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.