Young Breast Cancer Patients Undergoing Breast Conserving Surgery See Improved Prognosis

Excerpt:

“A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery. The analysis included 1331 patients younger than 40 years treated with breast conserving surgery and whole breast radiotherapy in a single cancer centre in Italy between 1997 and 2010.

“Breast cancer recurrences and deaths significantly decreased over time. A dramatic improvement in prognosis was observed after 2005, when the use of several new diagnostic and  were implemented in routine clinical practice.”

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New Insights on Lung Cancer in Younger Patients


Lung cancer in young people—in particular, non-small cell lung cancer (NSCLC)—is a topic of great interest. It has been made even more so by the recent publication of a study in The Journal of the American Medical Association (JAMA) that analyzed over 2,000 NSCLC patients of all ages and resulted in two major conclusions: First, that younger patients (less than 40 years old) have a higher frequency of targetable mutations. Second, that they have relatively poor survival when compared to older patients, except those older than 70 years. Continue reading…


Older Early-Stage NSCLC Patients Benefit From Adjuvant Chemotherapy

“A retrospective study found that early-stage non–small-cell lung cancer (NSCLC) patients over 70 years old derive a similar benefit as younger patients from adjuvant chemotherapy following surgical resection. This suggests that age should not preclude patients from receiving adjuvant chemotherapy.

“ ‘Studies conducted in the last decade have provided evidence that adjuvant chemotherapy after surgical resection improves outcomes for patients with resected stages II and IIIA disease and selected patients with stage I (large tumor size) NSCLC,’ wrote study authors led by Apar Kishor Ganti, MD, of the University of Nebraska Medical Center in Omaha. These studies, however, have not focused specifically on elderly patients, and NSCLC has a median age of 70 years at diagnosis.

“The new study was a population-based retrospective review of 7,593 patients with stage IB to stage III NSCLC who underwent surgical resection; 2,897 (38%) were aged at least 70 years. Results of the study were published online ahead of print in Cancer.

“Among the younger patients, 31.6% received adjuvant chemotherapy, while only 15.3% of the older patients received this treatment (P .0001). Both groups saw changes in rates of adjuvant chemotherapy over time, though of different magnitudes: 9.3% of younger patients diagnosed between 2001 and 2003 received adjuvant chemotherapy, which rose by 27.8% by 2009 to 2011. In older patients, the rate was 4.5% in the earlier period and increased by 16.0%. The most common chemotherapy option used in all patients (64.6%) was carboplatin-based doublets.”


More Americans Surviving Cancer Today than 20 Years Ago

“Survival rates are improving for many people with cancers of the breast, prostate, lung, liver and colon or rectum, especially for those diagnosed at younger ages, a new study reports.

“Cancer is still a leading cause of death in the United States, but advances in radiation, chemotherapy and targeted treatments have improved , the researchers said.

” ‘Although for most cancers have improved over the past few decades, the improvements were less remarkable among elderly ,’ said lead researcher Dr. Wei Zheng, co-leader of the Cancer Epidemiology Research Program at the Vanderbilt-Ingram Cancer Center in Nashville.

“The study also found differences in survival based on race. Overall, blacks had poorer survival than whites. Black women with ovarian cancer experienced a decrease in survival over the past two decades for unknown reasons, he said.

” ‘Black Americans experienced poorer survival than whites for all cancers during the study period,’ Zheng said.”


Counseling Needed to Allay Fear of Lymphedema in Breast Cancer Survivors

“Individualized education and counseling should begin before surgery and continue throughout treatment for breast cancer survivors fearful of developing lymphedema, especially younger patients and those at higher risk after axillary lymph node dissection (ALND), a recent study found.

“More than 300 patients undergoing treatment for unilateral breast cancer were screened for lymphedema before and every 3 to 8 months after surgery and asked to fill out questionnaires assessing their fear. Higher preoperative fear score, age younger than 50 at diagnosis, and ALND were significantly associated with higher mean postoperative fear scores. The findings were published in the September issue of Oncology Nursing Forum.

“ ‘If and when fear of lymphedema is identified, nurses should evaluate whether that fear generates appropriate proactive behavior to prevent lymphedema or whether it negatively affects the survivor’s physical or mental state,’ the authors wrote. ‘In the latter case, such fear should alert nurses to counsel, educate, reassure, support, and reassess the patient on an ongoing basis.’

“The findings indicate that lymphedema—characterized by abnormal accumulation of fluid in the interstitial spaces of the arm, hand, shoulder, breast, or chest wall—is  distressing to many women regardless of whether or not they develop the condition, the authors said. In addition to physical symptoms such as swelling, heaviness and discomfort, and an increased risk of infection, many women experience psychological distress leading to poor body image, lower self-esteem, and increased anxiety.”


Reducing the Risk of Melanoma in Young Men

Young men are 55% more likely to die of melanoma than young women, according to a recent study that followed more than 25,000 white adolescents and young adults with melanoma. About 95% of skin melanomas occur in non-Hispanic whites. The disparity between the sexes held across melanomas matched for thickness, suggesting a biological basis. But even so, young men can reduce their risk with sun protection and skin checks. Another large study suggested that using sunscreen regularly could cut the incidence of melanoma by half. In addition, men are less likely to get skin checks and young adults are less likely to go to doctors, period. Dermatologists recommend professional skin exams for people with changing moles or ‘ugly duckling’ moles, which don’t match the others. Ugly duckling moles tend to grow up, can be small and uniform in color, and may bleed.


Cancer Patients Want to Be More Involved in Treatment Decisions

Some cancer patients feel that they do not have enough say in their treatment decisions, a recent survey from the UK reveals. While 70% of respondents felt satisfied with their level of involvement, patients with certain rarer cancer types expressed a wish for more participation in treatment decisions, including those with rectal, ovarian, multiple myeloma, and bladder cancers. The desire for greater involvement was also more common in younger patients and ethnic minorities. While the survey was performed in the UK, similar issues are likely to affect patients in other countries, including the U.S. Several U.S. states have recently introduced legislation to support shared medical decision-making.


Cancer Patients Want to Be More Involved in Treatment Decisions

Some cancer patients feel that they do not have enough say in their treatment decisions, a recent survey from the UK reveals. While 70% of respondents felt satisfied with their level of involvement, patients with certain rarer cancer types expressed a wish for more participation in treatment decisions, including those with rectal, ovarian, multiple myeloma, and bladder cancers. The desire for greater involvement was also more common in younger patients and ethnic minorities. While the survey was performed in the UK, similar issues are likely to affect patients in other countries, including the U.S. Several U.S. states have recently introduced legislation to support shared medical decision-making.


Cancer Patients Want to Be More Involved in Treatment Decisions

Some cancer patients feel that they do not have enough say in their treatment decisions, a recent survey from the UK reveals. While 70% of respondents felt satisfied with their level of involvement, patients with certain rarer cancer types expressed a wish for more participation in treatment decisions, including those with rectal, ovarian, multiple myeloma, and bladder cancers. The desire for greater involvement was also more common in younger patients and ethnic minorities. While the survey was performed in the UK, similar issues are likely to affect patients in other countries, including the U.S. Several U.S. states have recently introduced legislation to support shared medical decision-making.