Breast Cancer Survivors Who Experience Pain During Intercourse May Benefit from Lidocaine Treatment

Scientists at Oregon Health & Science University report that breast cancer survivors who experience pain during sexual intercourse, a common side effect of breast cancer treatment, may achieve comfort when liquid lidocaine is applied strategically to prevent pain. Their research was published online today in the Journal of Clinical Oncology.

“ ‘The physical and psychological consequences for the more than 2.8 million breast cancer survivors in the U.S. are very real and often misunderstood, or not treated,’ said Martha F. Goetsch, M.D., M.P.H., adjunct assistant professor in the OHSU Department of Obstetrics and Gynecology, the study’s lead author. ‘This noninvasive treatment will offer distinct help in alleviating the physical — and quite frankly the emotional — pain associated with sexual intercourse, making sexual function more enjoyable and fulfilling for them and their partner.’

“It is estimated that anywhere from 70 to 100 percent of breast cancer survivors, including those treated at OHSU Knight Cancer Institute, experience some sort of sexual dysfunction, including dyspareunia, which is the clinical term for pain during sexual intercourse. Breast cancer survivors are especially vulnerable to the condition because their treatment is focused on eradicating estrogen. This increases the severity of the typical menopausal symptom of pain with sex. A high proportion of women in menopause who have not had breast cancer also suffer from what is now termed vulvovaginal syndrome of menopause where estrogens decline.”


Benefit of End-Stage Chemotherapy Is Questioned

“It is an excruciating question for cancer patients with a prognosis of only months to live. Should they try another round of chemotherapy?

“Guidelines for oncologists say no for very sick patients, those who are often bedridden and cannot handle most daily needs themselves. But for patients who are more self-sufficient, chemotherapy is considered a reasonable option. Despite its well-known toxic side effects, many end-stage patients and their doctors have considered chemotherapy worth trying, believing it may ease discomfort or buy time.

“Now, a study suggests that even those stronger patients may not benefit from end-of-life chemotherapy — and that for many their quality of life may worsen in their final weeks compared with patients who forego last-ditch treatment.

“ ‘It worsened quality of life for those that are relatively healthy, and those are the ones that the guidelines support treating,’ said Dr. Charles Blanke, a medical oncologist at Oregon Health and Science University, who was not involved in the study. ‘Chemotherapy is supposed to either help people live better or help them live longer, and this study showed that chemotherapy did neither.’ “


Data Shows Disconnect Between Healthcare Professionals and Patient Perceptions of Impact of Chemotherapy and Radiotherapy-Induced Nausea and Vomiting

“Norgine B.V. has presented new data highlighting a perceptual gap between healthcare professionals and patients in terms of the incidence and impact on patients’ daily life of chemotherapy and radiotherapy induced nausea and vomiting (CINV/RINV).

“These data were sponsored by Norgine and presented at the joint Multinational Association of Supportive Care in Cancer (MASCC) / International Society of Oral Oncology (ISOO) 2015 Annual Meeting.

“The data demonstrate that physicians and oncology nurses overestimate the incidence of CINV/RINV, but underestimate the impact of the condition on patients’ daily lives (p1

“In addition, just 38% of patients reported full compliance with physicians’/nurses’ guidelines when self-administering anti-emetic medication, compared with 60% estimated by physicians and nurses. Leading factors given for poor patient compliance included reluctance to add to a pill burden and fear that swallowing itself would induce nausea/vomiting.”


Important New Research on Early Palliative Care for Advanced Cancer Patients Published

“Researchers at Trinity College Dublin and Mount Sinai in New York have just published new research which for the first time provides strong evidence on the economic benefits of early palliative care intervention for people with an advanced cancer diagnosis. Their findings were published today in the highly esteemed international peer reviewed Journal of Clinical Oncology.

“Previous research has shown the clinical benefits of early palliative care, but this new study robustly demonstrated how early access to expert palliative care decision making resulted in very significant cost reductions of up to 24%. The intervention reduced both the length and intensity of hospital stay for patients with advanced cancer.

“The researchers from Trinity’s Centre for Health Policy and Management and Mount Sinai’s Icahn School of Medicine, led by Peter May, HRB Economics of Cancer Fellow at Trinity, studied over 1000 patients’ pathways of care in five major US hospitals and looked at costs associated with their care based on whether they saw a specialist palliative care consultation team or received standard hospital care.”


Study Supports Early Intervention for Prostate Cancer Patients Who Experience Significant Emotional Distress

“A study led by the University at Buffalo and Roswell Park Cancer Institute has identified beliefs and personality traits that are associated with higher levels of distress in newly diagnosed prostate cancer patients.

“The findings support the value of emotional and informational support for patients and perhaps early counseling for some who are the most distressed.

“Factors that were associated with greater distress included a lack of confidence in deciding how to treat the cancer, being concerned that the cancer will progress, feeling that one’s masculinity was under threat and tendencies to be less optimistic and resilient.

“The study, ‘Factors Associated with Emotional Distress in Newly Diagnosed Prostate Cancer Patients,’ was first published online in Psycho-Oncology in January 2015. The results are from a larger longitudinal study of prostate cancer patients, ‘Live Well Live Long!’ The research was based on assessments of 1,425 men newly diagnosed with prostate cancer at five different centers.”


When Pain Persists After Breast Cancer Surgery

“I could hear the anxiety in my sister’s voice. A week after her double mastectomy and breast reconstruction for breast cancer, she had developed a burning sensation under her right arm where her surgeon had removed several dozen lymph nodes for a postoperative biopsy. The throbbing and itching were so intense it felt ‘like poison ivy lit by a blowtorch.’ ”

“The physician assistant at her reconstructive surgeon’s office told her it was probably “neuropathic in origin” — probably arising from nerve damage during surgery — and that the condition, known as postmastectomy pain syndrome, or PMPS, would subside over time. And luckily for my sister, five weeks out from surgery, the pain began to wane.

“But for many of the estimated 20 to 50 percent of women who develop pain after a mastectomy, it may never go away.”


Living With Cancer: Keep On Cooking

“Julia put a glass jar of turkey-tail mushrooms on the restaurant table. Drinking home-brewed tea helps her combat the side effects of treatment. The day before a blood test — which would reveal whether or not an experimental drug was working — I placed one delicate bit on the center of my palm. The ridged striations and concentric ruffles reminded me of the tiny angel-wing shells that Leslie’s partner had collected on Sanibel Island for our cancer support group.

“When I put down the mushroom to pick up a menu, nothing on it resembled the foods I had been enjoined to eat at a cancer conference I had just attended.

“Next to the podium a speaker stood beside a blender in which she put almond milk, half of an avocado, a banana and flax seeds. Conference participants were told to eat fresh fruits and vegetables, to abstain from sugar and dairy and meat. We were urged to avoid white foods and instead to consume dark greens, bright oranges, vivid reds and glowing yellows. Raw and organic are the way to go, or slow roasted and locally grown. Whole grains should be a staple, but turmeric, garlic and ginger can be added abundantly, along with blueberries, walnuts, wild salmon and especially kale.”


Exercise Offers Cancer Survivors Significant Improvements in Quality of Life

“For many cancer survivors, a better quality of life is as close as the nearest pair of sneakers. That’s because a growing body of research, including two recent studies led by Yale Cancer Center, show that exercise is a powerful way for survivors to improve quality of life.

“The studies were presented at the 2015 Annual Meeting of the American Society of Clinical Oncology in Chicago. The first evaluated the effect of the LIVESTRONG at the YMCA program on cancer survivors who participated in twice-weekly, 90 minute exercise sessions for 3 months at local YMCAs. The other study explored whether home-based exercise programs that encouraged brisk walking could improve fatigue and quality of life for ovarian cancer survivors. Both studies showed exercise to be a potent tool for survivors to improve life in many areas.

“The LIVESTRONG at the YMCA study was conducted by Dr. Melinda Irwin, associate professor of Epidemiology in Yale School of Public Health and associate director of population sciences at Yale Cancer Center; and Dr. Jennifer Ligibel of Dana Farber Cancer Institute. It evaluated 186 participants for quality of life, physical activity and fitness. After 12 weeks, participants were shown to experience significant increases in physical activity (71 percent exercising a minimum of 150 minutes/week vs. 26 percent for the control group); and improvements in both overall quality of life and fitness performance (according to a six- minute walk test). The participants had been diagnosed with stages I-IV of cancer and 50 percent had breast cancer. In addition, at the outset of the program, the majority of the participants had been inactive.”


New Screening Method for Prostate Cancer Recurrence

“The American Cancer Society estimated that 220,800 new cases of prostate cancer will be diagnosed in the United States in 2015. Approximately 27,540 men will die of the disease, accounting for 5 percent of all cancer deaths.

“A common treatment for prostate cancer is a , in which all or part of the is removed. Recent studies have shown that this procedure is often over-prescribed. As early as 2010, the New England Journal of Medicine reported that such a procedure extended the lives of just 1 patient in 48. Side effects from the surgery, including urinary incontinence and impotence, can affect the quality of life of the patient.

” ‘For every 20 surgery procedures to take out the prostate, it is estimated that only one life is saved,’ said Gabriel Popescu, director of the Quantitative Light Imaging Laboratory (QLI) and senior author on the study. ‘For the other 19 people, they would be better left alone, because with removing the prostate, the quality of life goes down dramatically. So if you had a tool that could tell which patient will actually be more likely to have a bad outcome, then you could more aggressively treat that case.’ ”