COVID-19 and cancer panel discussion: managing stress, anxiety, and grief during uncertain times

As part of its wellness blog series, the National Coalition for Cancer Survivorship has created a series and webinars and resources for cancer patients and survivors experiencing increasing stress and anxiety amidst the COVID-19 pandemic.  Isolation and fear are serious risk factors for many cancer survivors.  The tips provided by a psychologist and cancer control expert in the webinars focus on the importance of virtual connections with family and friends, as well as the importance of exercise, adequate sleep, and proper nutrition.

Click here to view the webinars and learn more about the information resources provided.

Chronic, late effects of cancer treatment: the consequences of a cure

A recent interview with Dr. Balazs Bodai, Director of the Breast Cancer Survivorship Institute at Kaiser Permanente Health, states that long-term management of cancer survivors may increasingly fall under the responsibility of primary care providers.  The interview also presents the views of Dr. Catherine Alfano, vice president of survivorship at the American Cancer Society.  Dr. Alfano informs readers about the differences between chronic vs. late effects of cancer treatment.  Chronic effects are issues that first present during cancer treatment and continue in the post-treatment period, while late effects do not occur while a patient is treated, "but pop up seemingly out of nowhere a few years, even 10 years later." 

To read more about this interview, click here.

Practicing oncology during the COVID-19 pandemic: protecting medical staff to ensure cancer patients can safely receive care

The European Society of Medical Oncology (ESMO) has launched a new series, Practicing Oncology During the Pandemic, sharing experiences and perspectives from medical personnel during the COVID-19 pandemic.  Via a series of interviews, readers will learn about current COVID-19 testing policies, daily routines of medical oncologists, along with treatment and follow-up strategies for cancer patients.

Click here for further information

COVID-19 Infection in Cancer Patients in Wuhan: Emphasis on Severe Events

A new retrospective study on COVID-19 among cancer patients, focusing on risk factors associated with admission to the intensive care unit (ICU) has been conducted by a team of clinicians from 3 hospitals in Wuhan, China, and recently published in the Annals of Oncology.  Clinical data gathered from 28 cancer patients with COVID-19 infection between January 13, 2020 - February 26, 2020 indicates that 17 patients (60%) were male, with an average age of 65 years.  Of the 28 cancer patients studied, 7 (25%) had lung cancer, followed by oesophageal cancer (4 patients), and breast cancer (3 patients).  10 patients had a stage IV cancer diagnosis and 8 patients developed COVID-19 from hospital-associated transmission.  Further, of the 6 patients who received anti-tumour treatment within 14 days of their COVID-19 diagnosis, 5 (83%) developed severe events.

To read more about this study, click here.

Study mentioned: Zhang L, Zhu F, Xie L, et al. Clinical characteristics of COVID-19-infected cancer patients: A retrospective case study in three hospitals within Wuhan, China. Annals of Oncology; Published online 23 March 2020. DOI: https://doi.org/10.1016/j.annonc.2020.03.296

Patient Education: FAQ on COVID-19 (coronavirus) and cancer patients

The University of California, San Francisco (UCSF) has unveiled a FAQ, Coronavirus (COVID-19) and Patients with Cancer.  This document includes a brief history of the COVID-19 outbreak, common symptoms, and precautions that must be taken amongst cancer patients.

Click here for more information.

Cancer treatment in the age of COVID-19

OncoLink, a prominent cancer blog created by the University of Pennsylvania recently posted 3 blogs entries on their forum pertaining to the COVID-19 pandemic.  The first, On the Front Lines with Cancer and COVID-19,  provides personal perspectives from a radiation therapist, while Cancer Treatment in the Age of COVID-19 contains key resources to address concerns cancer patients may have regarding coronavirus.   Finally, the OncoLink team focuses on the mental health perspective of COVID-19, providing suggestions on dealing with mandated self-isolation periods.  To read more, click here.

Breast MRI associated with significantly higher rate of invasive cancer detection than digital breast tomosynthesis

A recent cross-sectional study with longitudinal follow-up on 1444 women undergoing breast cancer screening indicates that invasive cancer rate was considerable higher (11.8/1000) for breast MRI, compared to 4.8/1000 for digital breast tomosynthesis. While the authors of the study caution that further investigation of the correlation between screening methods and clinical outcome should be undertaken, the findings do support the notion that "improved screening methods for women with dense breasts are needed because of their increased risk of breast cancer and of failed early diagnosis by screening mammography."

To read more about this study, click here.

Source mentioned:   Comstock CE, Gatsonis C, Newstead GM, et al. Comparison of abbreviated breast MRI vs. digital breast tomosynthesis for breast cancer detection among women with dense breasts undergoing screening.  JAMA 2020;323(8):746-756. doi:10.1001/jama.2020.0572.

New trial alert: Hypofractionated whole-pelvis radiation therapy (WPRT) vs. conventionally-fractionated WPRT in prostate cancer

A new trial sponsored, in part by the Canadian Association of Radiation Oncology is seeking to determine "if 5 fractions of external radiation therapy with higher radiation doses per fraction to the pelvis leads to similar results to the standard of care external radiation therapy treatment that is comprised of 25 fractions of external radiation therapy with lower radiation doses per fraction to the pelvis."  The primary outcome of the trial is quality of life with regards to late bowel function, while secondary outcomes include acute urinary and sexual quality of life outcomes.

To learn more about this trial, click here.

Largest real world database of immune checkpoint inhibitors in melanoma

Results of the largest real world dataset in metastatic melanoma via uptake of immune checkpoint inhibitors was presented at the 2020 ASCO-SITC Clinical Immuno-Oncology Symposium in Orlando Florida, February 6-8, 2020.  The dataset, comprised of 5465 melanoma patients studied between April 2014 - March 2018 reports that 2322 of the 5465 patients received first-line treatment with immune checkpoint inhibitors (1174 were administered pembrolizumab, 724 ipilimumab, 52 nivolumab, and 372 a combination of both ipilimumab and nivolumab.

To read more about this study, click here.

Source mentioned:  Corrie PG, Chao D, Board R, et al. Metastatic melanoma patient outcomes since introduction of immune checkpoint inhibitors in England between 2014 and 2018. J Clin Oncol 2020; 38:(suppl 5; abstr 55).   

First baby born to cancer patienst from eggs matured in lab and frozen

The Department of Reproductive Medicine and Fertility Preservation at the Antoine Béclère University Hospital near Paris, France have "announced the birth of the first baby to be born to a cancer patient from an immature eff that was matured in the laboratory, frozen, then thawed and fertilized five years later."  According to the announcement, the 34-year old mother of the baby boy was infertile due to the chemotherapy she underwent for breast cancer.  Prior to beginning her cancer treatment, her immature eggs were removed and allowed to fully develop via in vitro maturation (IVM).  This study is believed to be the first successful pregnancy in cancer patients following IVM and vitrification.

To read more about this study, click here.

Cancer Related to Infections

A recently published article by investigators from the International Agency on Cancer (IARC) provides a global analysis of cancer diagnoses attributable to infections.  According to the study, "an estimated 2.2 million infection-attributable cancer cases were diagnosed worldwide [in 2018]."  Primary causes included Helicobacter pylori, human papillomavirus (HPV), and hepatitis B and C viruses.

To read more about this study, click here.

Source mentioned: de Martel C, Georges D, Bray F, Ferlay J, Clifford GM. (2020). Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis. Lancet Glob Health. 2020 Feb;8(2): e180-e190.

Can working night shifts put you at greater risk of cancer?

The United States Nurses' Health Study recently revealed results of a study indicating that extensive rotating night shift work over 15 years leads to a greater risk of developing haematopoietic cancer. Haematopoietic cancers, (the 2 most common types are leukaemia and lymphoma) account for 10% of all new cancer diagnoses.  While this study admits that several occupational, environmental, lifestyle, and physiological factors can lead to a higher risk of a cancer diagnosis, "it is speculated that night shift work may suppress melatonin, which regulates the sleep-wake cycle and is a powerful antioxidant."

To read more about this study, click here.  

Immune checkpoint inhibitors associated with lower risk of developing severe adverse events vs. chemotherapy

A recently published meta-analysis in Annals of Oncology reports on 22 clinical trials conducted on 12,727 patients with advanced solid tumours.  Findings from the joint Canada-U.S. study indicated that patients "treated with immune checkpoint inhibitors were less likely to develop severe adverse events than those receiving chemotherapy.  16.5% of patients developed an adverse event when treated with immune checkpoint inhibitors, compared to 41.1% treated with chemotherapy.  Other adverse events, including fatigue, diarrhea, and acute kidney injury were more prevalent following chemotherapy treatment, while colitis, pneumonitis, and hypothyroidism occurred more frequently after treatment with immune checkpoint inhibitors.

To read more about this study, click here.

Study source: Magee DE, Hird AE, Klaassen Z, et al. Adverse event profile for immunotherapy agents compared with chemotherapy in solid organ tumors: a systematic review and meta-analysis of randomized clinical trials. Annals of Oncology; Published online 6 January 2020. https://doi.org/10.1016/j.annonc.2019.10.008 

Artificial Intelligence speeds brain tumour diagnosis

A recent National Institutes of Health (NIH)-funded clinical trial of patients requiring brain surgery indicates how artificial intelligence (AI) is able to provide "neurosurgeons with valuable real-time information about what type of brain tumour is present, while the patient is still on the operating table."  In the joint study by researchers from NYU Langone Health and University of Michigan, Ann Arbor, the benefits of AI and a technique known as Stimulated Raman History (SRH) can provide real-time data and predictions related to a patient's brain tumour diagnosis.  AI overall performance in this study was 95% accurate (compared to 94% accuracy for conventional pathology).

To read more about this study, click here.

Source mentioned: Hollon TC, Pandian B, Adapa AR, Urias E, Save AV, Khalsa SS, et al. Near real-time intraoperative brain tumor diagnosis using stimulated Raman histology and deep neural networks. Nat Med. 2020 Jan 6. doi: 10.1038/s41591-019-0715-p [Epub ahead of print]

Recommended physical activity levels linked to lower risk of seven cancers

A recent joint study conducted by investigators at the National Cancer Institute, American Cancer Society, and the Harvard T.H. Chan School of Public Health indicates that adherence of leisure-time physical activity is linked to lower risk of developing 7 cancers.  Lower risk levels for the 7 identified cancers include: colon cancer in men (8%-14%), female breast cancer (6%-10%), endometrial cancer (10%-18%), kidney cancer (11%-17%), myeloma (14%-19%), liver cancer (18%-27%), and non-Hodgkin lymphoma (11%-18%).

To read more about this study, click here.

Source mentioned: Matthews CE, Moore SC, Arem H, Cook MB, Trabert B, Hakansson N., et al. Amount and intensity of leisure-time physical activity and lower cancer risk. J Clin Oncol. 2019 Dec 26: JCO1902407 [Epub ahead of print]

AI detects breast cancer as accurately as expert radiologists, study finds

Researchers in the United States and Britain recently reported that Google DeepMind, an artificial intelligence (AI) system, "proved as good as expert radiologists at detecting which women had breast cancer based on screening mammograms and showed promise at reducing errors."  According to the American Cancer Society, radiologists miss about 20% of breast cancers in mammograms; Google Deep Mind can reduce false positive results by 5.7%.

To read more about this study, click here.

Study mentioned: McKinney SM, Sieniek M, Godble V, Godwin J, Antropova H, Back T, et al. International evaluation of an AI system for breast cancer screening.  Nature, 2020 Jan; 577 (7788): 89-94.

Happy Holidays - blog postings resume in January 2020

To all Grey Horizon readers,

Thank you for your continued support of this blog.  Happy Holidays and best wishes for 2020 - postings will resume in January.

Sustained weight loss linked to reduced breast cancer risk

A new study conducted by the American Cancer Society shows that sustained weight loss in women 50 years of age and older and not using postmenopausal hormones had significantly reduced levels of breast cancer risk.  According to study findings on 180,000 women 50 and older, women who lost 2-4.5 kg had a 13% lower risk of developing cancer, while those losing 4.5-9 kg saw the risk fall to 16%, and women losing 9 kg or more had a 26% lower risk.

To read more about this study, click here.

Source mentioned: Sustained weight loss and risk of breast cancer in women >50 years: a pooled analysis of prospective data. JNCI: Journal of the National Cancer Institute; DOI: 10.1093/jnci/djz226  

Breast cancer subtype incidence in men differs from trends in women

A new study conducted by the American Cancer Society indicates that "incidence rates for hormone receptor (HR+) breast cancers are considerably higher in black men than white men, in stark contrast to lower incidence rates of those cancer subtypes in black versus white women." The study is unique as it is the first report studying rates of breast cancer racially and gender.  Findings indicate a 41% higher incidence for HR+/HER- breast cancers, 65% higher for HR+/HER2+,  among black men.

To read more about this study, click here.

 

Permanent hair dye and straighteners may increase breast cancer risk

A new study conducted at the National Institutes of Health indicates a tends towards higher risk of developing breast cancer in women who use permanent hair dye and chemical hair straighteners. Known as the Sister Study, data from 46,709 women "found that women who regularly use permanent hair dye...were 9% more likely to develop breast cancer" than those that didn't use this hair product.

Click here for more information about this study.

Study mentioned: Eberle CE, Sandler DP, Taylor KW, White AP. Hair dye and chemical straightener use and breast cancer risk in a large US population of black and white women. Int J Cancer. 2019 Dec 3. doi: 10.1002/ijc.32738 [Epub ahead of print]

People with mental illness receive less cancer screening

A recent systematic review and meta-analysis conducted in the Neurosciences Department at the University of Padua in Italy indicates that "despite increased mortality from cancer in people with mental illness, this population receives less cancer screening compared with that of the general population."

To read more about these findings, click here.

Study mentioned:

Solmi M, Firth J, Miola A, et al. Disparities in cancer screening in people with mental illness across the world versus the general population: prevalence and comparative meta-analysis including 4 717 839 people. The Lancet Psychiatry; Published online 28 November 2019.DOI: https://doi.org/10.1016/S2215-0366(19)30414-6

New trial alert: Robotic nipple-sparing mastectomy with immediate prosthetic breast reconsrtuction

Researchers at the University Health Network in Toronto are conducting a new trial utilizing a surgical robotic system to reduce visible scarring of the breast, and nipple-areolar complex malposition/distortion.  The Robotic Nipple-Sparing Mastectomy (RNSM), while thus far utilized in only a few centres in North America (The University Health Network trial will be the first of its kind in Canada), investigators do emphasize that the robotic technique is safe, feasible, and can "provide superior cosmetic outcomes with less morbidity and higher patient satisfaction compared to traditional nipple-sparing techniques.

 To read more about this trial, click here.

American Cancer Society updates position on electronic cigarettes

The American Cancer Society has revised its position statement on electronic cigarettes, due to increases in e-cigarette use among children, teens, and young adults.  The 3 revised statements in the position statement include:

• No youth or young adult should begin using any tobacco product, including e-cigarettes 
• E-cigarettes should not be used to quit smoking 
• E-Cigarette users should not also smoke cigarettes or switch to smoking cigarettes, and former smokers now using e-cigarettes should not revert to smoking 

To read the completed, revised position statement, click here. 

Prescribing exercise as cancer treatment

The American College of Sports Medicine (ACSM) recently released updated guidelines emphasizing the importance of physical activity and regular exercise in cancer prevention and survivorship.  Dr. Kathryn Schmitz, co-chair of the expert panel that created these guidelines states that conclusive evidence has been foundling linking exercise and longer survival for breast colon, and prostate cancer patients.  While it is not possible to applying this evidence to all cancer types yet, Dr. Schmitz is adamant that "there are enough benefits of physical activity, in general, that we recommend that survivors of all cancers follow the general public health recommendations for physical activity: 1.5-5 hours/week of moderate-intensity activity, or 1.25-2.5 hours/week of vigorous activity."

To rad more about these guidelines, click here.

Source mentioned: Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, Morris GS, Patel AV, Hue TF, Perna FM, Schmitz KH.  Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary rounds. Med Sci Sports Exerc. 2019 Nov; 51(11) 2375-2390.

Detection and management strategies for cancer-related cognitive impairment in cancer survivors

Researchers in the Medical Oncology Department at the Centre Francois Baclesse in Caen, France have recently completed a study on the importance of cognitive rehabilitation programs for cancer survivors.  Lead by Professor Florence Joly, this studies emphasizes the importance of collaboration between oncologists, neurologists, imaging researchers, and neuroscientists "to define mechanisms of cancer-related cognitive impairment (CRCI) and to optimize medical care and patients' rehabilitation."

To read more about this study, click here.

new cancer guidelines database launched

The Canadian Partnership Against Cancer (CPAC) has launched a searchable database of nearly 1,000 cancer control guidelines.  Previously known as the Standards and Guidelines Evidence (SAGE) Directory, creator Dr. Melissa Brouwers from McMaster University, along with her research team, obtained funding from CPAC to unveil a resource that "address all stages of the cancer continuum, from screening to survivorship and end-of-life care."

Access to the cancer guidelines database is available here.

rectal cancer biorepository

U.S. researchers have created a biorepository of "65 patient-derived rectal cancer organoid cultures from patients with primary, metastatic, or recurrent disease."  According to study authors, patients respond different to chemoradiotherapy treatment regimens and may require additional extensive surgery.  The establishment of the biorepository thus creates the opportunity to study rectal cancer more closely on a molecular level.  It is believed that continued enhancements of this methodology will lead to drug screen in a pre-clinical setting lead to more effective, targeted treatments.

To read more about this study, click here.

News release: Young Adult Cancer Cancer first-of-its-kind study

Young Adult Cancer Canada (YACC) has released early data from their Young Adults With Cancer in their Prime (YAC Prime) study, a report discussing the "impact and intensity of issues facing young adults with cancer."  Results from a survey conducted on 622 young adults highlighted quality of life (physical, social, emotional), as well as financial hardship when faced with diagnosed with cancer.  Findings show that 49% of patients in this age group missed from 1-4 years of work, with 84% experiencing significant levels of fear of cancer recurrence.

To read more about this report, which was presented at the International Psycho-Oncology Society (IPOS) Symposium (September 23-26, 2019) in Banff, click here.

New trial alert: Evaluating optimal timing of endocrine therapy and radiation therapy in early-stage breast cancer (REaCT-RETT)

The Ottawa Hospital Research Institute is presently recruiting early-stage breast cancer patients in a new trial evaluating concurrent vs. sequential endocrine therapy in conjunction with post-operative radiation therapy.  Outcomes of the phase 4 trial are endocrine toxicity, radiotherapy toxicity, rates of starting endocrine therapy and compliance, and cost-effectiveness ratios.


Click here for more information regarding this trial.  

Canadian Cancer Statistics 2019 report now available

The 2019 report on cancer statistics is now available on the Canadian Cancer Society website.  While current estimates suggest that lung, colorectal, breast and prostate cancer will account for half of all cancers diagnosed this year, new figures also indicate that 63% of Canadians diagnosed with cancer will survive for at least 5 years after their diagnosis.  Further, the report shows that over the past 20 years, 5-year survival for blood cancers has increased significantly since the early 1990s.  Of particular note, the survival rate for non-Hodgkin lymphoma, multiple myeloma, and leukemia has gone from 49% to 68%, 27% to 44%, and 43% to 59% respectively. 


To access the complete report, click here.