Breaking Research News from sources other than Breastcancer.org
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Health-care system causing rampant burnout among doctors, nurses
As many as half of all clinicians suffer from the problem, creating risks to patients, malpractice claims and absenteeism, study finds.
Imagine a health-care system in which doctors and nurses are so exhausted and beaten down that many of them work like zombies — error-prone, apathetic toward patients and at times trying to blunt their own pain with alcohol or even suicide attempts.
That is what America's broken health care system is doing to its health workers, according to a 312-page report released Wednesday by the National Academy of Medicine, one of the country's most prestigious medical institutions.
"It's incredibly inefficient, and the workload is unsustainable," said Liselotte Dyrbye, a doctor and researcher at the Mayo Clinic. "The system is built for billing and not taking care of patients."
Wednesday's report outlined a hefty list of needed changes...
https://www.washingtonpost.com/health/2019/10/23/b...
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Seattle Genetics Announces Positive Topline Results from Pivotal Trial of Tucatinib in Locally Advanced or Metastatic HER2-Positive Breast Cancer
10/21/2019
-HER2CLIMB Trial Met Primary Endpoint and Both Key Secondary Endpoints-
-Global Regulatory Strategy Includes NDA Submission to U.S. FDA Planned for First Quarter of 2020-
-Data to be Presented at the 2019 San Antonio Breast Cancer Symposium-
https://investor.seattlegenetics.com/press-release...
{Seattle Genetics Press Release}
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Seattle Genetics Announces Initiation of Phase 3 Clinical Trial of Tucatinib in Combination with Ado-trastuzumab Emtansine (T-DM1, Kadcyla®) for Patients with Advanced or Metastatic HER2-Positive Breast Cancer
10/10/2019
https://investor.seattlegenetics.com/press-release...
{Seattle Genetics Press Release}
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Thanks Lumpie. Good info for us HER2+ people.
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My pleasure, MinusTwo!
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Blame rising cancer overdiagnosis on 'irrational exuberance' for early detection
Here's some good news for a change about cancer: Cancer mortality — the rate of death from cancer — has fallen substantially over the last four decades. There is also, however, some not-so-good news: Cancer incidence — the rate of cancer diagnoses — has been rising. This doesn't reflect increasing dangers in our environment, but a danger in our medical system. Even though overall mortality from cancer is falling, the overall incidence is rising.... overdiagnosis — the diagnosis of cancers not destined to cause symptoms or death. This exuberance began with the observation that patients in whom cancer was detected early lived years longer than those in whom cancer was detected later. The simple inference was that they had benefited from early detection. Many doctors recognized the logical fallacy here, one that has nothing to do with overdiagnosis: If we start the clock earlier in the course of disease, patients will always appear to live longer — even if their time of death is unchanged. These are not epidemics of disease. They are epidemics of diagnosis. Paradoxically, overdiagnosis helps fuel the exuberance for early detection. Survival rates skyrocket either because the clock started ticking earlier or the disease was not destined to cause death. More people appear to be cured. And more survivors — as well as more politicians — advocate for more early detection. Overdiagnosis isn't the only danger caused by early detection. False alarms are another... Early detection is great for the business of medicine.
https://www.statnews.com/2019/10/02/overdiagnosis-...
https://www.nejm.org/doi/full/10.1056/NEJMsr190544...
{The author cautions that early detection in not a panacea. NEJM allows access to a limited number of articles each month for non-subscribers.}
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How Much Money Has Your Doctor Received From Drug Companies?
Use ProPublica's Dollars for Docs database to find out.
article:
https://www.propublica.org/article/dollars-for-doc...
search database:
https://projects.propublica.org/docdollars/
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Researchers uncover dangers of ringing a bell to celebrate 'victory' over cancer
Williams, who led the study while completing his residency in radiation oncology at the Keck School of Medicine of USC, expected the bell to have a positive impact on patients. After all, they rang it in celebration. Instead, people who rang the bell viewed their overall treatment as more distressing than those who didn't...
When he surveyed the patients again after three months, the effect had worsened. Williams speculates that ringing the bell locks in painful memories of treatment through a phenomenon called emotional arousal...
Now Williams, who works in a cancer treatment center in Santa Maria, Calif., encourages his patients — especially those who went through a prolonged and painful treatment regimen — to consider subtle and calm ways to celebrate.
https://news.usc.edu/161762/victory-bell-cancer-treatment-usc-research/
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Lymphedema Bill of Rights - there is legislation to add lymphedema treatment to Medicare. It has not gotten out of committee. This site describes lymhedema, who in congress is on board/who is not, and has links to your representatives, as well as boiler plate statements to include in letters. If Congress keeps getting these, maybe they will start listening. Maybe tie it to voting for a candidate. I wrote a letter, response from my representatives was rather pathetic. https://www.stepup-speakout.org/
Exercise very regularly, if not at the gym, then walk/hike, weights, stretch, swim, x-country ski etc.
Supplements: GAIA turmeric-joint; glucosamine-chondroitin; magnesium glycinate; biotin; potassium-iodine; C; B-complex ; D; Fish oil (but not now). For a year or so after bi-lateral used Juven Nutritional therapy for wound healing with 7g arginine, 7g glutamine for about a year. Often add turmeric to meals. Ran out of fish oil supplement that I liked, other brand caused fish burps, so have not taken for a while
2009 ER+ left breast. 52 yrs. Lumpectomy, Sentinel node removal, negative. Radiation 6 weeks, tamoxifen 5 years. Dense lumpy left breast, normal right. Acupuncture offered at facility as part of integrative medicine. It really helped with anxiety/stress during radiation treatment.
2016 ER+ left breast. Probably a new cancer, but unknown. 4 rounds TC Aug-Oct 2016, Bi-lateral (my choice) Nov 2016, no reconstruction. 2 sentinel nodes remove, negative. Cold Capping using Chemo Cold Caps (DIGNICAP not available). Anastrozole 1 mg starting May 2017. Joint issues noticed immediately. Stopped Anastrozole after 3-4 months due to joint stiffness in. After several months of no AIs, fingers were feeling better. Started tamoxifen March 2018
10/2018 noticed stiffness and some trigger finger again. Was eating meat a lot more (daily) than normal. Usually 1-2 /wk. Have cut way back on the meat, seems to help, but one finger still very prone to trigger finger. Trigger finger seemed to be getting better, but now 4/2019 seems worse, is it the break from added turmeric to meals?
7/19/2019 - swelling in R-arm, opposite side from where lymph nodes removed. Noticed 6/18/2019. Could have been swelling earlier but wearing long sleeves. Trip to urgent care. They did ultrasound, concerned that there might be a clot, there was not. Started seeing lymphatic therapist 7/2/2019.
8/2019 CT, Breast/chest , neck/thyroid ultra sound
9/2019 DR ordered biopsy, said it could be lymphoma, cancer, benign lymphatic. Biopsy R-axilla. Cancer. Genetic test showed no known markers (20+ looked for)
9/29/2019 PET scan, no indication of spread. Arimadex and Ibrance prescribed to shrink tumor prior to surgery
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They turn to Facebook and YouTube to find a cure for cancer — and get sucked into a world of bogus medicine
Mari pressed kale leaves through the juicer, preparing the smoothie that she believed had saved her life. The video, first uploaded in 2016, remains on YouTube, but there's an "important update" attached to the video's description. It was written by Liz, her niece, a year later. Mari's cancer had returned, the note said, and she had died.
...the web of false, misleading and potentially dangerous cancer "cures" and conspiracy theories isn't just there for those who stumble into it accidentally. More often it ensnares people who are reeling from bad news and groping for answers.
Google and Facebook have promised to crack down on health misinformation in recent months .... But bogus health information cannot be eradicated from the Web....
https://www.washingtonpost.com/lifestyle/style/the...
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PFAS: Controlling, Preventing, and Understanding Exposure
PFAS, or perfluoroalkyl and polyfluoroalkyl substances, are ubiquitous fluorinated organic compounds found widely in manufactured products, from firefighting foam to stain-resistant carpets. These water- and oil-repellent compounds are known to degrade slowly over time, and have been found in humans, drinking water, and even in Arctic ecosystems.
What do we know about human exposure to PFAS? How can contaminated media be treated? How can these compounds be controlled, and how can exposure be prevented? Last month, the Environmental Health Matters Initiative of the National Academies of Sciences, Engineering, and Medicine hosted a two-day workshop that brought together experts and stakeholders from academia, research, government, and industry to address these and other important questions about PFAS.
View recordings of the event here.
http://www8.nationalacademies.org/onpinews/newsite...
https://vimeo.com/showcase/6332191
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Anti-CDK4/6 Strategy Tops Chemo in Premenopausal Breast Cancer
CDK4/6 inhibition plus endocrine therapy bests single-agent chemotherapy
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KOLs Cover Pivotal Findings in Breast Cancer, Ovarian Cancer, GI Cancers, and Prostate Cancer
Hope Rugo, MD, and Joyce O'Shaughnessy, MD, recap the biggest breast cancer data, Mansoor Mirza, MD, highlights top abstracts in ovarian cancer, Tanios Bekaii-Saab, MD, shares insight on exciting gastrointestinal cancer research, and Brad McGregor, MD, covers pivotal prostate cancer trials.
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I'd be curious to find out how many patients actually see the box that their implants come in. Is it like when you wear shoes out of the shoestore and they send you home with an empty shoebox? Somehow I just don't think we'd see the box anyway.
They also talk about brochures from the makers that help patients decide about reconstruction options. I sure didn't get any of those from my PS!
Oct 25, 2019 12:34AM Lumpie wrote: FDA Calls for Boxed Warning on All Breast Implants Agency seeks to boost genuinely informed patient consent
The FDA issued a draft guidance recommending that manufacturers of breast implants include a boxed warning that clearly spells out the risks of their products. The agency also called on implant-makers to include a patient decision checklist and list the devices' ingredients, and updated its own recommendations for implant rupture screening.
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Re the implants, I am required to sign a page-long warning every time I get a scan. Given the issues raised, I don't think the box that the implants come in will be relevant. I feel certain that anyone getting them will be required to sign an extensive disclosure before surgery. As a practical matter, the record of disclosure must be acknowledged and scanned into the electronic medical record. So we can expect it to be on 8.5x11 paper (in the US) or other standard size paper. I just hope that there is meaningful "education" before the day of surgery! As serious as some of the problems have been, I think that if they do not make meaningful disclosures *before* the date of surgery, purveyers and surgeons are going to be inviting liability. These guys aren't stupid.
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Anticoagulants and breast cancer survival, a nationwide cohort study
Pete T. Kinnunen, Mika O. Murto, Miia Artama, Eero Pukkala, Kala Visvanathan and Teemu J. MurtolaDOI: 10.1158/1055-9965.EPI-19-0147Abstract
Background: Various components of the coagulation cascade have been linked to breast cancer (BrCa) progression. In vivo results suggest that anticoagulants possess anticancer properties, but there are virtually no studies in human populations. Our nationwide study explored the association between anticoagulant use and BrCa survival. Methods: All anticoagulants used from 1995-2015 in women (n=73,170) diagnosed with invasive BrCa in Finland between 1995-2013 were identified from the national prescription database; women were identified from the Finnish Cancer Registry. Cox regressions were performed to analyze BrCa survival as a function of pre- and post-diagnostic anticoagulant use; analyses were conducted for different anticoagulant subtypes and overall. Models were adjusted for age, mammography screening, tumor clinical characteristics, comorbidities, statin use, antidiabetic use, and antihypertensive use. To control for immortal time bias, post-diagnostic anticoagulant use was analyzed as a time-dependent variable. Results: At a median of 5.8 years after BrCa diagnosis, 10,900 (15%) women had died from BrCa. In total, 25,622 (35%) women had used anticoagulants during the study period. Post-diagnostic anticoagulant use increased the risk of BrCa death (HR=1.41, 95% CI 1.33-1.49). The risk was especially high for low-molecular weight heparin, although the effect disappeared in long-term users. Conclusion: Anticoagulant use provides no clinical benefit for BrCa survival; however, the association between thrombosis and cancer might mask potential survival benefits. Impact: Future pharmacoepidemiological studies should adjust for anticoagulant use. Research should focus on the use of new oral anticoagulants because these are rarely studied and might be associated with improved BrCa survival.
- Received February 2, 2019.
- Revision received April 4, 2019.
- Accepted October 7, 2019.
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ESMO Breast Cancer Roundtable: Episode 3
How do we sequence therapy in patients with advanced disease?
@{Video @ 10 minutes and transcript.}
https://www.medpagetoday.com/meetingcoverage/esmoe...
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Breast Cancer Scare for Beyoncé's Dad
Mathew Knowles reveals his diagnosis
"...breast cancer is not only a woman's disease. Men can certainly get it too. Previously, "Shaft" actor Richard Roundtree and Kiss drummer Peter Criss have both publicly revealed their breast cancer diagnoses."
The article notes that he has talked with the New York Times and Good Morning America. Kudos to Mr. Knowles for taking action to build awareness.
https://www.medpagetoday.com/blogs/celebritydiagno...
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CMS Aims to Broaden Coverage for NGS Testing in Breast, Ovarian Cancer
Expansion would include patients with risk factors for inherited susceptibility mutations
In a proposed decision memo on Tuesday, the agency stated that sufficient evidence exists to support testing when treating physicians determine that patients with breast and ovarian cancer have clinical indications for germline testing, risk factors for an inherited cancer, and have yet to receive such testing.
https://www.medpagetoday.com/publichealthpolicy/me...
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New Study Shows Growing Shortage of U.S. Oncologists Poses Risks to Women's Health
Analysis Identifies the 10 Major U.S. Cities Most Likely to Suffer a Shortage of Oncologists
The demand for cancer treatment is expected to grow by 40 percent over the next six years and at the same time, the American Society of Clinical Oncology (ASCO) is projecting a shortage of more than 2,200 oncologists over the next six years.
https://www.doximity.com/press_releases/new_study_...
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3D-Printed Device Finds 'Needle in a Haystack' Cancer Cells by Removing the Hay
Finding a handful of cancer cells hiding among billions of blood cells in a patient sample can be like finding a needle in a haystack. In a new approach enabled by 3D-printed cell traps, researchers are removing the hay to expose the cancer cells.
Next steps will be to narrow the channels in the device, test white blood cell removal without the use of biotin, boost the percentage of white cell extraction and connect cell traps to increase trapping capacity.
https://www.news.gatech.edu/2019/10/29/3d-printed-...
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Chemotherapy may spread cancer and trigger more aggressive tumours, warn scientists
Many are given chemotherapy before surgery, but the new research suggests that, although it shrinks tumours in the short term, it could trigger the spread of cancer cells around the body.
It is thought the toxic medication switches on a repair mechanism in the body which ultimately allows tumours to grow back stronger. It also increases the number of 'doorways' on blood vessels which allow cancer to spread throughout the body.
https://stm.sciencemag.org/content/9/397/eaan0026
DOI: 10.1126/scitranslmed.aan0026
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Ok that is a highly unsettling treatise. There is just so much we still don't understand about this disease.
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Great article on melatonin someone on my Facebook Repurposed Drugs page posted yesterday:
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Love the melatonin info. I have been on 20 mg at night since diagnosis (I worked up to that amount). I sleep very restfully and easily.
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Living Proof
{This isn't exactly news, but some may be interested in this 2008 movie. It is a dramatization about Dr. Slamon who was instramental in developing developed Herceptin. Free to watch on YouTube.}
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New Study Shows Regional Differences in Improved Survival of Patients with De Novo Metastatic Breast Cancer Over Time
The newly published article looked at regional differences in survival in patients with de novo MBC (dnMBC), which is a first diagnosis of breast cancer that is stage IV. The authors studied dnMBC patients in the Surveillance, Epidemiology, and End Results (SEER) 9 registry....They also studied an institutional cohort...They found that 5-year survival with dnMBC is different depending on where the patients lived. Survival also improved as new treatments were introduced. For patients followed from 1990 through the present day.... women with dnMBC had a 5-year survival rate of 44% compared to 20% of women with rMBC (recurrent MBC). Over the 20-year period, dnMBC 5-year survival improved ...from 28% to 55%, but rMBC survival decreased over time. The authors found a significant decline in rMBC over time, but no increase in survival.Details and links to articles here:DOI: 10.1158/1055-9965.EPI-16-0889 Published June 2017
https://link.springer.com/article/10.1007%2Fs10549-017-4529-5
https://doi.org/10.1007/s10549-017-4529-5
https://link.springer.com/article/10.1007%2Fs10549-018-05090-y
https://doi.org/10.1007/s10549-018-05090-y
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Lumpie... that Chemo may be helping to spread the cancer and trigger more aggressive tumors is very unsettling indeed, to borrow Rah's word. I'll be asking my MO about this one.
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Lumpie thank you for the link for Living proof! I've been trying to get it for about 2 months now, but unsuccesfully! Nowhere to see it legally in my country. I am watching it tonight. thank you
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Simple blood test could spot breast cancer five years before any symptom
The new research, presented at the National Cancer Research Institute's conference in Glasgow, found that a blood test could identify changes in the body's immune response to substances produced by tumour cells...
Presenting the research at the NCRI Conference, researcher Daniyah Alfattani said: "The results of our study showed that breast cancer does induce autoantibodies against panels of specific tumour-associated antigens. We were able to detect cancer with reasonable accuracy by identifying these autoantibodies in the blood."
The most successful technique was able to identify disease in 37 per cent of cases with cancer, and rule it out, in 79 per cent of the control group.
"We need to develop and further validate this test," said Ms Alfattani. "However, these results are encouraging and indicate that it's possible to detect a signal for early breast cancer. Once we have improved the accuracy of the test, then it opens the possibility of using a simple blood test to improve early detection of the disease..."
Researchers said that with sufficient investment, tests could be available in clinics in four to five years.
ETA more info at this link: https://www.eurekalert.org/pub_releases/2019-11/ncri-sbt103119.php
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