On the pulse...for people affected by breast cancer

Cancerkin's news update….

Funding announcement

Cancerkin has secured a grant of £10,000 from Capacity Builders, a Government sponsored organisation which provides support to third sector organisations i.e. charities. The grant is from the Modernisation Fund Grants Programme which focuses on organisations providing services to those worst hit by the recession. The funding is for Cancerkin's project to provide support to those affected by breast cancer in East London.

In the news…

CT scans may cause more cancers than previously thought

Scientists are claiming that CT scans can be triggering cancer in as many as one in 80 patients. This is far higher than the one in 1000 odds that are generally quoted. Although American findings where CT scans are more routinely offered, there is now the possibility that this new development will hold true for the UK. During 2008/9 in England there were a total of almost 36 million scans, x-rays and tests involving ultrasound, magnetic and radio waves, and radiation, of which 3.3 million were CT scans.

This story can be found in:

Daily Telegraph: CT scans may pose higher risk of cancer than first thought
The Independent: CT scans 'could raise the risk of cancer

Daily Express: Under the microscope

Alopecia

Hair specialists used to see women with hair loss problems twice a year, now they're getting them once a week. Yet, surprisingly little is known about female hair loss or alopecia. A recent survey revealed that as many as one in three women over the age of 25 will suffer from some sort of hair loss.

An article in the Telegraph takes a first person perspective on female hair loss. Highlighting that scientists don't know what triggers alopecia or how to stop it.

Nanosensors

The Sun has a story about a microchip that can detect cancer in 20 minutes by using nanosensors to seek out specific proteins in blood. These tests are meant to detect prostate and breast cancer biomarkers. The research was reported in the journal Nature Nanotechnology.

New breast cancer drug offers last hope to women

Forty per cent of women with an aggressive and advanced form of breast cancer who were given the treatment in clinical trials saw the size of their tumours reduced for at least six months. This new drug combines a combination of Herceptin and a particular type of chemotherapy.
Dr Jane Maher, Chief Medical Officer at Macmillan Cancer Support said: "These findings are definitely promising. What we need is more work quickly to see if the results are as good using large scale, randomised control trials."

Hormone replacement therapy and breast cancer

The Guardian's Dr Crippen asks 'Is hormone replacement therapy a health risk? A myth has grown up that nobody should stay on HRT for longer than five years. But the truth is more complex?'


This is the last On the pulse newsletter before Christmas. Nicky Waldman will be back from America in January in time for the next edition so I shall simply say a big thank you for all your support throughout the year and especially to those of you who have given so freely of your time. I hope you have a restful Christmas and I am looking forward to working with you again in the New Year.


Victoria Todd (v.todd@cancerkin.org.uk)

On the pulse...for people affected by breast cancer

Cancerkin’s news update….

CANCERKIN’S TOMBOLA EXTRAVAGANZA and Christmas card sale will be held at the Royal Free Hospital between 11am and 4pm outside the Atrium on the ground floor on 9th December; there are lots of fantastic prizes to be won. We look forward to seeing you there.

PATIENT SUPPORT GROUP – the next meeting will be held between 11am and 1pm on 8th December at the Cancerkin Centre. The speaker will be Norma Goldman (a pharmacist with a Masters degree in health promotion) author of a newsletter called Menopause Exchange. She will be talking about the menopause generally, with particular reference to issues relating to breast cancer. All are welcome!

In the news…

NICE REJECTS USE OF AVASTIN FOR BOWEL CANCER SUFFERERS…on the basis that they calculate that the annual cost is £36,000 p/a, whereas their maximum limit is £30,000 p/a. Campaigners for the drug estimate that 4-5,000 people with advanced forms of the disease could benefit from the drug which it is claimed can extend life for up to 2 years. Avastin is also used to treat some cases of secondary breast cancer, but according to the Daily Mail, its use in the NHS is in limbo until the bowel cancer issue is resolved. Read more about this here: Daily Mail

BENEFITS OF PETS - a report close to my own heart says that stroking a pet can help patients to halve the amount of painkillers they take. Julia Harvey who led the research project at Loyola University of Chicago said that pet therapy could play an important role in healing. She said: “Evidence suggests animal assisted therapy can have a positive effect on a patient’s emotional and physical well being.” A study for Warwick University found that having a pet dog or cat helped women beat the pain and fear of breast cancer and provided more support than a loving husband! Previous US research has shown that having pets is a great stress buster, with pet owners having lower heart rates and blood pressure. See the story here: Pets

INTERNAL BRA - The Daily Express reports on a new ‘internal’ bra that has been designed to improve sagging or misshapen breasts. It has been designed by Israeli plastic surgeon Professor Eyal Gur of Tel Aviv’s Sourasky Medical Centre who claims that it has none of the drawbacks of breast implants and will look good for years. He said “It would be really beneficial to women who have had partial or full mastectomies. They often complain about their breast shape or position.” The ‘bra’ is fitted under the skin, using keyhole surgery and performed under a local anaesthetic. It is anticipated that this procedure will become available In Europe within 18 months.

TUMOUR CAUSING ENZYME – a breast cancer study published in the journal Cell has identified an enzyme (LOX) that is crucial for turning tissue in the breast into a tumour. Blocking LOX reduced the size and frequency of tumours in mice. Dr Jamie Erler from the Institute of Cancer Research said: “The enzyme triggers a clear physical change in breast tissue and if we could stop this happening, we expect it would slow the growth of any cancers that did develop and make them easier to eradicate”. Dr Alex Willett, head of policy at Breakthrough Breast Cancer said: “The next stage will be to test whether LOX has the same effect in humans…” Read the full story here: BBC news


Nicky Waldman (n.waldman@cancerkin.org.uk) 25 November 2009

On the pulse...for people affected by breast cancer

Cancerkin’s news update….

PATIENT SUPPORT GROUP – the next group meeting is on 24th November, 11am - 1pm and we will be demonstrating relaxation techniques.

NEW THERAPIES – dance therapy, hypnotherapy and soul therapy – please ask Jean Hafezi for more info.

CHRISTMAS & NEW YEAR – the Cancerkin Centre will be closed 24th December 2009– 1st January 2010 inclusive.

In the news…

10 WAYS TO REDUCE YOUR RISK OF CANCER
World Cancer Research Fund has developed 10 recommendations for people to follow to reduce their risk of cancer. They say that nearly 80,000 cases of cancer in the UK annually could be prevented by following their suggestions, including over 19,000 cases of breast cancer. They emphasise that having a healthy lifestyle is no guarantee against cancer, but that the risk can be reduced considerably. You can read more about these recommendations in WCRF’s press release on their website and on the front page of the Daily Express (16th November 2009).

BREAST REGROWTH TRIALS PLANNED
This story was widely reported last week in the national press and refers to an exciting new technique that scientists hope will enable women who have had a mastectomy to re-grow their breast, using their own cells. There are two trials planned – one in the UK and one in Australia. If the trials are successful, it is thought that this technique, of injecting stem cell enhanced fat tissue (from the patient’s body) into a cavity under the skin, could revolutionise breast reconstruction, potentially producing a result that feels and looks more natural. Professor Kefah Mokbel of the London Breast Institute and St George’s Hospital said: “This is the next step in breast reconstruction surgery. It is potentially a very exciting development”. For more information on this story click here.


ANTI CANCER VACCINE FOR BREAST CANCER SUFFERERS
An article in the Daily Express reports on the start of trials for an anti cancer vaccine. The aim of the drug, called Stimuvax, is not to prevent cancer, but rather to stimulate the immune system to recognise the cancer cells and to destroy them. So far it has been used with some success on patients with lung cancer, but it is hoped that it can be developed to treat other cancers. Currently it is being tested on patients with advanced breast cancer. Dr Oliver Kisker, head of cancer treatment at Merck, which has designed the drug, said: “We are extremely excited about this vaccine. We have seen amazing effects in lung cancer patients and we believe it will work in the future with breast cancer patients.”


Nicky Waldman (n.waldman@cancerkin.org.uk) 16 November 2009

On the pulse...for people affected by breast cancer

Cancerkin’s news update….

Children’s Corner – as mentioned a few weeks ago, the Hampstead Women’s Club have generously created a fantastic area for children at the Cancerkin Centre. It is stacked with toys, games, crayons and books and is a lovely environment for Mum’s who are being treated in hospital to spend time with their children away from the ward. The area is now open – so please do visit. On the topic of children, Breast Cancer Care has produced a book called Mummy’s Lump that tries to help explain to young children what their Mum is going through. Copies of the book can be ordered from BCC.

Fundraising events & activities – as you will know, all of our services are provided free of charge. We receive no income from the NHS or other statutory bodies, which means we have to raise all the funds needed to keep Cancerkin running. We are constantly thinking of new ways to raise funds, but we would like to know what you think? Please tell us what sort of events you like going to, whether you would like to hold an event yourself or be involved in one we are running. WE WANT YOUR IDEAS NOW! You can email us at n.waldman@cancerkin.org.uk

In the news…

New Lymph Node Test

The Times and the Daily Mail report on a relatively new procedure to check if cancer in the breast has spread to the lymph nodes. It is called a breast lymph node assay and it could make a real difference to the treatment time for breast cancer.
With this technique, patients having breast cancer surgery to remove a tumour can be tested immediately to see if the disease has spread to their lymph nodes. Usually, a small piece of tissue will be sent for testing, after the initial surgery, to see if the lymph nodes are affected; the tests can take 2-3 weeks. If the nodes are affected, the patient may require further surgery and thus a delay in starting chemotherapy and/or radiotherapy. The assay produces results within 30-45 minutes, meaning that if necessary, the surgeon can treat the nodes during the same initial operation, thereby avoiding the need for further surgery. In addition it is thought that this method of testing is much more accurate than sending a sample to a lab for analysis.
This technique is already being used at two hospitals in the UK and in 2010 it is due to be recommended for implementation across the NHS.
Dr Graham Layer, breast surgeon at the Royal Surrey County Hospital in Guildford, who started using the technique in 2007 said:
‘We can see cases where cancer has spread that we could not have spotted with conventional ultrasound or biopsy tests. For those women with a positive result, we are able to deal with that much more quickly than if we had waited for the results of routine pathology tests following a traditional breast cancer operation.’

For more information see:
http://www.timesonline.co.uk/tol/life_and_style/health/article6897567.ece

http://www.dailymail.co.uk/health/article-1224258/30-minute-breast-cancer-test-save-lives-thousands.html

Nicky Waldman (n.waldman@cancerkin.org.uk) 4 November 2009

On the pulse - for people affected by breast cancer

Cancerkin’s news update….

On 2nd November, we are starting Hypnotherapy treatments at the Cancerkin Centre. We have also started Spiritual Healing sessions and appointments are available; however, if you would like to know more about it, Kathryn Scorza is holding a group meeting on 17th November, where people can have a 15 minute ‘taster’ session. To book an appointment or for more information on these or any other treatments, please contact Jean Hafezi (020 7830 2323) at the Cancerkin Centre.

In the news…

NICE to refuse use of drug for women with advanced breast cancer

I reported in March 2009 that GlaxoSmithKline, the manufacturers of the drug Lapatinib (also known as Tyverb), were appealing the decision by NICE[1] to reject funding for use of the drug by the NHS, on the basis that they considered it was not a cost effective use of resources. Lapatinib is commonly used to treat a particular type of advanced breast cancer which has returned, despite use of standard treatments. It is not a cure, but can delay the progression of the cancer. It is thought that about 2000 women could be eligible for the drug.
The appeal has now been heard, but it seems that it will be turned down again, essentially for the same reasons as last time - cost. NICE have reached this decision despite the fact that GSK had offered to fund the first 12 weeks of treatment with the drug and despite their own new rules whereby they were going to be more flexible in their approach to end of life cancer drugs.
This story was carried in many newspapers, including The Guardian at:
http://www.guardian.co.uk/lifeandstyle/2009/oct/21/women-denied-cancer-drug

The Guardian also quotes Alison Jones, member of Cancerkin’s Medical Advisory Panel and Consultant Medical Oncologist at the Royal Free Hospital as saying:
"This is a useful drug for patients with breast cancer. It is not the cure. This is second-line disease and you don't expect stunning results," she said. "Anywhere else in Europe you can have it. I think it should be here."

Triple Negative Breast Cancer

In a regular column on health issues in the Daily Express, Dr Rosemary Leonard gives some information on triple negative breast cancer, explaining what it is and how it can be treated. See the article at www.express.co.uk/ourcomments/view/135147 and more detailed information on this type of breast cancer, which affects approximately 15% of those diagnosed with the disease, can be found at:
http://www.cancerhelp.org.uk/about-cancer/cancer-questions/triple-negative-breast-cancer

Nicky Waldman (n.waldman@cancerkin.org.uk) 26 October 2009


[1] The National Institute for Health & Clinical Excellence – drugs watchdog for England & Wales

on the pulse - for people affected by breast cancer

Cancerkin’s news Update….

Breast Cancer Awareness Month:
As one of our many initiatives during Breast Cancer Awareness Month, Cancerkin had a stand in the Royal Free promoting the work that we do and the various treatments that we offer patients affected by breast cancer (and their families). We were delighted to welcome so many visitors to the stand, who were treated to delicious fairy cakes! We sold a variety of our goodies, including tee shirts, cosmetics, books and key rings. We raised a massive £1,000 for Cancerkin! So a big thank you to all those who gave so generously and to our volunteers who (wo)manned the stand during the course of the day.

Hampstead Women’s Club:
We are delighted to report on a new collaboration with the Hampstead Women’s Club – a multi national social organisation for women living in the London area, who provide a sense of community through social, educational and charitable activities. They have kindly given their time and resources to creating a new Children’s Corner at the Cancerkin Centre. This will provide a welcoming facility for Mums receiving care at the hospital to be with their children in a comfortable child friendly environment, away from the ward. Children’s Corner will be open soon…watch this space!

In the news…

Vitamin and Mineral Supplements and Cancer Risk:
According to an expert at World Cancer Research Fund (WCRF), high doses of vitamin and mineral supplements can do more harm than good in terms of cancer risk and the message from WCRF and Cancer Research UK is to try and get all the minerals and vitamins you need from a healthy, balanced diet. Yinka Ebo, health information officer at Cancer Research UK, said: "Many large studies have looked at the effects of vitamin supplements on cancer risk and most have found that these supplements have no effect. But some studies have found that, far from improving your health, high doses can be harmful and even increase the risk of cancer."The best way to get your full range of vitamins and minerals and help protect against cancer is to eat a healthy, balanced diet with a wide variety of fruit and vegetables."
For more on this article, follow this link to the Cancer Research website: http://info.cancerresearchuk.org/news/archive/newsarchive/2009/october/19414129

Relationships and Illness:
The Times (15th October 2009) reported on the effect that serious illness can have on a relationship and the different ways in which men and women respond to this. http://women.timesonline.co.uk/tol/life_and_style/women/relationships/article6875081.ece
The article looks at various studies that have been carried out, with particular reference to the effect of a cancer diagnosis and there are also several stories by cancer sufferers, relating their own experiences.

Nicky Waldman (n.waldman@cancerkin.org.uk)
19th October 2009

ON THE PULSE… for people affected by breast cancer

Cancerkin’s news Update….

Intrabeam handover and Santy Parbhoo

On 8th October, Cancerkin celebrated the formal handover of the Intrabeam Machine to the Royal Free Hospital and honoured the work of our much loved Chairman, Mr Santilal Parbhoo, who stepped down from the Chair and became our Life President.
The Intrabeam machine is part of Cancerkin’s commitment to research into breast cancer and its treatment. Cancerkin raised over £200,000 to buy the machine to study the effect of a single dose of intra-operative radiotherapy as against several weeks of conventional radiotherapy. The study is part of a multi centre international study known as TARGIT and during the evening Mo Keshtgar, consultant surgical oncologist and member of the TARGIT team, updated the guests on exciting developments in the study. He, along with Trustee Chair of the hospital, Dominic Dodd and new Chair of Cancerkin, Dr John Carrier, also praised the pioneering work of Santy Parbhoo at this hospital and in the creation of Cancerkin and its renowned lymphoedema clinic. Santy was presented with a silver photograph frame as a small token of appreciation by his fellow trustees and after his response and thanks to those with whom he has worked over the years, guests enjoyed champagne and nibbles!

In the news…

The annual conference of the National Cancer Research Institute (NCRI) has resulted in a lot of headline material on breast cancer and its treatment. Also, with October being breast cancer awareness month, there have been many articles in the press on this subject. Here is a selection of the articles:
In the Mirror on Sunday magazine (04.10.09), there was an article on what they call ‘cancer-fighting foods’ - foods they say can help cut your risk of cancer and those that should be avoidedhttp://www.mirror.co.uk/life-style/sex-health/2009/10/05/eat-your-way-to-beating-cancer-115875-21723000/
The Cancer Research UK website reports on the results of a survey published online in the British Journal of Cancer which shows that an estimated 40% of people in Britain would delay going to their GP with cancer symptoms because they did not want to bother them, were worried what they would find or did not want to waste their time. Professor Jane Wardle, from Cancer Research UK said: "A lot of work now needs to be done to help people feel like they can go to their doctor as soon as they find something that could be a symptom of cancer."Changes to public attitudes along with changes within the healthcare system will be fundamental to making a difference."Cancer is more likely to be treated successfully when it's spotted early, so it's crucial that we do something with the results of this survey quickly." http://info.cancerresearchuk.org/news/archive/pressreleases/2009/october/late-cancer-diagnosis
BBC News reports on a government grant that has been awarded to a charity called ‘My New Hair’ (www.mynewhair.org.uk) set up by celebrity hairdresser Trevor Sorbie. The charity aims to train hairdressers in wig styling and hair-care for cancer patients who have lost their hair after chemotherapy. The government grant will extend training and education to nurse led training to hairdressers in aftercare for patients whose hair is growing back and the psychological implications of hair loss.
In Monday’s edition of the Daily Telegraph: http://www.telegraph.co.uk/health/women_shealth/6256195/Breast-Cancer-Why-are-so-few-women-having-reconstructive-surgery.html
They report on the findings from the National Mastectomy and Breast reconstruction Audit that just 48% of women with breast cancer were offered the option of reconstruction in 2007/08. This is despite the fact that NICE guidelines say that 100% of eligible patients should be offered this procedure. They also talk about various breast reconstruction options with Dr Charles Nduka a consultant plastic and reconstructive surgeon.
Reuters http://www.reuters.com/article/latestCrisis/idUSL5638086 has an article on tamoxifen and a study in Germany that has identified a gene enabling some people to respond to the drug better than others. If all patients could be tested for this gene, it seems that it might be possible to prescribe from the start one of the alternative drugs for those who will be unable to benefit from tamoxifen, thereby creating a more personalised treatment.
An article in the Daily Mail talks about a technique using stem cells and liposuction to replace missing breast tissue after removal of a lump and also to smooth out scars. Fat is removed from the stomach, hips or thighs of the patient and the stem cells are separated and treated before being recombined with the fat cells and then injected back into the breast. Mr Nader Khonji, a plastic surgeon who is leading the trial at the Singleton Hospital in Swansea said: “There are no new scars involved and the system encourages the growth of new blood vessels which has been the failing of fat grafts in the past”. http://www.dailymail.co.uk/health/article-1218860/Stem-cells-hide-scars-New-hope-women-disfigured-cancer.html
Finally, back to the Daily Telegraph, for a report on the possibility of a stem cell vaccine for cancer. Research in the US and China is still in its infancy and is related to bowel cancer at the moment, but the hope is that the work could be widened to provide a vaccine for all cancers.http://www.telegraph.co.uk/health/healthnews/6269084/Stem-cell-vaccine-for-cancer-step-nearer.html

14th October 2009

ON THE PULSE… for people affected by breast cancer

Cancerkin’s news Update….
October is Breast Cancer Awareness Month and this is already proving to be a busy month for Cancerkin. On 1st October, Floris held a fundraising event for us at their Jermyn St shop. For more details of the evening, see the ‘latest news’ section on our website at www.cancerkin.org.uk
On 8th October, we are celebrating the formal handover of the Intrabeam machine to the Royal Free Hospital; Cancerkin raised over £200,000 towards the cost of this piece of equipment, which it is hoped could revolutionise radiotherapy treatment for women with breast cancer. We will also be celebrating with our much loved Chairman, Santy Parbhoo, who is standing down from this position to become President of Cancerkin.
On 14th October, we will be manning a stand in the hospital, telling visitors and patients about Cancerkin and the work that we do. Please do come along and visit us on the day, just by the Atrium or indeed on any weekday 9am – 5pm in the Cancerkin Centre.

In the news…
Critical Illness and travel insurance
A report in Telegraph Money on Saturday 3rd October http://www.telegraph.co.uk/finance/personalfinance/insurance/criticalillness/6251215/How-important-is-critical-illness-cover.html talked about the importance of critical illness cover in an age where medical advances mean that many more people are surviving conditions (e.g. cancer and heart attacks) that have killed previous generations. They point out that according to the Office for National Statistics, more than 80% of women diagnosed with breast cancer in the UK are still alive 5 years later. The article refers to the fact that one in five claims for this type of cover is for breast cancer, but points out that there may be conditions attached to the policy preventing a full or even partial pay out. Kevin Carr, spokesman for PruProtect said: “Breast cancer is covered by critical illness policies, but many policies exclude ‘early stage cancer’ which is when cancer is considered to be non-invasive. Breast cancer may be considered to be ‘early stage’ even if a lumpectomy or mastectomy is required and therefore, many insurers will not pay out”.
However, there are insurers who will pay out in whole or in part. It is important to check the wording and conditions covered or excluded. Many people do have critical illness cover and have either forgotten about it or are not aware that it could cover the hard financial situation they are in.
A further article in the same section of the newspaper talks about the difficulty many cancer patients (some, who were successfully treated many years ago) have in finding travel insurance. In some cases, they are charged significantly higher premiums and in others, they are refused altogether. However, they do give examples of specialist providers such as Insurepink, Free Spirit, MRL, GetMy.com, Saga, Flexicover Direct, Cancertravelinsurance.com and insurecancer.com. Please note that these companies are not recommended, but are mentioned on the basis that they are known to offer insurance to those with pre existing medical conditions.

5th October 2009

ON THE PULSE… for people affected by breast cancer

Cancerkin’s news Update….
EXERCISE CLASSES
Please remember that we run the following weekly exercise classes:
Alexander Technique; Pilates (twice a week); Tai Chi (twice a week); Yoga

The classes are a good opportunity for a gentle work out and to meet old and new friends in a welcoming environment.
All are welcome at these classes, but it is helpful if you can let us know in advance if you plan to be there.
Remember that all classes are free of charge.
We look forward to seeing you soon.

In the news…
NEW DRUG TO TREAT UP TO A THIRD OF CANCERS
PARP inhibitors have already shown promise in dealing with some breast and ovarian cancers, which are strongly linked to BRCA gene mutations; but according to a recent study[1], there is a possibility that they could be used to treat several other cancers too.
Cells with faulty PTEN genes have been found to be 25 times more sensitive to the inhibitors than cells with normal PTEN. Faults in the PTEN gene account for 30-80% of breast, prostate, melanoma, womb and colon cancers.
Dr Chris Lord, lead researcher at Breakthrough Breast Cancer said: ‘This new class of drugs could potentially make a big difference for many thousands of cancer patients, including some with very limited treatment options’.
Professor Alan Ashworth, director of Breakthrough Breast Cancer Research Centre at the Institute of Cancer Research said:‘These results are exciting because they show that PARP inhibitors are potentially a powerful targeted treatment with few side effects which may help a broad range of cancer patients.’
See the following for further information:
http://news.bbc.co.uk/1/hi/health/8256494.stm
http://www.thesun.co.uk/sol/homepage/news/2639319/Wonder-drug-is-hailed-as-a-cancer-buster.html
16th September 2009
[1] The study appears in the EMBO Molecular Medicine journal.

MANY THOUSANDS A YEAR COULD BE SAVED BY EXERCISE AND DIET…

…so says the latest study by the World Cancer Relief Fund (WCRF) in an update of their cancer prevention report in 2007, which looked at many different types of the disease.
The study says that up to 4 in 10 cases could be avoided (up to 18,000 per annum) if women in this country were more active, drank less and kept a healthy weight.
This report was picked up by a number of newspapers including the Daily Mail[1] and the Guardian[2].
Professor Martin Wiseman, medical and scientific adviser for the WCRF said the report:
“represents the clearest picture we have ever had” on how lifestyle affects the risk of breast cancer.

7th September 2009

[1] www.dailymail.co.uk/news/article-1210331

[2] www.guardian.co.uk/lifeandstyle/2009/sep/01/breast-cancer-report-diet-health

LOW TAKE UP RATE FOR FREE PRESCRIPTIONS

Since 1st April 2009, cancer patients in England have been entitled to free prescriptions, but it seems that only a minority are taking advantage of this, with approximately 90,000 of an estimated 150,000 people with cancer in England still paying for their prescriptions (£7.20 each).
To get the exemption from charges, patients must complete a form which they can get from their GP or cancer specialist and which needs to be signed by the GP or specialist. The form is then sent to the NHS Business Services Authority and the patient is given a five year exemption certificate, in the form of a credit card sized document, which you can carry in your wallet.
The scheme is available to people undergoing treatment for cancer or for the effects of cancer treatment.
Martin Ledwick, head of Cancer Research UK's information nurses, said:
“It's disappointing if cancer patients are missing out on the free prescriptions they're now entitled to have. These prescriptions will help tens of thousands of people struggling with the heavy cost of having cancer.”
For more information see: www.news.bbc.co.uk/1/hi/health/8227371.stm

7th September 2009

A STORY OF TWO MOTHERS

Here are links to two stories in the news this week concerning mothers and breast cancer.

The first was reported in The Daily Telegraph and is an extract from Sarah Gabriel’s book Eating Pomegranates: A Memoir of Mothers, Daughters and Genes. The author lost her own mother to breast cancer and the book deals with how she tries to tell her own young daughters about her diagnosis.
http://www.telegraph.co.uk/health/6016056/How-do-I-tell-my-children-Ive-got-cancer.html

The second story was reported in the Daily Mail and concerns Rebekah Gibbs, actress, who stars in BBC1’s Casualty. She was diagnosed with HER2 breast cancer at 36, just 9 weeks after giving birth to her first child, although she had found a lump part way through the pregnancy. She is taking part in a trial of the drug Lapatinib[1] (which can be taken in pill form), to see if it can be used as an alternative to Herceptin[2] (which is taken intravenously) in reducing the recurrence of cancer. At the moment, Lapatinib is used to treat secondary breast cancers that are not responding to other treatment.
http://www.dailymail.co.uk/health/article-1207194/Why-Casualty-star-Rebekah-Gibbs-trying-new-potentially-dangerous-breast-cancer-drug.html


19th August 2009


[1] http://www.breastcancercare.org.uk/server/show/nav.800


[2] http://www.breastcancercare.org.uk/server/show/nav.397

DEADLY STING OF NANOBEES

There has been much reporting in the press this week of new trials using ‘nanobees’ that effectively sting cancerous tumours to death. The poisonous chemical in a bee sting, melittin, is attached to ‘nanoparticles’ (tiny molecules) which are in turn injected into the patient. The melittin attacks cancerous cells, but leaves healthy cells alone. So, one of the potential advantages of this form of treatment over chemotherapy is that it is more targeted, meaning doses could be lower with far fewer side effects. Tests on groups of mice with cancerous breast tumours showed that after 4-5 injections of melittin-carrying nanobees over several days, the growth of these tumours was slowed by nearly 25%. The team working on these studies plan to start human trials next year.
The study was published in the Journal of Clinical Investigation on 10th August 2009.
Read more about these trials at:
http://www.timesonline.co.uk/tol/life_and_style/health/article6790927.ece
and
http://www.sciencedaily.com/releases/2009/08/090810174226.htm

12th July 2009

Only 3% aware of link between weight and cancer…

This is according to a survey by Cancer Research UK, the results of which were released on 4th August 2009. Each year, they survey a sample of the population to find out what they know about cancer risk factors and symptoms.
This year, 3,947 people were asked ‘What are the main changes people can make to their lifestyles to reduce the risk of cancer? ’Participants were not given any hints as to what these might be, but named the following:
Smoking – 66%
Food and diet – 59%
Exercise – 29%
Alcohol – 22%
Sun and skincare – 11%
Bodyweight – 3%
Don’t know/nothing – 7%

Sara Hiom, director of health information at Cancer Research UK said:

“We have estimated that more than 13,000 cases of cancer could be prevented each year if everyone maintained a healthy weight.”
“While many people associate weight with being healthy in general, this survey shows that most people don’t link it directly with their risk of cancer, or don’t know how much it can reduce their risk.”
“Leading a healthy life with a balanced diet and plenty of exercise does not guarantee that a person won’t get cancer but these healthy habits can help to cut the odds."

Being overweight is seen to be a risk factor as the fat tissues in overweight people produce more hormones and other growth factors than those in people of a healthy weight. High levels of some of these hormones can increase the risk of certain cancers, including breast cancer in women after the menopause.[1]



5th August 2009



[1] Source: http://info.cancerresearchuk.org/healthyliving/obesityandweight/

Spotlight on Cancer

In August, the Community Channel [1] is running The C Word, a month long season of programmes highlighting the need to spot cancer early to get the best chance of successful treatment and also the work of the organisations in this field.
A new series of films called Spotting Cancer Early are being premiered on the Channel during this season. They are covering lung, bowel, mouth and breast cancer.
There are two other programmes specifically relating to breast cancer - one on how to spot the symptoms of breast cancer in a new film called Being Breast Aware and another on how to get back to health after breast cancer, where women share experiences of how diet and exercise have improved their wellbeing called Eating Well, Being Active. There are a number of other films and programmes relating to other cancers.
On their website, they are featuring personal stories of those affected by cancer.
For more information see their website at www.communitychannel.org/cword
Cancer Research UK are also campaigning for the early detection of cancer and have information on their website at www.spotcancerearly.com

5th August 2009
[1] Sky 539: Virgin TV 233: Freeview 87 (6-9am)

Report reveals that Britain is spending less on latest generation of cancer drugs

On 26th July, the Daily Express (www.express.co.uk/posts/views/116468) referred to a new report showing that Britain is spending less than other major European countries on the latest generation of cancer drugs. Dr Graeme Poston, director of surgery at University Hospital in Aintree and leading cancer specialist has collated the figures which show that the NHS bill for cancer treatments works out at 60p per head of population. This compares to Italy who spend £2.94, Germany - £3.63, Spain - £4.58 and France £7.35.
Dr Poston said: “There’s a limit to what surgery can do. We need modern drugs to help survival rates and in many cases, people are unable to get them.”

Swine Flu

There has been an enormous amount of news coverage given to this issue in recent weeks and you will no doubt be aware that this virus is being managed at primary care level for patients considered to be at risk or with health conditions (such as those with weakened immune systems). The National Flu Service (going live on Thursday 23rd July) is intended to relieve the pressure on the NHS and GP surgeries by taking calls and emails from all other sufferers, going through a checklist to diagnose cases and giving access to anti-flu drugs where appropriate. They will refer high risk patients to their GPs.
However, for patients receiving care and treatment for breast cancer, a Consultant at the Royal Free Hospital and member of Cancerkin’s Medical Advisory Panel gives the following additional advice:
1. If you have swine flu, you should cancel your clinic appointment and rebook and let the breast care nurse and relevant secretary know. You should get tamiflu through your GP (not your hospital) and the same applies to the vaccine (when it becomes available).
2. All patients on chemotherapy or within 12 months of chemotherapy should get priority for the vaccine when it is out.
3. Patients don’t need to interrupt hormone treatment but would have to interrupt chemotherapy or radiotherapy if they have swine flu.

23 July 2009

Nearly two-thirds of UK adults risk their health through lack of exercise

This is according to a new survey published by the Chartered Society of Physiotherapy (CSP) to launch their new UK wide ‘Move for Health’ campaign on 1st July 2009, highlighting the importance of exercise in maintaining good health and preventing illness.
The findings of the survey are that the majority of adults (63%) are not physically active enough, which can have serious medical consequences including a higher risk of cancer, obesity, heart disease, type-2 diabetes and stroke.
Dr Laura Bell, Cancer Research UK science information officer said:
“We know that being physically active reduces the risk of breast and bowel cancer and that the more active you are, the more you can reduce your cancer risk. Aim to do at least 30 minutes of moderate activity a day, 5 days a week.”
“This means something that makes you warm and slightly out of breath like brisk walking, gardening or housework. Research tells us that around half of all cancers could be prevented by changes to lifestyle.”
Bridget Hurley, chartered physiotherapist and CSP spokesperson said:
“Regular physical activity is as important as eating 5 portions of fruit and vegetables a day… Without sufficient physical activity you are increasing your risk of life-threatening illnesses”
Exercise doesn’t need to be expensive, boring or time consuming. Just going outside at lunchtime for a half an hour walk every day will greatly increase your fitness levels.”

1 in 3 women may be receiving treatment for breast cancer 'needlessly'

This is according to the results of a survey reported in the British Medical Journal on 10th July 2009, by a team from the Nordic Cochrane Centre in Denmark. The story was reported widely, including in a number of newspapers and in the BBC online at http://news.bbc.co.uk/1/hi/health/8143564.stm
The results of the survey suggested that up to one in three breast cancers detected by screening may be harmless and that while screening[1] may lead to earlier detection of lethal cancers, it is also detecting harmless ones for which women are receiving needless and (in some cases) gruelling treatment.
However, as can be seen from the report, a number of health professionals are concerned that the study has not only been “…selective in the statistics that it used…”, but also that it may deter women from attending screening which is estimated to save up to 1400 lives a year.
Dr Sarah Cant from Breast Cancer Care said:
“Unfortunately, it is currently not possible to predict which cancers found through screening will develop aggressively and which will grow very slowly” She added: “Based on all the current evidence, we believe the benefits of detecting breast cancer still outweigh the risks.”

[1] The NHS Breast Screening Programme provides free breast screening every three years for all women in the UK aged 50 and over. Around one-and-a-half million women are screened in the UK each year. Women aged between 50 and 70 are now routinely invited.

June 2009

AVAILABILITY OF PROMISING NEW DRUGS AND TECHNIQUES TO CANCER SUFFERERS
A story in the Daily Mail on 25th June 2009 (www.dailymail.co.uk/health/article-1194817) reported on the existence of promising new drugs or surgical techniques that are currently available for cancer patients, often on the NHS, although many patients are unaware of them. They say that this may be due to a postcode lottery, a lack of expertise in how to go about getting them or a lack of the right equipment at a local hospital. So the question is how to go about getting these ‘cutting edge treatments’?
They refer to the new government guidelines, whereby each patient has a right to choose the hospital where they have their treatment. They suggest ways of getting hold of a drug or treatment you think might be of benefit, but is not being offered to you for a variety of reasons. Examples are referral for a second opinion, an appeal to an independent panel of a local primary care trust (PCT), use of the top up scheme and getting help and advice from a relevant charity.
The article then goes on to discuss the latest drugs and treatments that are available either on the NHS or privately for various cancers. In respect of breast cancer, they refer to instances where some NHS doctors are prescribing chemotherapy before surgery in an attempt to shrink the tumour. There has already been success with this approach, particularly with larger tumours, where the results in some cases have reduced the need for radical surgery and allowing for a lumpectomy rather than a mastectomy. They also talk about the use of the sentinel lymph node biopsy, which is available in some NHS hospitals, to determine if the breast cancer has spread through the lymphatic system. By using this technique, surgeons can avoid removing all the lymph nodes, possibly unnecessarily, to determine if the cancer has spread in this way.

PROMISING NEW DRUG IN TREATMENT OF CANCERS CAUSED BY FAULTY BRCA1 OR BRCA2 GENES
June 2009 - Cancer Research UK report on a promising new drug called Olaparib which has successfully completed a Phase 1 clinical trial at the Institute of Cancer Research and the Royal Marsden Hospital in London. Early results indicate that the drug appears to be particularly effective in people whose cancers carry mutations in the BRCA1 or BRCA2 cancer predisposition genes which are linked to breast, ovarian and prostate cancers.
The drug was given to 60 patients who had an inherited form of breast, ovarian or prostate cancer, caused by faulty BRCA1 or BRCA2 genes. These genes are thought to be responsible for about 5% of breast and ovarian cancers and about 1-2% of early onset prostate cancers.
Early results of the trial (sponsored by AstraZeneca), published in the New England Journal of Medicine show that more than half of the patients saw their tumours shrink or stabilise, despite the failure of previous treatments. The drug is now being tested in larger trials.
Dr Peter Sneddon, an executive director of clinical and translational research funding at Cancer Research UK, which part funded the trial said:
“Although development of this drug is in its early stages, it is very exciting to see that it has the potential to work when other treatment options have failed.”

CANCER INCIDENCE & SURVIVAL BY MAJOR ETHNIC GROUP, ENGLAND 2002-2006
This is the name of a first report on ethnicity and cancer incidence, published on 25th June 2009 and produced by the National Cancer Intelligence Network (NCIN) and Cancer Research UK. It is the first national analysis of cancer incidence in ethnic groups and looks at all cases of cancer diagnosed in England between 2002 and 2006.
It is said that the report will help shape policy on targeting relevant public health messages to the ethnic communities around the signs and symptoms of cancer.
Dr Lesley Walker, a director of cancer information at Cancer Research UK said:
“This report is a hugely important step forward in understanding how such a complex disease affects people from different ethnic groups.
The next step is to think about how we can target health messages appropriately, making sure different communities are aware of the signs and symptoms of the cancers that are most likely to affect them.”
It seems that while the white population is at a higher risk overall from cancer (including breast cancer), the report highlights the increased risk of certain cancers, like stomach, prostate and myeloma, in the black population, based on the data collected.

NON INVASIVE TREATMENT FOR BREAST CANCER
30th June - The Daily Mail and the Daily Telegraph reported on a ground breaking treatment for breast cancer, which uses light to target and kill tumours without the need for surgery. Photodynamic Therapy (PDT) has already being used to treat some other cancers, but a medical team at the Royal Free Hospital are trialling it for the first time on primary breast cancer. This pioneering work is being led by Mr Mo Keshtgar, leading breast cancer surgeon and member of Cancerkin’s Medical Advisory Panel. The treatment works by injecting the patient with drugs which make the target area sensitive to light. The drug is activated when a low power red laser is beamed at the area. The process starves the cells of oxygen, causing them to die. The potential advantages are that this treatment only attacks the cancer cells, rather than affecting surrounding healthy cells and could (in some cases)avoid the need for surgery. It could become an alternative to radiotherapy in the future.
Clinical trials are due to start on 20 patients this year at the Royal Free Hospital and it is hoped that if these and future trials are promising, with patients being monitored for 5 years after treatment, that this technique might be available within 6 years.

April 2009

Record fall in deaths from breast cancer

Data from Cancer Research UK has revealed that for the first time since records began, in 1971, the number of women dying from breast cancer has fallen below 12,000. This is despite the increase in breast cancer diagnosis, up by more than 50% in the last 25 years.
Cancer Research UK data showed that in 2007, 11,990 women died from breast cancer in the UK. In 1971, the figure was 12,472. That figure rose to a peak in 1989 with 15,625 women dying from the disease, but since then figures have been falling, apart from a small rise in 2005.
The fall in deaths is thought to be due to a range of factors including the introduction of the NHS Breast Screening Programme in 1988, breast awareness among women and improved treatments given in addition to surgery, such as chemotherapy, radiotherapy and hormone treatments, used to try and prevent the disease from coming back.
Professor Peter Johnson, Cancer Research UK's chief clinician, said: "It's incredibly encouraging to see fewer women dying from breast cancer now than at any time in the last 40 years, despite breast cancer being diagnosed more often. Research has played a crucial role in this progress leading to improved treatments and better management for women with the disease. The introduction of the NHS breast screening programme has also contributed as women are more likely to survive the earlier cancer is diagnosed. We hope these new figures will encourage women over the age of 47 to attend screening and to know that even if a tumour is found, their chances of beating it are better than ever."
However, rates of breast cancer have risen significantly over the last 25 years and continue to rise year on year. It is the most common cancer in the UK and is the second most common cause of death from cancer after lung cancer. This is thought to be due to a number of factors such as age, obesity, drinking alcohol, reproductive factors and to a decreasing extent, HRT.
Also, many believe that improved detection rates may be leading to a higher incidence of breast cancers being detected. According to figures produced by the NHS Breast Screening Programme, more than 19 million women have been screened and over 117,000 cancers have been detected. In 2007-08 over 2 million women were invited for screening and 1.7 million were actually screened. This figure was an increase of 500,000 from the previous decade. It seems that inevitably, this rise in the number of women being screened has had a significant impact on the numbers being diagnosed.

The NHS Breast Screening Programme is currently available to women aged 50-70, but is intended to include women aged 47-73 by 2012 as part of the Government’s Cancer Reform Strategy.

Sources and references:
Cancer Research UK
BBC website
The Times newspaper


Eating walnuts could help reduce the risk of developing breast cancer

This is the claim made by a US study presented to the 100th Annual Meeting of the American Association for Cancer Research.
Researcher Dr Elaine Hardman, of Marshall University School of Medicine, said that although the study was carried out in mice, the beneficial effect of walnuts was likely to apply to humans too.
Dr Hardman and her colleagues studied mice that were fed a diet that they estimated was the human equivalent of two ounces of walnuts per day. A separate group of mice were fed a control diet. Standard testing showed that walnut consumption significantly decreased breast tumour incidence, the number of glands with a tumour and tumour size and that those that did arise took longer to develop and were smaller.
Dr Hardman said: "We know that a healthy diet overall prevents all manner of chronic diseases. It is clear that walnuts contribute to a healthy diet that can reduce breast cancer."
The BBC reports Anna Denny, a nutrition scientist at the British Nutrition Foundation, saying that evidence for nuts reducing the risk of heart disease was currently stronger than it was for their anti-cancer properties. She said: "Although nuts are high in fat (and thus calories), the fatty acids in nuts are predominantly 'good' unsaturated fatty acids.
"Other additional components of nuts that may contribute to a reduction in heart disease and cancer risk include fibre and 'bioactive' compounds.
"More research is needed before it will be possible to attribute specific health benefits of nuts to specific bioactive compounds because nuts contain a complex mixture of different bioactive compounds."
They also report Josephine Querido of Cancer Research UK saying that there was insufficient evidence to show that eating walnuts could prevent breast cancer in humans. She said: "We know that a healthy balanced diet - rich in fruit and vegetables - plays an important part in reducing the risk of many types of cancer.”
Dr Alexis Willett, Policy Manager at Breakthrough Breast Cancer, said: “It is very difficult to know which individual foods influence the chance of getting breast cancer. That’s why this study in mice is interesting, but more research is needed in humans so we can understand more about how walnuts may affect breast cancer risk. “

Sources and References:
BBC
American Association for Cancer Research
Breakthrough Breast Cancer

March 2009

Alcohol Risks - red and white wine.

It has been known for some time that one of the risk factors associated with breast cancer is alcohol consumption. However, while previously, some research had suggested that red wine might have a small beneficial effect, a recent study says that this is not the case and that red and white wine have a similar impact on risk.
A study looking at alcohol, tobacco and breast cancer was published in the British Journal of Cancer in 2002. The results showed that not only was the risk of developing breast cancer slightly increased by drinking but the evidence also suggested that the more a woman drank, the greater her risk of developing breast cancer. Although the increase in risk per drink is small, it does add up (i.e. about 7% per drink)
The figures suggested that by the age of 80, the number of women who would develop breast cancer would be:
• 8.8 out of 100 if they don't drink at all
• 10.1 out of 100 if they have 2 drinks a day
• 13.3 out of 100 if they have 6 drinks a day
In March 2009, the results of a study carried out at the Fred Hutchison Cancer Research Centre in the US (and published in the Cancer Epidemiology, Biomarkers and Prevention journal) showed that red and white wine have a similar effect on the risk of developing breast cancer.
The team interviewed over 6,000 women with breast cancer and over 7,000 who had no history of breast cancer. All were aged between 20 and 69. Both groups drank a similar amount of alcohol, including equal amounts of red and white wine. The results showed that women who drank 14 or more alcoholic beverages were 24% more likely to develop breast cancer than those who drank no alcohol, regardless of the type of alcoholic drink.
Dr Polly Newcomb, head of the Centre’s Cancer Prevention Programme said:
‘The general evidence is that alcohol consumption overall increased breast cancer risk, but other studies made us wonder whether red wine might in fact have some positive value’.
However: ‘We found no difference between red or white wine in relation to breast cancer risk. Neither appears to have any benefits… And if a woman chooses red wine, she should do so because she likes the taste, not because she thinks it may reduce her risk of breast cancer.’
Sources and references:
Cancer Research UK
‘No Difference Between Red Wine or White Wine Consumption and Breast Cancer Risk’ : Cancer Epidemiology, Biomarkers and Prevention, 18 (3) 1007-1010 DOI


Night Shifts and Breast Cancer

A number of news sources reported that Denmark had begun compensating “dozens” of women who developed breast cancer after working night shifts. The BBC said the Danish government’s decision was based on a report from WHO’s International Agency for Research on Cancer (IARC), which concluded that working nightshifts could increase women’s risk of breast cancer. Although this report has not yet been published, a summary “found a modestly increased risk of breast cancer in long-term employees compared with those who are not engaged in shift work at night".
The NHS website commenting on this story said: ‘It is not clear exactly how working at night might increase risk of cancer. There is a theory that disruption of the circadian system and the hormone melatonin are involved. Working at night is known to disrupt our circadian system, which regulates how we respond to night and day. This system affects how active we are, which hormones are produced, and which genes are switched on and off. Some of the genes affected by the circadian system can affect tumour growth, while the hormone melatonin, which is normally produced at night, affects immune system function.’
The UK’s Health and Safety Executive (HSE) has commissioned its own report (due to be published in 2011) on the health impact of night-shift work, including its effects on breast cancer risk and will then consider what if any changes need to be made to recommended working practices in this country.
Cancer Research UK, commenting on this story have said that in their opinion: ‘the studies to date are unclear as to whether shift work actually causes breast cancer, in and of itself, or whether shift workers are more likely do other things that increase their risk, like being inactive or overweight’.

Sources and References:
• Straif K, Baan R, Grosse Y, Secretan B, El Ghissassi F, Bouvard V, Altieri A, Benbrahim-Tallaa L, Cogliano V, WHO International Agency for Research on Cancer Monograph Working Group. Carcinogenicity of shift-work, painting and fire-fighting. Lancet Oncol 2007; 12:1065-1066.
• NHS website
• Cancer Research UK


NICE reject NHS funding for cancer drug Tyverb (lapatinib) – GSK to appeal

GSK , the manufacturers of the drug Tyverb (also known as lapatinib) are appealing a decision by NICE (and also the SMC ) to reject funding for it by the NHS.
Tyverb is commonly used to treat a particular type of advanced breast cancer which has returned, despite use of standard treatments. It is not a cure, but can delay the progression of the cancer. It hit the headlines when it was used by Jane Tomlinson, who was given the drug as part of a trial. Her husband claimed the drug: ‘… gave Jane three months of reasonable quality life’. However, NICE said that it did not extend life by long enough to justify the cost to the NHS and as such would not recommend it for routine treatment.
GSK had offered to fund 12 weeks of treatment, on the basis that the NHS would only have to pay for ongoing treatment if the patient was still benefitting at the end of the trial period. GSK claimed that the cost for patients would be about £16,000 per annum and added that it could control the disease after standard chemotherapy and treatment with Herceptin had not stopped the disease from returning. They also said that a number of other European countries had granted funding for the drug (including France and Germany).
However, NICE considered that the cost would be nearer to £70,000 per annum and concluded that it was not a cost-effective use of NHS resources.
GSK have appealed the decision and the appeal panel will convene on 8th June 2009 to hear representations from the appellants.

GlaxoSmithKline
The National Institute for Health & Clinical Excellence – drugs watchdog for England & Wales
Scottish Medicines Consortium – Scotland ‘s drugs watchdog


Sources and References:
The Scotsman
NICE

February 2009

Breast cancer screening peril

In a letter to The Times 23 signatories accuse the NHS Screening Programme of failing to provide women with all the facts when inviting them to routine breast cancer checks . They say that ‘none of their invitations for screening comes close to telling the truth. As a result, women are being manipulated…into attending’. The letter says that ‘there are harms associated with early detection of breast cancer by screening that are not widely acknowledged’. It notes that many breast cancers will not do any harm if left alone; but once detected, a woman may go on to a conveyor belt of unnecessary and often aggressive treatment, including surgery, radiotherapy and possibly chemotherapy.
This letter was published the day before an analysis by the Nordic Cochrane Centre of breast cancer and screening was published in the British Medical Journal. The analysis concluded that the information distributed by the NHS was one sided and misleading for those invited to take part. While it talks of the benefits of attending the programme, it does not tell them of the disadvantages i.e. the possibility of over-diagnosis, misdiagnosis, the potential harm of the treatments for cancer and the psychological trauma of being given a cancer diagnosis. They say ‘The leaflet has the authoritative title Breast Screening: The Facts suggesting that the information can be trusted…[but] it is inadequate as a basis for informed consent’. Their research showed that if 2000 women were screened regularly for 10 years, one would avoid dying from breast cancer, but 10 healthy women would be treated unnecessarily and a further 200 healthy women will have a false alarm.
The Nordic Centre study, led by Peter Gotzsche, notes that despite the fact that20% of cancers detected by screening were DCIS cases, the NHS leaflet makes no mention of this. Fewer than half of DCIS cases become invasive cases and it is often referred to as a pre cancerous condition. DCIS has been found to exist harmlessly in the breasts of about 9% of women at post mortem, but the increased use of mammography has led to vastly increased rates of DCIS being reported. One of the signatories to The Times letter, Professor Michael Baum, said that more cases should be treated like many prostate cancer cases, with a number of men allowed to live with the cancer and often dying of unrelated causes. He said ‘the number of invasive breast cancers being detected is not falling, despite the number of cases picked up by screening rising dramatically… You would expect serious cancers to drop because the early detection means the DCIS cases are not progressing. It just doesn’t add up.’ He has said that instead of screening the whole female population over the age of 50, every 3 years, women should be tested according to their level of risk.
However, the study is disputed by the NHS who report that the national screening programme detects more than 14,000 cancers annually and saves 1,400 lives. They add that 79% of cancers detected through screening are invasive. Professor Peter Johnson, Cancer Research UK's chief clinician, said that any debate about the details "should not be allowed to distract anyone from the benefits of breast screening".
"Screening offers the best possible opportunity for early diagnosis of breast cancer and experts agree that this means a better chance of successful treatment," he explained.
"The information women receive at time of screening is based on careful research into the views of the women being screened. Improvements can always be made and we are contributing to a review by the Department of Health.”

19th February 2009
including surgeons, GP’s, oncologists, public health specialists and patient representatives
Done by mammography
Currently available to all women aged 50-70 every three years. It is to be extended to include women from 47-73 by 2012.
Ductal carcinoma in situ

Sources and Information:
The Times
The Sunday Times
Cancer Research UK
NHS
‘Breast Screening: the facts - or maybe not’ by Peter Gotzsche et al in the BMJ 2009;338:b86


Decline in breast cancer risk when HRT use stopped

The results of a US study, published in the New England Medical Journal, has provided further evidence that post menopausal women who take HRT (combined oestrogen plus progestin hormone therapy being the most commonly prescribed HRT in the UK) face a greater risk of breast cancer, but that when they stop taking HRT, the risk falls sharply again.
The study was part of a larger trial, started in the early 90’s, investigating post menopausal women. The HRT part of the study was stopped in 2002, when researchers found that women taking HRT had higher rates of breast cancer than those taking a placebo. This was followed by a significant drop in the number of women taking HRT, which was in turn followed by a corresponding fall in breast cancer rates. There has been much debate on whether these two facts are linked, but in this latest study, the researchers were satisfied that there was a clear link.
The study continued monitoring 15,000 women from the original study, who had all been urged to stop taking HRT in 2002 and compared this with data from women not originally involved, who had been given no specific advice on giving up. In the first group, the incidence of breast cancer was much higher in the 5 years up to 2002, but then fell rapidly, with diagnosed cases falling by 28% in a year. These women had approximately the same number of mammograms before and after 2002. This is relevant as some had argued previously that a reduction in the frequency of mammograms among women who stopped taking HRT might have contributed to the apparent fall.
Many women in the other group of women chose to stop taking the therapy and this coincided with a 43% fall in breast cancer rates between 2002 and 2003. Women in this group who continued taking HRT were at a higher risk of cancer, with the risk doubling for every 5 years of taking the HRT.
Dr Marcia Stafanik (co author and professor of medicine at Stanford University) said:
‘You start women on hormones and within five years, their risk of breast cancer is clearly elevated. You stop the hormones and within one year, their risk is essentially back to normal. It’s reasonably convincing cause-and-effect data’.
Dr Rowan Chlebowski, (chief investigator at the Los Angeles Biomedical Research Institute and lead author of the study) advised:
‘Postmenopausal women and their physicians should consider these findings in weighing the risks and benefits of combined oestrogen plus progestin use, especially if the women plan to take the medication for more than five years’.
Professor Valerie Beral (director of Cancer Research UK Epidemiology Unit at Oxford University) said:
‘There has been a big drop in HRT use since 2002. Because of this about 1000 fewer UK women are developing breast cancer every year’.
However, Dr David Sturdee (president of the International Menopause Society, which represents HRT specialists) is not convinced. He said:-
‘There’s no doubt there has been a drop in breast cancer rates, which is good news, but this started before the reduction in HRT use. Breast cancer takes years to develop, so if this drop was due to stopping HRT, we wouldn’t be seeing it just yet. There’s something happening, which is worth investigating, but it’s unlikely to be HRT.

Sources and References:-
BBC News
Cancer Research News
Chlebowski RT et al. Breast Cancerafter use of estrogen plus progestrin in postmenopausal women.
N Engl J Med Feb 5; 360:573

Hormone injections improve survival in premenopausal breast cancer patients

A study in the Journal of the National Cancer Institute is thought to be the first to look at the long term impact of goserelin (more commonly known as Zoladex and given by injection) and its effectiveness compared to tamoxifen, an oestrogen blocking drug. Cancer Research UK scientists and their colleagues have shown that treatment with goserelin improves long term survival in premenopausal breast cancer patients.
Hormonal therapies interfere with the production or action of particular hormones in the body. Most breast cancers need supplies of the hormone oestrogen to grow. Production of oestrogen by the ovaries is stimulated by a hormone called leuteinising hormone, which is produced by the pituitary gland in the brain. Zoladex stops the production of leuteinising hormone from the pituitary gland, which leads to a reduction in oestrogen levels. The cancer cells then grow more slowly or stop growing altogether. The cancer may shrink in size.
Researchers recruited over 2700premenopausal women with breast cancer and placed them randomly in one of four treatment groups, receiving either Zoladex, tamoxifen, both drugs or neither one, for 2 years.
It was found that women who were given Zoladex experienced similar outcomes to those taking tamoxifen. 15 years after the start of treatment there were 8.5 fewer deaths per 100 and 13.9 fewer recurrences per 100 among those who were given Zoladex alone than among those taking neither drug. There was no significant benefit from taking both drugs.
It seems that based on long term follow up of this trial, Zoladex is as effective as tamoxifen when each are given for 2 years. Researchers said:
‘IT may be that women who are unlikely to complete 5 years of tamoxifen tablets may prefer two years of goserelin injections.’

Sources:
Cancer Research UK
Cancerbackup

January 2009

Cancer patients eligible to apply for free prescriptions

From 1 April 2009, all cancer patients will be eligible for free NHS prescriptions covering all treatments, not just those related to their cancer.
The scheme is available to those undergoing treatment for cancer, the effects of cancer or the effects of cancer treatment.
Patients need to get an application form from their GP’s surgery or oncology clinic. The form must be signed by the patient and their GP, hospital doctor or service doctor.
The certificate lasts for 5 years and can be renewed as many times as necessary, as long as the patient still satisfies the qualifying conditions.
If you haven’t got a certificate yet, ask for a refund form whenever you pay for a prescription after April 1. When you receive your certificate, you can reclaim that money, but note that after April 1, any certificates issued will only be backdated to begin one month prior to receipt of application.
It is estimated that up to 150,000 people will benefit from this scheme, with individuals saving up to £100 each year in prescription charges.

Source: www.nhs.uk

Drinking tea can cut risk of breast cancer

In January 2009, various newspapers reported that drinking 3 cups of tea a day could cut the risk of younger women developing breast cancer on the basis that the anti cancer properties of tea could have a more potent effect on the types of tumours commonly seen in younger women.
The claim was based on a case-control study of 5,000 women aged 20-74, who had been treated for breast cancer. These women were interviewed on their consumption of tea over the 5 years prior to their cancer being diagnosed and their responses were compared with those of 4,500 healthy women, with similar medical histories and lifestyles.
While the authors say that tea consumption is not related to breast cancer risk overall, they report that in their sub group analyses, women under 50, who drank 3 or more cups of tea a day, had a 37% reduced breast cancer risk compared to women reporting no tea consumption. The researchers said that while further research was needed on this issue, their results provide support for the theory that ‘regular tea consumption, particularly at moderately high levels, might reduce breast cancer risk in younger women’.
The research was conducted by Dr Nagi Kumar of the Cancer Center & Research Institute in Tampa, Florida and colleagues from various other institutions and published in a peer-reviewed medical journal.
The view of the NHS Knowledge Service is that while this study is interesting, they should not provide the basis by which people decide what to drink and that the research should be seen as low-level evidence .

Sources and References:
www.nhs.uk/news
‘Tea Consumption and Risk of Breast Cancer ‘– Cancer Epidemiology Biomarkers & Prevention 18, 341-345, January 1, 2009 by Kumar N, Titus-Ernstoff L, Newcomb PA et al.

Embryo Screening and the BRCA1 gene

January 2009, saw the birth of the first British baby, genetically screened before conception, to be free of the faulty BRCA1 gene. Paul Serhal (medical director of the assisted conception unit at University College Hospital, London) said:
‘This little girl will not face the spectre of developing this genetic form of breast cancer or ovarian cancer in her adult life. The parents will have been spared the risk of inflicting this disease on their daughter. The lasting legacy is the eradication of the transmission of this form of cancer that has blighted these families for generations.’’
A woman carrying a faulty BRCA1 gene has a 50%-85% chance of developing breast cancer and in this case, the girl was considered to have an 80% chance of developing the disease based on the fact that the faulty gene ran through her father’s family.
PGD (pre-implantation genetic diagnosis) has already been used in this country to free babies of life shortening inherited diseases such as cystic fibrosis and Huntington’s, but special permission had to be sought from the Human Fertilisation and Embryology Authority by the London Clinic which performed the procedure. For the first time, embryo selection was made for the purpose of reducing rather than eliminating the baby’s chances of getting breast cancer as an adult. PGD involves testing a group of embryos to ensure that the one returned to the womb does not carry faulty genes. In this case, 6 out of the 11 embryos tested carried the defective BRCA1 gene. Two embryos which were free of the gene were implanted, resulting in a single pregnancy.
However, it is recognised that the decision to screen embryos for this gene is a complex area and raises a number of ethical issues. The discarded embryos might have become women who would never have had cancer and although women with faulty BRCA1 and 2 genes have a risk of up to 7 times higher than other women of developing breast or ovarian cancer, some of them will be cured and some might never have developed these diseases at all. Finally, it cannot be said that this baby will be cancer free during her lifetime; all that can be said with certainty is that she does not carry the BRCA1 gene.

Source:
The Guardian Newspaper