New Study Provides BRCA Mutation Carriers Guidance for When Surgery Has Greatest Impact

Excerpt:

“Of the women who carry the mutated BRCA1/2 genes, 45-65 percent will develop breast cancer, and 15-39 percent will develop ovarian cancer in their lifetimes. Many women, especially those who have experienced the death of family members to these cancers, elect to undergo preventive surgeries that can significantly increase life expectancy, but require extensive recovery time and can impact later fertility and quality-of-life. However, few guidelines exist that shed light on the optimal age to undergo these procedures, and in what sequence. A new study in the INFORMS journal Decision Analysis provides insight to help enable physicians and patients make better-informed choices.

“The study, ‘Was Angelina Jolie Right? Optimizing Cancer Prevention Strategies Among BRCA Mutation Carriers,’ was conducted by Eike Nohdurft and Stefan Spinler of the Otto Beisheim School of Management, and Elisa Long, of the UCLA Anderson School of Management.”

Go to full article.

If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our ASK Cancer Commons service.


Timing of Surgery After Neoadjuvant Chemoradiation in Stage IIIA NSCLC Impacts Overall Survival

Excerpt:

“The timing of surgery after neoadjuvant chemoradiation in patients with stage IIIA non-small cell lung cancer (NSCLC) affects the overall survival of patients receiving trimodality therapy.

“Approximately one third of all NSCLC patients have locally advanced (stage III, subtypes IIIA and IIIB) disease at the time of diagnosis, with a five-year survival ranging from 7 to 19%. Patients with stage III NSCLC represent a significant clinical challenge due to the poor prognosis associated with this stage of the disease. Trimodality therapy involving the use of radiation concurrently with chemotherapy, otherwise known as neoadjuvant chemoradiation therapy (NCRT), followed by surgery is an acceptable treatment strategy for stage IIIA patients with resectable tumors and limited mediastinal node (N2) involvement. However, trimodality therapy has not been shown to have significant survival advantage over definitive chemoradiation therapy and the optimal interval to surgery (ITS) after completion of NCRT has not been well explored.”

Go to full article.

If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Lifeline service.


HYPRO: Shorter RT Course No Better, Worse in Localized Prostate Cancer

Excerpt:

“A randomized phase III trial found that a hypofractionated radiotherapy (RT) regimen was not superior to, but generally equivalent to a conventional RT scheme in men with localized prostate cancer. The study joins a growing body of literature on hypofractionation in this malignancy, generally showing that the shorter courses are a reasonable option.

“A low α-β ratio for prostate cancer has generated interest in hypofractionation, as it could increase the tumor dose without increasing toxicities. ‘Moreover, hypofractionated radiotherapy is delivered in fewer fractions, improving patients’ convenience, hospital logistics, and possibly reducing healthcare costs,’ wrote study authors led by Luca Incrocci, MD, PhD, of Erasmus Medical Center Cancer Institute in Rotterdam, the Netherlands.

“A study was presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago that found a hypofractionated regimen of 60 Gy in 20 fractions was noninferior to conventional RT. Another, presented this past January at the ASCO Genitourinary Cancers Symposium, again found a 60 Gy/20 fractions regimen was noninferior to conventional RT and to another hypofractionated regimen of 57 Gy/19 fractions.”

Go to full article.

Do you have questions about this story? Let us know in a comment below. If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Ask Cancer Commons service.


Delays in Radiation Therapy Increase Chance of Breast Tumor Development in Women Treated for Ductal Carcinoma in Situ

Excerpt:

“Women who underwent treatment for ductal carcinoma in situ (DCIS), a noninvasive breast abnormality, were at higher risk of developing malignant breast tumors if they did not receive timely radiation therapy as part of their treatment, according to a study presented here at the AACR Annual Meeting 2016, April 16-20.

“DCIS is the most common premalignant breast lesion, with over 60,000 women diagnosed each year. Not all DCIS will develop into invasive cancer, but because it is difficult to predict which cases will become cancerous, most women diagnosed with DCIS undergo treatment for it.

“ ‘According to the National Comprehensive Cancer Network guidelines, primary treatment options for DCIS include breast-conserving surgery plus radiation, total mastectomy, and breast-conserving surgery alone,’ said the study’s lead author, Ying Liu, MD, PhD, instructor of surgery at Washington University School of Medicine and a research member at Siteman Cancer Center in St. Louis, Missouri. ‘This study shows that it is important for women to understand the benefits of timely receipt of radiation therapy after breast-conserving surgery.’ ”

Go to full article.

Do you have questions about this story? Let us know in a comment below. If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Ask Cancer Commons service.


Early Chemotherapy Improves Survival for Men with Prostate Cancer

“Two papers from UCL show that having early chemotherapy improves survival for men with prostate cancer. The papers, published in the Lancet and Lancet Oncology, report the results from the STAMPEDE clinical trial and a meta-analysis.

“Both papers looked at the use of a chemotherapy drug called docetaxel. Docetaxel is already used for men with prostate cancer once hormone therapy has stopped working. In STAMPEDE and the meta-analysis, the researchers looked at using it earlier, when men are starting long-term hormone therapy. Both studies found that adding docetaxel improved survival for these men.

“The studies also looked at whether the drug zoledronic acid improves survival. Zoledronic acid is used to reduce the risk of bone problems in men whose cancer has spread to their bones, and whose hormone therapy has stopped working. The new studies looked at using it earlier, when men are starting long-term hormone therapy. Both studies found that adding zoledronic acid did not improve survival for these men.”


Early Initiation of Chemotherapy May Prolong DFS for Early Breast Cancer

“Shorter time to initiation of adjuvant chemotherapy may reduce relapse and improve outcomes in patients with rapidly proliferating early breast cancer, according results of a phase 3 study.

“Earlier chemotherapy may improve OS and DFS in patients with certain subtypes of breast cancer that are rapidly proliferating and aggressive, such as triple-negative or HER-2–positive disease.

“Alberto Farolfi, a medical oncologist in training at the Scientific Institute of Romagna for the Study and Treatment of Cancer in Meldola, Italy, and colleagues sought to examine the influence of time to chemotherapy on the outcome of these patients and to set a threshold value for time to chemotherapy to better define the clinical outcome.”


Two-Drug Combination Boosts Survival in Metastatic Prostate Cancer

“Newly diagnosed patients with metastatic, hormone-sensitive prostate cancer gained a dramatic survival benefit when started on two drugs simultaneously, rather than delaying the second drug until the cancer began to worsen, according to results of a clinical trial led by a Dana-Farber Cancer Institute scientist.

“Patients who underwent six cycles of treatment with the chemotherapy drug docetaxel along with a hormone blocker survived for a median of 57.6 months, more than a year longer than the median 44-month survival for men who received only the hormone-blocker, according to a report in The New England Journal of Medicine. The immediate combination also prolonged the period before the cancer began to worsen – a median of 20.2 months versus 11.7 months with the single agent.

“The multi-center, phase III trial, involving 790 patients, ‘is the first to identify a strategy that prolongs survival in men newly diagnosed with metastatic, hormone-sensitive prostate cancer,’ said Christopher J. Sweeney, MBBS, of Dana-Farber’s Lank Center for Genitourinary Oncology. He said the results of the multi-center phase III trial should change the way doctors have routinely treated such patients since the 1940s.”


Delay in Treatment, Missed Diagnostic Testing Found Among Lung Cancer Patients

“Patients undergoing surgery for lung cancer may wait too long to receive treatment, and too many patients skip vital diagnostic steps that are needed to help determine the best possible treatment, according to an article in the August 2015 issue of The Annals of Thoracic Surgery.

“The 5-year relative survival of all patients diagnosed with lung cancer in the United States is approximately 17%, according to the National Cancer Institute, and has changed little in the last 30 years. Fewer than half of all patients who undergo surgery for lung cancer survive as long as 5 years.

“Nicolas Faris, MDiv and Raymond Osarogiagbon, MBBS led a group of researchers from Baptist Cancer Center and the University of Memphis in Tennessee, who reviewed hospital records for all patients who underwent surgery for suspected lung cancer at Baptist Memorial Hospital between January 2009 and June 2013. Using only patients who had surgery for suspected lung cancer, the researchers examined how long it took to begin care and what steps were taken to determine appropriate treatment.”


(Video) Dr. Saad on Radium-223 in Patients with mCRPC

“Fred Saad, MD, FRCS, professor, Department of Surgery, University of Montreal, discusses the use of radium-223 for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC).

“The approved indication for radium-223 is in patients with metastatic disease to the bone, but no visceral disease. Patients should also demonstrate symptoms, though they do not need to be in significant pain, Saad explains. If patients wait too long to seek treatment, they are less likely to receive all six cycles of treatment and the added survival benefit.

“Researchers have not witnessed negative effects associated with administering radium-223 into earlier lines of therapy, Saad says. Compared with other treatments, few adverse events occurred with radium-223 in the international early access program. The treatment is also said to be well-tolerated regardless of disease stage.”