How Can We Unleash the Immune System?

Excerpt:

“Cancer has an insidious talent for evading the natural defenses that should destroy it. What if we could find ways to help the immune system fight back?

“It has begun to happen. The growing field of immunotherapy is profoundly changing cancer treatment and has rescued many people with advanced malignancies that not long ago would have been a death sentence.”

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Vitamin D and Fish Oils Are Ineffective for Preventing Cancer and Heart Disease

Excerpt:

“In recent years, many Americans have embraced vitamin D and fish oil pills, their enthusiasm fueled by a steady trickle of suggestive research studies linking higher levels of vitamin D with lower rates of cancer and other ills, and fish consumption with reduced heart disease.

“Now a large and rigorous government-funded randomized trial — the only such study of omega-3 fish oils ever carried out in healthy adults, and the largest trial ever done of high-dose vitamin D — has found the supplements do not lower cancer rates in healthy adults. Nor do they reduce the rate of major cardiovascular events, a composite of heart attacks, strokes and deaths from cardiovascular disease. The trial is of the kind considered the gold standard in medicine.”

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Prostatectomy Plus Radiotherapy May Improve Survival in Advanced Prostate Cancer

Excerpt:

“Patients who underwent primary radical prostatectomy followed by radiotherapy for locally or regionally advanced prostate cancer had better survival outcomes than patients treated with radiotherapy plus androgen deprivation therapy, according to findings from a population-based, retrospective study published in Cancer.

” ‘There is a lot of debate about whether to remove the whole prostate and follow-up with radiation therapy or, as a second option, spare the prostate and treat it using radiation therapy plus hormone-blocking therapy,’ Grace Lu-Yao, PhD, associate director of population science at the Sidney Kimmel Cancer Center at Jefferson Health, said in a press release. ‘Our study suggests that removing the prostate followed by adjuvant radiotherapy is associated with greater OS in men with prostate cancer.’ ”

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The Link Between Apalutamide and QOL in Non-Metastatic CRPC

Excerpt:

“Adding apalutamide to androgen deprivation therapy (ADT) does not appear to harm health-related quality of life (HRQOL) in men with nonmetastatic castration-resistant prostate cancer (CRPC), according to new research published in Lancet Oncology.

“Previous research has showed that men in this patient population who received apalutamide had longer metastasis-free survival and a longer time to symptomatic progression compared with those who received placebo. This new study found that adding apalutamide still preserves HRQOL. Specifically, the group mean patient-reported outcome scores over time demonstrated HRQOL was maintained from baseline (initiation of apalutamide), and it was similar over time among men receiving apalutamide versus placebo.”

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Groups Endorse Shorter RT for Prostate Cancer

Excerpt:

“Hypofractionated external beam radiation therapy (EBRT) for early prostate cancer represents a reasonable alternative to standard treatment protocols involving lower doses of radiation administered over a longer period of time, according to a new clinical guideline.

” ‘Moderately hypofractionated’ EBRT regimens result in similar disease control and side effects as compared with conventional protocols, although the shortened regimens confer a small risk of more short-term gastrointestinal toxicity. Additionally, physicians should counsel patients about the limited data on oncologic outcomes beyond 5 years of follow-up, according to a panel representing the American Society for Radiation Oncology, American Society of Clinical Oncology, and American Urological Association.”

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Accuracy and Precision Define Radiation Oncology

A Q&A with Eddy Yang, MD, PhD, Professor and Vice Chair of Translational Sciences Department of Radiation Oncology; Deputy Director, Associate Director of Precision Oncology at the Hugh Kaul Precision Medicine Institute; Birmingham, AL; shyang@uabmc.edu

Originally published December 5, 2017

Q: You are a radiation oncologist with a particular interest in cancer of the prostate. How does the molecular study of prostate, as well as other cancers, including Next Generation Sequencing (NGS), help inform Precision Radiation Oncology?

A: Radiation oncology is a specialty where the accuracy and precision of treatment delivery is vital to the safety and outcomes of our patients. Many specialized techniques are utilized to enhance this precision, including intensity modulated radiation therapy, image-guided radiation therapy, and volumetric arc therapy. Emerging modalities such as proton and carbon therapy take advantage of the physics of heavy ions to potentially minimize normal tissue toxicity. With these methods, we are in essence, performing precision oncology, tailoring radiotherapy to each individual patient. However, precision oncology is much more than that, as novel technologies have expanded our understanding of the drivers of cancer that may be targetable or dictate response to treatment. Currently, emerging evidence has shown the benefits of biomarker-directed systemic treatments, but what about genomic markers to guide radiation therapy? Although the preclinical and retrospective data supports the notion of this possibility, results from prospective studies are not yet available. Continue reading…


What to Expect When Active Surveillance Leads to Prostatectomy

Excerpt:

“A high proportion of men who entered active surveillance for early prostate cancer had one or more high-risk disease characteristics when they subsequently had radical prostatectomy, a Swedish study showed.

“Medical records showed that 52 of 132 men had at least one adverse pathology feature at radical prostatectomy. All the men initially opted for active surveillance, and the median time from enrollment to surgery was 1.9 years.”

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Apalutamide Maintains Health-Related QoL in Nonmetastatic CRPC

Excerpt:

“Treatment with apalutamide (Erleada) was not associated with a significant impact on health-related quality of life (HRQoL) in patients with high-risk nonmetastatic castration-resistant prostate cancer, according to patient-reported outcome (PRO) data from the phase III SPARTAN trial.

“In the study overall, patients treated with the addition of apalutamide to standard hormone therapy also had an improvement in metastasis-free survival (MFS) and longer time to symptomatic progression compared with those who were treated with placebo.”

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ASCO and Friends Submit Recommendations to FDA Aimed at Reducing Barriers to Clinical Trial Participation

Excerpt:

“ASCO and Friends of Cancer Research (Friends) have submitted recommended language to the U.S. Food and Drug Administration (FDA) for five guidance documents on ways to broaden eligibility criteria for cancer clinical trials. The recommendations are part of an ASCO and Friends collaboration to broaden eligibility for participating in clinical trials by addressing five specific areas: minimum age requirements for trial enrollment, HIV/AIDS status, brain metastases, organ dysfunction, and prior and concurrent malignancies.”

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