Surgery May Be Best for Advanced Melanoma

Excerpt:

“Surgery to remove melanoma—the deadliest form of skin cancer—can extend the lives of patients whose disease has spread to the abdomen area, new research suggests.

“Patients who get and to remove their cancer live twice as long—18 months on average—as those who only get medication, researchers found.

” ‘Now that there are better options systemically, the decision-making about treatment has become more complex. Having this data available could potentially impact discussions about treatment and benefit long-term,’ said study leader Dr. Gary Deutsch, a cancer surgeon at Northwell Health in Great Neck, N.Y.”

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When the Doctor Recommends Against the Surgery a Breast Cancer Patient Wants

Excerpt:

“More women with breast cancer are electing to have both breasts removed, even when cancer affects only one breast. The procedure, called contralateral prophylactic mastectomy (CPM), is a more complex surgery that has not been shown to improve survival.

“A new study from the University of Michigan Comprehensive Cancer Center examines the complex interaction between patients’ desires for the most extensive and surgeons’ responsibility to minimize harm.

“The population-based survey, published in JAMA Surgery, found that few patients sought a second opinion or went to a different hospital when their surgeon recommended against CPM. Further, patients were overwhelmingly satisfied with their treatment, even when their surgeon dismissed CPM with little discussion.”

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More Women With Breast Cancer Opt to Remove Healthy Breast

Excerpt:

“One in three breast cancer patients under 45 removed the healthy breast along with the breast affected by cancer in 2012, a sharp increase from the one in 10 younger women with breast cancer who had double mastectomies eight years earlier, a new study reports.

“The rate is especially high in some parts of the country, the study in JAMA Surgery found. Nearly half of younger women in five neighboring states — Nebraska, Missouri, Colorado, Iowa and South Dakota — had double mastectomies in 2010-12. Women often remove the healthy breast so they don’t have to worry about developing another cancer, even though there is no evidence that removing the healthy breast extends lives.”

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Chemo Benefit Unclear in Breast Cancer Patients With Higher Recurrence Scores

Excerpt:

“In patients with hormone receptor–positive, HER2-negative, lymph node–negative breast cancer with a recurrence score (RS) based on a 21-gene expression assay of 11 to 25, outcomes were similar whether chemotherapy was used or not used, according to a retrospective analysis. However, the study’s limited follow-up means a benefit from chemotherapy in these patients cannot be ruled out.

“The Oncotype DX 21-gene expression assay is the most commonly used test of this kind in breast cancer in the United States. It offers an RS, and previous research has shown that patients with an RS below 11 fare very well when treated with endocrine therapy alone. ‘To our knowledge, it is unknown whether chemotherapy provides any additional benefit in outcomes in patients with hormone receptor–positive, HER2-negative, lymph node–negative, early-stage breast cancer with an RS of 11 to 25 who are treated with endocrine therapy,’ wrote study authors led by Carlos H. Barcenas, MD, MSc, of the University of Texas MD Anderson Cancer Center in Houston.”

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Four New Studies of Oncotype DX® Genomic Prostate Score™ (GPS) Reconfirm Value of Test in Guiding Early-stage Prostate Cancer Risk Assessment and Treatment Selection

Excerpt:

“Genomic Health, Inc. (GHDX) announced today the presentation of results from four studies evaluating the clinical value and utility of its Oncotype DX® Genomic Prostate Score (GPS) in the management of early-stage prostate cancer. Collectively, these new data highlight the test’s ability to predict disease aggressiveness and refine risk stratification across National Comprehensive Cancer Network (NCCN) clinical risk groups.

” ‘We now have 22 clinical studies, involving more than 4,200 prostate cancer patients, that distinguish Oncotype DX as the only test developed specifically for men who are deciding between active surveillance or definitive treatment. The test is validated to provide individualized information about both the current state and future risk of patients’ prostate cancer,’ said Phil Febbo, M.D., chief medical officer, Genomic Health. ‘Together with the recently published economic analysis demonstrating substantial cost savings of more than $2,200 per patient tested, the data presented will support increased adoption and reimbursement of Oncotype DX as physicians aim to bring precision medicine to their prostate cancer patients.’ “

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More Patients with Early-Stage Breast Cancer May Be Able to Avoid Chemotherapy in the Future

Excerpt:

“Women with early-stage breast cancer who had an intermediate risk recurrence score (RS) from a 21-gene expression assay had similar outcomes, regardless of whether they received chemotherapy, a new study from The University of Texas MD Anderson Cancer finds.

“The encouraging research, published in the journal CANCER, still needs to be validated in an ongoing international trial. If verified, women with intermediate scores may one day be able to avoid chemotherapy as standard of care.”

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Super Patient: Peter Fortenbaugh Faces the Uncertainty of Pioneering Melanoma Treatment


In spring of 2014, Peter Fortenbaugh noticed what appeared to be a tick that had bitten his lower calf. “It turned out not to be a tick, but it didn’t really go away,” he says.

The spot began to grow and bulge, and in October, Peter showed it to his primary care doctor, who referred him to a dermatologist to remove it. At the time, Peter recalls, it did not occur to him that the growth could be serious.

“I was actually very concerned about skin cancer because I spent a lot of time out in the sun sailing,” Peter says. “I put on a tremendous amount of sunscreen and protection, but never on my legs…I never connected the dots.”

However, a biopsy of the growth came back positive for melanoma. Peter, who lives in Palo Alto, California, with his wife and three children, immediately reached out to several doctors in the San Francisco Bay Area, and all had the same advice: “Take it out, take a biopsy.” Continue reading…


Some Early Breast Cancer Patients Benefit More from Breast Conservation Than from Mastectomy

Excerpt:

“Breast conserving therapy (BCT, breast conserving surgery combined with radiation therapy) is superior to mastectomy in certain types of breast cancer patients, according to results from the largest study to date, to be presented to the European Cancer Congress 2017 today (Monday).

“Professor Sabine Siesling, from the Netherlands Comprehensive Cancer Organisation (IKNL) and University of Twente and Mirelle Lagendijk, MD, from the Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands, and colleagues from other hospitals, studied survival nationwide in nearly 130,000 , divided into two groups: those diagnosed between 1999-2005 and those diagnosed between 2006-2012. The patients selected from the Netherlands Cancer Registry had no metastases (spread of the cancer to organs other than the lymph nodes close to the tumour). To obtain information on cause of death, data were linked to the cause of death register.”

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New Marker May Identify Men Who Require More Aggressive Prostate Cancer Treatment

Excerpt:

“A prostate-specific antigen (PSA) nadir (the lowest level a PSA drops following treatment) greater than 0.5 ng/mL following radiation and androgen deprivation therapy seems to identify men prior to PSA failure who are at high-risk for death, and would thus require more aggressive treatment for their prostate cancer, according to the results of a recent study in JAMA Oncology.

“The study looked at data from a randomized trial of 206 men treated with either radiation or radiation plus 6 months of hormonal therapy and compared early markers of prostate cancer death to identify men at risk of dying early.”

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