 40 or older. They had undergone breast conserving surgery (“lumpectomy“) and were randomly assigned to receive either the hypofractionated radiation or conventional radiation.

During treatment, those in the higher-dose radiation group had fewer radiation-related side effects such as breast pain, eczema, skin darkening and fatigue than those in the conventional group. Six months after treatment, patients in the hypofractionated group had less fatigue and were better able to care for their families than those in the conventional group.

WebMD Health

Study Questions Radiation Use for ‘Low-Risk’ Prostate Cancers


Radiation Use and ‘Low-Risk’ Prostate Cancers

Upping the dosage didn’t alter survival rates for men with these slow-growing tumors

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

FRIDAY, July 17, 2015 (HealthDay News) — Higher doses of radiation may improve survival in men with medium- and high-risk prostate cancers, but it does not do the same for those with low-risk disease, a new study suggests.

As is the case with many cancers, doctors must balance the risks and side effects of radiation therapy against its potential benefits when deciding if it’s right for a particular patient.

When it comes to prostate cancer, “surgery and radiation treatments remain equal options for men with this disease,” noted Dr. Louis Potters, chair of the department of radiation medicine at North Shore-LIJ Health System in Great Neck, N.Y.

So when is radiation warranted, and at what dose, based on the aggressiveness of the tumor?

The new study, led by radiation oncology resident Dr. Anusha Kalbasi of the University of Pennsylvania, looked at the issue using data from more than 42,000 prostate cancer patients.

Some of the men had received the standard dose of radiation, while others received higher-dose radiation.

The researchers found that every incremental increase in radiation dose was associated with a 7.8 percent decline (for those with medium-risk cancer) and 6.3 percent decline (for high-risk cancer) in the rate of death for the men from any cause.

However, the equation changed when it came to men with slower growing, “low-risk” prostate tumors. In those cases, using a higher dose of radiation made no difference in survival rates, according to the study published July 16 in JAMA Oncology.

The researchers noted that low-risk prostate cancer was the most common type of prostate cancer diagnosed in the United States in 2014, affecting about 150,000 men.

Therefore, the study “raises the provocative question of whether radiation dose reduction for patients with low-risk prostate cancer could achieve similar cure rates while avoiding the increased risk of side effects associated with higher radiation doses,” Kalbasi said in a university news release.

Study senior author Dr. Justin Bekelman, a professor of radiation oncology at the university, believes that “the dose of radiation should be personalized to the specific characteristics of the prostate tumor.”

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Chest Radiation May Help Fight Some Advanced Lung Cancers: Study

MONDAY Sept. 15, 2014, 2014 — Adding chest radiation to chemotherapy allows some people with small-cell lung cancer to live longer and cuts recurrence rates by nearly 50 percent, European researchers report.

Based on the results of a four-country study, the researchers recommended that chest radiotherapy be routinely offered to patients with advanced small-cell lung cancer who respond to chemotherapy.

Small-cell lung cancer (SCLC) is an aggressive form of the disease that accounts for roughly 13 percent of all lung cancers. For most people, the disease spreads to other parts of their body. But chest (thoracic) radiation is not regularly given to patients with small-cell lung cancer, the researchers pointed out.

“Although most SCLC patients have persistent tumors within the chest after chemotherapy, at present local thoracic radiotherapy is not generally given because of the spread of disease outside the thorax, and is reserved for [ease] of symptoms,” study author Dr. Ben Slotman, a radiation oncology professor at VU University Medical Center in Amsterdam, said in a news release from The Lancet.

The research was published Sept. 14 in the journal, to coincide with its presentation at the American Society for Radiation Oncology’s annual meeting in San Francisco.

“In recent years, we have made some progress in improving survival by giving prophylactic cranial radiotherapy [radiation to the head to reduce the risk of cancer spreading to the brain] after chemotherapy, and this is now considered the standard of care. However, survival for patients with extensive disease remains poor [two-year survival of less than 5 percent] and the likelihood of the cancer recurring and spreading to other parts of the body remains high,” Slotman noted.

The study involved 498 adults undergoing chemotherapy at 42 facilities in the Netherlands, the United Kingdom, Norway and Belgium. The patients were randomly assigned to two weeks of standard care with either radiation to the head alone or radiation to the head and chest.

Although survival rates among the two groups of patients was similar during the first year, by the second year, 13 percent of patients who received head and chest radiation had survived, compared to 3 percent of those who received standard therapy.

Six months after treatment, 7 percent of patients who underwent chest radiation did not experience a worsening of their condition, compared to 24 percent of those who received standard therapy.

The researchers noted that 20 percent of patients who received chest radiation had a recurrence of cancer in their thorax, compared to 46 percent of those who only received head radiation.

Slotman noted, “While local control of the disease was good, the majority of patients still had disease progression outside the thorax and brain, indicating that additional radiotherapy should be investigated at sites of extrathoracic disease as well.”

One expert lauded the findings.

The study “is provocative, and possibly practice-changing, in the treatment of extensive stage small-cell lung cancer,” said Dr. Jed Pollack, chair of radiation medicine at Lenox Hill Hospital in New York City. “These results represent an incremental, but important, step forward in the treatment of extensive stage small-cell lung cancer. It would be intriguing to see whether or not a dose-escalation study could show even further survival benefit.”

Dr. Jan P. van Meerbeeck, from Ghent and Antwerp University in Belgium, and Dr. David Ball, from the University of Melbourne in Australia, wrote a commentary that accompanied the study.

“Refreshingly, the radiotherapy in Slotman and colleagues’ study was not technically complex, and it would be easy to provide at low cost in even the most modestly resourced radiotherapy departments,” they said in the journal news release.

More information

The American Lung Association has more on treatment for lung cancer.

Posted: September 2014

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Study Supports Radiation When Breast Cancer Spreads to Few Lymph Nodes

WEDNESDAY March 19, 2014, 2014 — Having radiation therapy after a mastectomy benefits patients with breast cancer that has spread to just a few lymph nodes under their arms, a new study suggests.

Researchers analyzed data from nearly 3,800 women in 14 clinical trials that started between 1964 and 1982. After their mastectomy and surgery to remove lymph nodes under the arms, the women were randomly selected to receive either no radiation therapy or radiation therapy to the chest wall and other regions.

Some of the women had no cancer in the lymph nodes, some had cancer in one to three lymph nodes, and others had cancer in four or more lymph nodes.

The women were followed for an average of just over 11 years. Radiation treatment cut the risk of cancer’s return by 32 percent and the risk of dying from breast cancer by 20 percent in those women who had cancer in one to three lymph nodes, the researchers reported March 19 in the journal The Lancet.

Women with cancer in four or more lymph nodes were 21 percent less likely to have cancer recurrence and 13 percent less likely to die of breast cancer if they had undergone radiation therapy, the study found.

On the other hand, the risk of cancer recurrence and death in women with no cancer in their lymph nodes was unaffected by radiation therapy, according to the study, which will also be presented March 20 at the European Breast Cancer Conference in Glasgow, Scotland.

The benefits of post-mastectomy radiation were also similar “whether or not [patients] had also received chemotherapy or hormonal therapy,” said study lead author Dr. Paul McGale of the Clinical Trial Service Unit in Oxford, U.K.

He noted that, until this study, there was uncertainty about whether radiation therapy would benefit breast cancer patients with cancer that had spread to just a few lymph nodes under the arms.

“It is already accepted that women with four or more positive nodes benefit from radiotherapy after mastectomy, and these findings confirm this benefit,” McGale said in a meeting news release. “However, it is for women with between one and three positive nodes where the previous evidence has been unclear.”

The bottom line, he said, is that “women being treated today are likely also to benefit from radiotherapy if they have any positive lymph nodes.”

Two U.S. breast cancer experts said more data on the value of post-mastectomy radiation therapy has been sorely needed.

“The role of radiation therapy after mastectomy for women who have less than four lymph nodes involved by cancer has been controversial, due to a lack of sufficient evidence,” said Dr. Sheryl Green, assistant professor of radiation oncology at the Icahn School of Medicine at Mount Sinai, in New York City.

“Most current guidelines suggest that this treatment decision should be individualized based on a patients’ specific risk profile and careful consideration of both the benefits and risk of radiation therapy,” she said.

Green said the new study gives women and their doctors better guidance, but medicine has also changed since the time the trial was begun.

“Although this data suggests a benefit to radiation therapy in this group of women, we do not know if it’s directly applicable to women currently treated with more modern chemotherapy regimens, which are known to be more effective than those used in these studies,” she said.

“[Also], radiation treatment has become increasingly more targeted and can spare surrounding healthy tissues to a greater extent than was utilized in these studies,” Green added. “As such, the risks of radiation treatment are likely to be significantly lower than previously thought.”

Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, said there has been a “need for clarification” as to whether radiation therapy might help women whose breast cancer has spread to between one and three lymph nodes.

“This study may begin to change the practices of radiation oncologists in the United States,” Bernik said. “But some may feel that a randomized prospective trial is still needed.”

More information

The U.S. National Cancer Institute has more about breast cancer treatment.

Posted: March 2014

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Yoga May Help Breast Cancer Patients During Radiation Therapy

TUESDAY March 4, 2014, 2014 — Women with breast cancer who practiced yoga had lower levels of stress hormones and reported less fatigue and better quality of life, new research shows.

“Yoga is having an impact on subjective well-being, as well as better regulation of cortisol, a stress hormone,” said study co-author Lorenzo Cohen, director of the integrative medicine program at M.D. Anderson Cancer Center, in Houston. “Better regulation of stress hormones has been linked with better survival and longer survival.”

The study is published in the March 3 online edition of the Journal of Clinical Oncology.

Other research has found yoga helpful for cancer patients, Cohen said, but some of those studies have looked at small numbers of patients and others have not compared the yoga group to a “control” group to measure results.

For the new study, Cohen assigned more than 160 women with breast cancer who were undergoing radiation therapy to do either yoga or stretching up to three times a week for an hour each session. Those two groups were compared to a control group that received no instruction in either yoga or stretching.

The women reported on their quality of life, including how fatigued or depressed they felt, and described their daily functioning. They gave saliva samples at the study’s start, the end of treatment, and at one, three and six months after treatment, so cortisol could be measured.

Women in the yoga group had the greatest reduction in cortisol levels across the day, which reflected the ability of yoga to help regulate stress hormones, the study authors noted.

After finishing radiation treatment, which is linked with fatigue, only the yoga and stretching groups reported feeling less tired, the findings showed. The yoga group had more benefits in physical functioning than the other two groups.

No differences were found between the groups for mental health and sleep quality. That may have been because all the women were doing fairly well on those measures at the study’s start, Cohen said.

Previous studies have linked exercise with better well-being and less fatigue among cancer patients, said Dr. Joanne Mortimer, director of women’s cancer programs and co-director of the breast cancer program at City of Hope Cancer Center in Duarte, Calif.

Recommending exercise to a cancer patient who is already tired may sound counterintuitive, Mortimer said, but research suggests that’s not so.

“This study supports that the more you do, the better off you are,” Mortimer explained.

Cohen put it this way: “I think it’s important for breast cancer patients to engage in some sort of activity to buffer [dealing with the disease].”

Yoga, he said, provides an important mind-body approach to help patients get physical activity, relax and calm their mind.

While yoga class offerings are widespread, Cohen pointed out that “it’s important to find the right kind of yoga teacher. It’s about doing a gentler form of yoga.”

He suggested women with breast cancer ask their doctor first if they can participate in yoga, then find a yoga instructor with experience leading a class that includes cancer patients.

More information

To learn about physical activity and cancer, visit the U.S. National Cancer Institute.

Posted: March 2014

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Advanced Tonsil Cancer May Respond Well to Targeted Radiation

FRIDAY Feb. 21, 2014, 2014 — Targeted radiation therapy benefits people with advanced tonsil cancer, a new study suggests.

Such a treatment would effectively fight the disease while limiting the body’s exposure to harmful side effects.

Researchers looked at outcomes for 46 patients with advanced tonsil cancer who were treated at Washington University in St. Louis between 1997 and 2012. The patients were followed between three months and nearly nine years, with an average follow-up of nearly three years.

Limiting radiation treatment to lymph nodes on one side of the neck led to good local control of cancer and no cancer recurrence on the untreated side, according to the study being presented this week at the Multidisciplinary Head and Neck Cancer Symposium in Scottsdale, Ariz.

Lymph nodes are small structures that work as filters for harmful substances in the body, according to the American Cancer Society.

The new study also found that the location of the original tumor, rather than the amount of cancer in lymph nodes on the side of the neck with the tumor, affected the risk of cancer on the other side of the neck.

“All treatments for cancer — surgery, radiation therapy, chemotherapy — although effective, can cause temporary and/or permanent toxicity which can affect long-term quality of life,” study author Dr. Wade Thorstad, chief of head and neck services at Washington University School of Medicine, said in a symposium news release.

“Our research indicates that for appropriately selected patients with tonsil cancer, the volume of radiation therapy necessary to control the cancer can be significantly reduced, therefore reducing the side effects and toxicity of radiation, while maintaining a high rate of tumor control,” said Thorstad, who’s also an associate professor of radiation oncology.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

Cancer Research UK has more about tonsil cancer.

Posted: February 2014

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