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Topics - Cancer Health Editors

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Experts say treatment decisions should depend on the individual and factors such as cancer stage.

Amid the ongoing coronavirus pandemic, many cancer patients are facing a series of dilemmas, including whether or not to keep receiving treatment, Vox reports.

According to the Centers for Disease Control and Prevention, about 650,000 cancer patients are treated with chemotherapy in an outpatient oncology clinic in the United States each year.

But many people living with cancer have compromised immune systems and are among the groups of people at greater risk of contracting the novel coronavirus that causes COVID-19, a respiratory disease whose symptoms can range from mild to severe.

A recent report from the National Comprehensive Cancer Network found that cancer patients in China with COVID-19 had a 3.5 times higher risk of mechanical ventilation, ICU admission and death compared with those without the disease.

This puts both patients and oncologists in a difficult predicament. Oncologists ask themselves, “Should we continue to give immune-system-suppressing cancer treatments to patients during the COVID-19 pandemic?” On the other hand, patients ask, “What happens to me and my cancer if I stop treatment altogether?”

The problem is, chemotherapy drugs damage healthy white blood cells, which are the body’s defense against viruses like the novel coronavirus. But stopping treatment could also put people living with cancer at risk for even more problems, including tumor progression and shorter survival times.

What’s more, it’s unclear how long this pandemic will last. Although some patients have expressed a willingness to skip one or two chemo treatments, as Vox puts it, “If a patient were to delay their chemo treatment right now, it might not be any safer to resume the treatment should they reschedule it for the coming weeks or months.”


From Cancer Health Science Editor Liz Highleyman:

A month after the new coronavirus respiratory disease known as COVID-19 came to public attention, researchers and public health officials are continuing to learn about its spread, its mortality rate and who is most likely to become seriously ill.

Although much remains unknown, it’s clear that elderly people, those with other health conditions and people with compromised immune systems have a higher likelihood of severe illness. This includes people with cancer who are being treated with chemotherapy. But taking some basic precautions can lower your risk and improve your well-being.


Two new treatment options are emerging for women with metastatic breast cancer, following positive results from clinical trials. The trials tested the drugs tucatinib and trastuzumab deruxtecan (Enhertu) in women who had been previously treated for metastatic breast cancer that overproduces the HER2 protein, known as HER2-positive breast cancer.

In one of the trials, called HER2CLIMB, women treated with tucatinib in addition to trastuzumab (Herceptin) and capecitabine lived longer both without their disease progressing and overall than women who received only trastuzumab and capecitabine (Xeloda). The treatment also benefited women in the trial whose cancer had spread to the brain, a particularly challenging group to treat.

Trastuzumab deruxtecan was tested in a smaller trial, called DESTINY-Breast01, and wasn’t compared directly with another treatment. But many women in the study who received the drug saw their tumors shrink and lived for an extended period without their cancer getting worse.

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Today’s cancer treatments can sometimes feel like yesterday’s science fiction. In 2017, the Food and Drug Administration approved two therapies that manipulate immune cells’ DNA to give them the power to hunt down and kill certain blood cancers. Scientists are working to extend this treatment strategy to as many cancer types as possible, including solid tumors like breast and pancreatic cancers. But solid tumors pose new challenges even to empowered immune cells, such as the sheer number of cancer cells found in one solid-tumor mass.

Matthias Stephan, MD, PhD, at Fred Hutchinson Cancer Research Center developed a patented strategy to deliver active, genetically engineered anti-cancer immune cells to solid tumors, dramatically improving their efficacy in mouse models of cancer. Now, he’s combined this science-fiction cancer treatment with a science-fiction material to improve it even further.

In a study published Dec. 9 in the journal Nature Biomedical Engineering, Stephan showed that loading genetically engineered immune cells onto a metal micromesh-based tumor stent can keep tumors from growing into and blocking the stent in a preclinical model of pancreatic cancer. He and his team also demonstrated that the micromesh can also deliver curative, standardized doses of anti-cancer immune cells to mice with inoperable ovarian cancer.

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A special report from Cancer Health.

A cancer diagnosis often means extreme financial stress—and fights with insurance providers.

When Melinda Bachini’s bile duct cancer (cholangiocarcinoma) spread to her lungs three months after surgery—currently the main treatment, offering the only chance for a cure—as a mom of six, she knew she would have to find another way to beat her cancer. Her oncologist found a clinical trial, which was a potential financial godsend since it meant the experimental treatment would be free. But there was a hitch: Bachini’s insurance wouldn’t cover the cost of standard medical care that went along with the trial. “I didn’t even know that was a possibility,” she says. “I just had no idea. I felt like the rug was pulled out from under my feet. I wasn’t willing to put my family in financial distress over the clinical trial, so we didn’t do it.” She and other cancer patients successfully lobbied her home state of Montana to change the law, but it was too late for Bachini to join that particular trial and benefit from her advocacy. (She eventually qualified for a different federally funded clinical trial that paid all her expenses.)

The financial toxicity of cancer—the high price of care,  along with the anxiety and suffering those financial burdens  often cause—is well known. Last spring, a study that analyzed 42 clinical trials of cancer drugs approved by the Food and Drug Administration between 2006 and 2015 found that drug costs ranged from $5,454 to $45,004 per month. The average monthly cost more than doubled in that decade, from $7,103 in 2006 to $15,535 in 2015. Prices have continued to rise, and new drugs are prescribed in combination, further increasing costs. With rising co-pays, co-insurance and deductibles for private insurance, patients have to bear more of the costs of treatment. In one study of 9.5 million people diagnosed with cancer, 42.4 percent said they exhausted their entire savings and all their assets within two years of their diagnosis.


Daily consumption of less than half a cup of sugary beverages—even fruit juice—may be a risk factor for several kinds of cancer, according to a sizeable new study published this week in the British Medical Journal.

In an observational study involving over 100,000 initially healthy French adults, the majority of them women, the researchers found that an increase of 100 milliliters (about 3½ ounces, or less than a third of a 12-ounce soda) in sugary-drink intake was statistically correlated with a 22% greater chance of developing breast cancer and an 18% greater chance of developing overall cancer. The correlation was not apparent for prostate and colorectal cancers, however.

Although some earlier, smaller studies had suggested such a link, the evidence hadn’t been strong. While an observational study cannot determine causality, the researchers note that there are several reasons to believe that a high-sugar diet could increase cancer risk—for example, the fact that a high-sugar diet can contribute to obesity, itself a risk factor for cancer. But they believe that other biological mechanisms may also be at play.


Combining two different types of checkpoint inhibitor immunotherapy led to improved outcomes in people with advanced liver cancer, according to study results presented this week at The Liver Meeting, the annual meeting of the American Association for the Study of Liver Diseases (AASLD).

People treated with the most effective regimen of Opdivo (nivolumab) plus Yervoy (ipilimumab) had an overall response rate of 32% and a median survival of nearly two years—better than the outcomes seen with Opdivo alone. The dual treatment was generally safe and side effects were described as manageable.

Over years or decades, chronic hepatitis B or C, heavy alcohol use, fatty liver disease and other causes can lead to the development of liver cirrhosis and hepatocellular carcinoma (HCC), the most common type of liver cancer. HCC is often detected late and is difficult to treat, as it generally does not respond well to traditional chemotherapy. Opdivo and a similar immunotherapy, Keytruda (pembrolizumab), as well as several targeted therapies, have been approved for HCC treatment in recent years.


Over the past several years, cancer researchers have been investigating the benefits of medical marijuana for a wide variety of cancers, including brain cancer and breast cancer. Now, researchers at Penn State College of Medicine in Hershey, Pennsylvania, say some of the compounds in the drug may help combat colon cancer, a recent press release from the university reports.

The study, which tested the effects of synthetic versions of the cannabinoid compounds found in marijuana on colon cancer cells, suggests that some of them may inhibit the growth of colon tumors. Researchers also tested two other compounds most commonly associated with cannabis—THC and CBD—but those were found to have little to no effect.

For their report, published in the journal Cannabis and Cannabinoid Research, scientists tested how 370 different synthetic cannabinoid compounds affected seven different types of human colon cancer cells. Of these compounds, 10 were found to be effective at stopping cancer cell growth in its tracks. However, researchers remain unsure about how exactly many of these compounds worked to reduce the viability of these dangerous tumors.


People who have undergone cancer treatment often wish that their health care providers had better prepared them for the side effects they experienced.

So finds a national survey of 403 people treated for cancer with radiation therapy within the past five years. The survey was conducted by Public Opinion Strategies on behalf of the American Society for Radiation Oncology (ASTRO) and published in the Journal of Oncology Practice.

"An unfortunate reality of cancer treatment is that therapy also has side effects that can impact a patient’s quality of life,” Reshma Jagsi, MD, DPhil, the senior author of the study and the Newman Family professor of radiation oncology at the University of Michigan, said in a press release. “Nearly all patients in the survey felt confident about their treatment decisions, but a sizable number also expressed a clear need for more information about potential side effects.”

Thirty-seven percent of those who received radiation therapy, 36% of those who received chemotherapy and 34% of those who received surgery to treat their cancer said they would have liked to have received more information about the side effects they experienced. Thirty-eight percent of those who experienced severe side effects reported feeling insufficiently informed, compared with just 4% of those who reported minimal side effects.


In 2016, about 218,000 people were diagnosed with lung cancer. You may know someone with lung cancer—a family member, a friend, a neighbor or a colleague. This November, in recognition of lung cancer awareness month, here are nine incredible ways that you can support lung cancer survivors. (Spoiler: they’re not all that different than ways you would support other cancer survivors.)

1) Listen. Hearing, “You have lung cancer” can be an overwhelming experience. Sit with them as they process the information. Listen as they talk about their plans for treatment and their worries and their hopes.

2) Stay connected. Check in regularly throughout treatment. Ask if they would like a meal train. Offer to help with household errands or rides to appointments.

3) Ask before sharing. If you have a lung cancer story you believe might be helpful, ask before you share, if they’d like to hear your story or what happened with someone else that you may know. Other stories about lung cancer might frighten or minimize the experiences of the survivor you’re talking with.

Read all nine...

Combining an investigational anti-GD2 monoclonal antibody with induction chemotherapy yielded promising two-year event-free survival in pediatric patients with newly diagnosed high-risk neuroblastoma, according to results from a phase II trial published in Clinical Cancer Research, a journal of the American Association for Cancer Research.

Approximately 650 children are diagnosed with neuroblastoma each year in North America, and the disease predominantly affects children under the age of five years. Because the symptoms can be non-specific, about half of patients are diagnosed after the cancer has spread and progressed to high-risk neuroblastoma, according to Wayne L. Furman, MD, member of the Department of Oncology at St. Jude Children’s Research Hospital.

Patients with high-risk neuroblastoma undergo intense treatment that includes chemotherapy, surgery, stem cell transplant, radiotherapy, a biologic agent, and treatment with a monoclonal anti-GD2 antibody called dinutuximab. “Despite the aggressive treatment these kids receive, more than half have disease recurrence,” said Furman.


A healthy gut microbiome—the community of microbes in the intestines—may play an important role in influencing the effectiveness of immune-based cancer treatment, according to recent research.

People with advanced melanoma who respond well to checkpoint inhibitors have more diverse gut bacteria than nonresponders. But that doesn’t mean people about to start immunotherapy should begin taking probiotics, those widely available over-the-counter supplements full of beneficial bacteria. Indeed, the new research suggests that doing so may be worse than useless—it could actually reduce the chances that immunotherapy will work.

“For this reason, we specifically recommend that people undergoing immunotherapy do not take probiotics unless they are specifically called for in a clinical trial,” says Jennifer McQuade, MD, of MD Anderson Cancer Center in Houston.


Adolescents and young adults who acquire HIV around the time of birth are 13 times more likely to develop cancer and nine times more likely to die of any cause, according to research presented at the 22nd International AIDS Conference (AIDS 2018) last week in Amsterdam. The risk was linked to the nadir, or lowest-ever CD4 T-cell count and detectable viral load.

“Most youth with perinatally acquired HIV and a malignancy had a low nadir CD4 count and many years of sustained HIV viremia. It is hoped that early, sustained suppressive antiretroviral therapy will reduce the excess risk of malignancy in this cohort,” the researchers concluded.


Stem cell transplants, also known as bone marrow transplants, are used to treat a number of blood cancers and other disorders. There are two types of stem cell transplants: autologous transplants, in which the transplanted cells are from the patient’s own body, and allogenic, in which the cells are from a donor. The type of transplant used depends on the disease that is being treated.

In a recent Facebook Live Q&A, Edwin Alyea, MD, associate director of Dana-Farber Cancer Institute’s Stem Cell Transplant Program, and his patient, Don Lewis, explained the procedure—which involves transplanting healthy stem cells from one individual to another, or using an individual’s own stem cells.


Brain cancer is a relatively uncommon type of cancer, accounting for only 1 percent of new cancer diagnoses. More commonly, brain tumors arise because a patient’s cancer has metastasized, or spread, from other primary tumor(s).

The most common cancer in adults that originates in the brain is glioblastoma, which is characterized by the uncontrolled proliferation of glial cells, known as the “supporting cells” of the nervous system. Traditionally, metastatic brain tumors and brain cancer have been treated with surgery and radiation and/or chemotherapy, but researchers are investigating other therapies in the hopes of increasing survivorship and life expectancy.


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