Cancerkin’s News….

Class updates…

Over the coming weeks Beverley Drumm will be offering an introductory course of Yoga and Dance therapy classes on Monday mornings. Classes in Kundalini yoga, a powerful practice where your body is gently stretched and toned, inducing deep relaxation and including postures and meditations specifically for women will take place at 10am. Classes in The Nia Technique, an expressive, dance-based movement form that is an exhilarating treat for body, mind and soul, will follow at 11am. The sessions are on Monday 29^th November, 6^th December and 13^th December. Absolutely no experience is necessary and everybody is warmly welcome. To reserve your place, please email Laura at l.smith@cancerkin.org.uk or call 020 7830 2323.

Pilates classes will be put on hold over the Christmas period after this week’s session on Thursday 26^th November. They will restart in the New Year on Thursday 13^th January 2011.

Yoga will not take place this Friday, 26^th November, as our yoga instructor Martin is away. Classes will resume on 3^rd December 2010 when he returns.

Thank you from Cancerkin…

We would like to extend our thanks to Cheryl Berlin and Jenny Sandler, who helped us put on another successful patient support group session this week. Cheryl first gave an informative talk on genetics, breaking down the complex theory behind the BRCA1 and 2 genes, explaining how genetic testing is conducted and weighing up its benefits and disadvantages. Jenny then led a very enjoyable session in relaxation and exercise techniques. We would like to thank them both for giving us their time.

In the news…

The fight to reduce breast cancer risk…

This week, the Daily Mail has published an interesting article about the decision made by a young woman who discovered she carried a gene for breast cancer. After testing positive for the gene, Jodie Mason, 31, chose to have a radical double-mastectomy in order to reduce her risk of developing breast cancer. Although in perfect health, Miss Mason elected to have both breasts removed and replaced with gel implants, a decision that her mother had also taken five years earlier.

Miss Mason’s story highlights the difficult decisions faced by those who discover they have a familial predisposition to breast cancer - those with the gene have a higher risk of developing the disease. The BRCA1 and BRCA2 genes can be identified by blood test and, following a positive result, preventative surgery is an option that some women take.

Accounts of radical surgery like Miss Mason’s regularly appear in the press, and whilst some deem it a drastic move, others consider it a practical decision. Speaking to the Daily Mail about her own experiences, Miss Mason said 'It is something that hangs over you and now that I have had the operation I feel like I can get on with my life.' She added: 'The operation doesn't guarantee that I won't get another form of cancer but at least I have protected myself from breast cancer.' To read her story in full, please click here.

Annual screening for younger women continued…

As we reported in the last edition of On the pulse, a leading cancer screening expert, Professor Stephen Duffy, has argued for the introduction of annual breast screening for women in their 40s with a moderate to high risk of developing breast cancer. Cancer Research UK this week published more information about the study upon which his comments are based.

The study, conducted by researchers at Queen Mary, University of London, examined 6,710 women with an intermediate familial risk of developing breast cancer, in order to find out if annual screening at an earlier age could have an impact on how early cancers were detected and on a patient’s risk of dying within ten years of diagnosis. The whole group received annual screening for an average of 4 years. Results taken from the group were then compared to those of women in two other studies into breast cancer, most of whom had not received an annual mammogram. Researchers found that in women who had been screened, breast cancer tumours were on the whole significantly smaller, less likely to spread to the lymph nodes and of a lower grade. They also discovered that women who had been diagnosed with invasive breast cancer but who had received mammograms were more likely to survive to ten years after diagnosis.

Published in the Lancet Oncology medical journal, the study states that: “In women younger than 50 years who are at medium or greater familial risk of breast cancer, mammographic surveillance could increase cancer detection, reduce the risk of advanced stage disease and decrease predicted mortality.” Hazel Nunn, senior health information manager at Cancer Research UK, said: “Since it seems 5,000 women would need to be screened to save one life, it will be important to weigh up these benefits carefully against potential risks of routine mammography before deciding whether screening really is the best course of action for this group. We await the results of further research measuring the risks.”

To read more about the study, please click here.

Laura Smith 25^th November 2010

l.smith@cancerkin.org.uk

On the pulse

Cancerkin’s News….
Christmas is coming…
Preparations for the annual Christmas Tombola on 10th December are well underway and we have already received some generous prize donations, ranging from scented candles and book tokens to a family meal and haircuts. If you have any items that might make a suitable prize, such as a box of chocolates, toiletries or books, or if you work in a restaurant, café, shop or hairdressers and would be willing to donate your wares or services, we would love to hear from you. We are also looking for willing volunteers to shake some collection tins for us around the hospital on the day, so if you have a few hours to spare on 10th December, do get in touch. Please email Laura on l.smith@cancerkin.org.uk or call 020 7830 2323.

Yoga Classes Cancelled…
Unfortunately, our weekly yoga class will be cancelled this Friday, 19th November, and next Friday, 26th November, as our yoga instructor Martin will be away on holiday. Classes will resume on 3rd December 2010 when he returns.


In the news…
Annual breast screening for younger women?
As reported in The Telegraph, a leading cancer specialist has this week asserted that women under the age of 50 with a family history of breast cancer should be offered annual mammograms. Professor Stephen Duffy, a cancer screening expert at the Wolfson Institute for Preventative Medicine argued that those with a moderate to strong family history of the disease should be given annual screening from the age of 40. He estimates such a move could save up to 50 lives a year and could put the minds of many women in this category at rest.

Currently the NHS’s Breast Screening Programme offers a mammogram every three years to women aged between 50 and 70, helping to save between 1,000 and 1,500 lives a year. Prof Duffy points out that only a small number of women under 50 would require the annual checks he proposes – around 300,000 thousand women aged 40-49 fall into the high risk group. He states: "It's worth doing because nowadays people are more and more aware of relatives with cancer and it causes a lot of worry."

Prof Duffy’s comments follow the publishing of his study into breast cancer in women in their 40s. The study compared death rates of women in this age bracket with a family history of breast cancer who were given annual mammograms and those of two similar groups who were not given screening. He found that, in those who had had annual screening, cancers were smaller and less likely to spread and those with cancers that had spread were more likely to be alive 10 years after diagnosis.

To read The Telegraph’s article, please click here.

A quarter of all cancers discovered late…
Research conducted by the National Cancer Intelligence Network (NCIN) has revealed that 1 in 4 of all cancers in patients in England is found at a late stage following emergency admittance to hospital. Researchers at the NCIN examined the records of all English patients diagnosed with malignant cancer (excluding non-melanoma skin cancer and multiple tumours) in 2007, to find that 23 percent of patients presented as emergencies , that is via A&E, emergency GP referral, emergency consultant outpatient referral, emergency transfer, or emergency admission or attendance. An additional 25 percent were diagnosed through the ‘Two Week Wait’ urgent GP referral.

Results suggest that the route to diagnosis varied widely between types of cancer. In breast cancer patients, only 4 percent were diagnosed following an emergency admittance with 42 per cent diagnosed after urgent GP referral and 21 per cent following routine screening. In contrast, 57 percent of patients with acute leukaemia and 58 percent of those with brain tumours were diagnosed through emergency presentation. In terms of age and socioeconomic background, the under 25s, over 75s and those from poor backgrounds were most likely to be diagnosed in this way.

What the study most importantly revealed was that survival rates were much lower in patients diagnosed at this late stage in their disease. In patients presenting as an emergency with all cancers (except acute leukaemia), the likelihood of reaching a year after diagnosis was lower than with earlier diagnosis. Sara Hiom, Cancer Research UK's director of health information, said of the results: "Spotting cancer early can make all the difference to the outcome. And we're working hard to raise public awareness of the early signs and symptoms of cancer and to ensure that GPs have clear guidance on who and when to refer. It's also important that people take up their screening invitations. These new data show us there's a real opportunity to reduce the numbers of cancers diagnosed this way."

To read Cancer Research UK’s report in full, please click here.

New treatment for late-stage breast cancer…
A new chemotherapy drug called Halaven, used to treat patients with metastatic breast cancer, has this week been approved for use in the U.S. This approval follows a recent study into the drug which revealed its potential to significantly increase survival times for those in the late stages of the disease.

The study examined 762 women with metastatic breast cancer who had already had two other courses of chemotherapy. They were assigned treatment with either Havalen or another single agent therapy chosen by their oncologist. For those who received Havalen, the average survival time was 13.1 months, in comparison with 10.6 months for those receiving other treatments.

Havalen belongs to a group of drugs called microtubule inhibitors, which work by inhibiting the growth of cancer cells. It is a synthetic form of a chemotherapeutic agent found in the sea sponge Halichondria okadai and is received by injection. Richard Pazdur, M.D., director of the Office of Oncology Drug Products at the U.S.’s Food and Drug Administration Center for Drug Evaluation and Research, said: "There are limited treatment options for women with aggressive forms of late-stage breast cancer who have already received other therapies. Halaven shows a clear survival benefit and is an important new option for women."

To read the full article released by the U.S. Food and Drug Administration, please click here.

Laura Smith 18th November 2010
l.smith@cancerkin.org.uk

On the pulse

Cancerkin’s News….
Creative writing in December…
Lily Seibold will be holding her next creative writing session on Monday 6th December 2010 at 10am until 3pm. With the festive season imminent, the group will explore and write about what different seasons mean to them. Each season tells a different story and you can tell yours as well as listen to those of famous writers.

Tea and coffee will be available but lunch will not be provided. There are plenty of places around the hospital to eat, alternatively you can bring your own food and use our patient waiting room. If you would like to attend, please email Laura on l.smith@cancerkin.org.uk or call 0207 830 2323.

In the news…
Introducing the ‘Cyberknife’…
Announced in the news this week was the arrival of the first NHS ‘Cyberknife’ machine at the Mount Vernon Hospital in North London. Providing treatment that targets difficult to treat tumours, the Cyberknife was previously only available in the UK through private health care. The machine was purchased with an anonymous donation of £2 million and its services will be made available to cancer patients all over the country, bringing hope to many who had been told that their tumours were inoperable.

The non-invasive treatment uses a robotic arm to deliver multiple beams of high dose radiation from different angles, meaning it is able to reach tumours in difficult or dangerous areas such as the brain or the spinal cord. The machine is extremely precise – its beam is accurate to within a millimetre - and so, when it is targeted at a tumour, minimal damage is made to the surrounding healthy tissue. As a result, high dose Cyberknife treatment can be delivered in just a few sessions whilst conventional radiotherapy involves twenty or more short sessions with low-dose radiation.

A BBC report about the Cyberknife interviewed Daphne Duggan, a breast cancer patient with secondary brain tumours who has benefited from the treatment. She said: ‘it’s just so easy. Everybody who is offered the opportunity to have treatment with the Cyberknife should grab it with both hands.’ It has now been announced that a further machine will be installed at the Royal Marsden Hospital in London next spring. To watch the BBC news report, please click here.

New developments in breast cancer prevention for postmenopausal women…
A new study has revealed the impact Lasofoxifene can have on reducing the risk of breast cancer and other health problems in postmenopausal women with osteoporosis. A study conducted at the Fred Hutchinson Cancer Research Center in the US and published in the online Journal of the National Cancer Institute randomly assigned 8556 such women different doses of the drug or a placebo. Researchers found that, in comparison with those who took the placebo, the overall risk of breast cancer development in women who took 0.5 milligrams of the drug was dramatically reduced by 79%. Furthermore, the risk of estrogen receptor positive invasive cancer was reduced by 83%, and cases of coronary events, strokes, vertebral and non-vertebral fractures were all significantly lower.

Lasofoxifene belongs to the same group of drugs as Tamoxifen and Raloxifene, known as SERMs – or selective estrogen receptor modulators – which are sometimes used in breast cancer chemoprevention. The drugs work by blocking the effects of estrogen on breast tissue and all have similar effects on reducing breast cancer risk in postmenopausal women with osteoporosis as well as offering certain health benefits. However Tamoxifen can cause further complications and has been linked with endometrial cancer and other gynaecological problems, whereas Raloxifene is less widely used as it does not offer a wide enough range of health benefits. What this study reveals is that Lasofoxifene potentially offers a wider variety of health benefits but does not pose further risks to patients’ health.

Victor G. Vogel, MD, of the Geisinger Medical Center, said of the study: "We need more complete information about the long-term effects of Lasofoxifene on both beneficial and unfavourable outcomes, but the early data regarding its risks and benefits are encouraging." To read more about the study, click here.

Exercise can aid recovery…
At Cancerkin, we see first hand the positive impact undertaking exercise and staying active can have for our patients. In the news this week, preliminary results from a study into exercise for recovering breast cancer patients suggest that a structured programme of physical activity can help reduce the risk of breast cancer recurrence and improve quality of life. The pilot study, lead by researchers at the Peter MacCallum Cancer Centre in Melbourne, Australia, indicates that increasing physical activity improves general health and is therefore an important part of the rehabilitation process.

Researchers found that on the whole, breast cancer patients tended to do less exercise during treatment than they had beforehand. Many were motivated by their diagnosis to undertake a new healthier lifestyle but often failed to put such plans into action due to lack of support and structure. Annabel Pollard who led the study said: "Enabling cancer survivors to recover or improve their health after cancer treatment is perhaps as important as treating the disease […] The research indicates that simply providing information alone does not change behaviour; a structured approach is more conducive to change". Clinical Oncological Society of Australia President, Professor Bruce Mann, added: "Physical activity is not usually high on the list of priorities for patients, but we should be encouraging and supporting them to undertake structured programs." If you would like to read the article in full, please click here.

Laura Smith 11th November 2010
l.smith@cancerkin.org.uk

On the pulse

Cancerkin’s News…
Christmas Tombola coming soon…
Christmas is fast approaching and to celebrate the festive season Cancerkin will be holding a fundraising tombola at the Royal Free Hospital on 10th December. Last year a vast array of fabulous prizes were generously donated to us, ranging from books and toiletries to bottles of champagne and meals for two. If you, your business or your place of work are interested in donating a prize to help make the event a success, we would love to hear from you. Please contact Laura at l.smith@cancerkin.org.uk or call 0207 830 2323.

In the news…
New technique shows if treatment is working…
Cancer Research UK has reported on the development of a new method that quickly shows if breast cancer treatment is working. Current methods using CT scanning and MRI can only detect the impact of treatment when a tumour begins to shrink, a sign that can take a number of weeks to become visible. The new imaging technique, developed by scientists at Cancer Research UK’s Cambridge Research Institute, is able to recognise very early changes in cancer cells, allowing doctors to evaluate the effect of treatment at a much earlier stage.

Researchers used two specially labelled chemical markers on breast cancer cells treated with the chemotherapy drug Doxorubicin to highlight early signs of response to the treatment. The first marker, [1-13]pyruvate, shows if the drug is damaging the DNA of cancer cells and the second, [1,4-13C2]fumarate, shows if it is killing such cells, both positive signs that treatment is working.

Lead researcher, Professor Kevin Brindle, said of the impact the technique could have: “Our new imaging method not only shows early evidence that treatment is working but could also help predict the long term outcome.” Dr Lesley Walker, director of cancer information at Cancer Research UK, added: “We need fast and accurate ways of knowing that the treatment is working. This research could help us tailor treatment to each patient by giving doctors a useful tool to check treatments are working after a short time, rather than waiting several weeks to see if the tumour is shrinking, reducing unnecessary treatment for women.” To read more about the technique, click here.

Can green tea help fight breast cancer…?
Each week, the press pitches us new theories surrounding supposed breast cancer-fighting super foods. Writing off one such popular theory, a Japanese study published recently in the journal Breast Cancer Research has found that green tea, a drink previously thought to have breast cancer-fighting properties, in reality does nothing to reduce the risk of developing the disease.

Lead by Motoki Iwasaki at the National Cancer Centre in Tokyo, the study monitored 54,000 Japanese women who drank green tea over a period of five years. Researchers found that, regardless of how much the women drank, the tea had no effect on their breast cancer risk. The study contradicts earlier research into the drink during in-vitro and animal-based studies that suggested green tea could help prevent the disease.

Despite the study’s findings, it is not to say that green tea is without health benefits. As listed in The Independent this week following the study’s revelation, some of its healthful properties include: aiding weight loss, preventing tooth decay, regulating digestive functions and improving mental processes. More significantly, separate research into the drink has recently revealed that drinking five cups a day can reduce the risk of stomach cancer in women by up to 20%. To read more about the relative health benefits of green tea, please click here.

A phone ‘app’ for every occasion…

A new iPhone ‘app’ newly launched by Breakthrough Breast Cancer is aiming to help make more women breast aware. A thoroughly innovative approach to breast cancer awareness, the application, which can be downloaded free from the internet to your iPhone, follows three simple steps: images and a video demonstrate how you should check your breasts, using the TLC (Touch, Look, Check) routine; an alert reminds you to carry out regular checks; and a quiz-style “Risk-Report” examines your lifestyle, environment and family history to assess your risk of developing cancer.

In line with recent internet-based “Everyone is Art” and Facebook campaigns for breast cancer awareness month, as reported in On the pulse last month, this interactive ‘app’ is clearly targeted at a younger audience. Young women are increasingly at risk of developing breast cancer and so it is encouraging to see new approaches to breast awareness that are able to engage with younger women and teenage girls and to encourage them to check their breasts regularly.

Judith Potts, a former actress who was diagnosed with breast cancer in 2008, has shared her thoughts on the ‘app’ in her blog in The Telegraph this week – to read it, click here. If you would like to download the application yourself, please click here.

Laura Smith 4th November 2010
l.smith@cancerkin.org.uk

On the pulse

Cancerkin’s News….

A big Thank You from Cancerkin!

Breast Cancer Awareness Month at Cancerkin is now drawing to a close and we would like to say a huge thank you to everyone who has been busy raising money for Cancerkin this October. We would like to give a special mention to….

· Philippa Drew, who has raised £3000 from some talks she has been giving.

· Gina Atherton, who raised an amazing £800 for Cancerkin when she swam a mile earlier this month. Well done Gina.

· Alison Swan, who organised a charity Pilates day, raising £460 for Cancerkin. It was an impromptu decision on Alison’s part to stage this year’s event, but next year she is planning bigger and better things – watch out here for more information nearer the time.

· Linda Newton (Lauren Newton’s mum), who held a cake sale in aid of Cancerkin and was able to raise an impressive £450.

· Priya Mehta, a former intern at the Cancerkin office, who is donating the proceeds of a fundraising breakfast at Shaftesbury High School to mark breast cancer awareness month.

· Rada Ristic, who we would like to thank again for generously leaving her book collection to Cancerkin. Her donation helped to make our annual October stall a huge success, raising over £800.

Drama therapy starting next week…

Do you want to work creatively? Have fun? Explore ideas through music, drama games and improvisation? Maybe hone the acting skills last exercised at school? Well now’s your chance! This November we are holding weekly drama workshops, beginning Thursday 4^th November at 12 - 1.30pm and continuing on the 11^th, 18^th and 25^th. To reserve a place, please call 0207 830 2323 or email Laura, at l.smith@cancerkin.org.uk.

Cancerkin’s East London Programme…

Since June 2010 Cancerkin has been running free monthly information and complementary therapy sessions in East London at St Joseph’s Hospice, Hackney. Nearly 40 women from all over East London have participated in these sessions benefiting from a range of Cancerkin’s complementary therapies. The days have consisted of one-to-one sessions of massage, reflexology, reiki and soul therapy plus group sessions of art therapy, dance therapy and/or tai chi. Cancerkin has received extremely positive feedback from all the participants, many of whom have never experienced any of these therapies before. We scored top marks from the responses to our questionnaire (ranking the day on a scale of 1 (not helpful) to 10 (brilliant) - most gave us 10! Click here to see pictures of the sessions, taken by Chloé Meunier ©.

Cancerkin has not worked alone in this East London outreach programme. We would like to thank St Joseph’s Hospice for providing the most stunning venue plus a team of helpful and obliging staff members who supported us throughout the programme. In addition, we also wish to thank Newham, Homerton, St Bartholomew’s and Whipps Cross hospitals along with our local partner organisations for all their support in making these sessions such a success.

In the news…

MRI scans counter-productive for early stage breast cancer patients?

Much has been written in the press this week about the use of MRI scans on early stage breast cancer patients, following criticism of the screening technique by Malcolm Kell, a consultant surgeon and senior lecturer at the Eccles Breast Screening Unit, University College Dublin. Writing in the British Medical Journal, he questioned the increasingly routine use of the Magnetic Resonance Mammography (MRM) in newly diagnosed breast cancer patients, arguing that it could do more harm than good and may lead to unnecessary surgery.

Using strong magnetic fields and radio waves to produce a detailed image of the breast, the MRM is a highly sensitive technique, capable of picking up difficult to spot tumours that may be missed by the traditional X-Ray Mammography. Used in conjunction with ultrasound and X-ray, the screening technique is most frequently used for monitoring patients with advanced breast cancer and for assessing a patient’s response to chemotherapy. MRM may be also be offered to young women with a genetically high risk of developing breast cancer, as breast tissue in women of a younger age is firmer and consequently harder to screen using other methods.

Mr Kell’s criticisms, however, lie in the technique’s implications for patients in the early stages of breast cancer. Research suggests that, due to its sensitivity, the MRM picks up harmless growths in such patients at an early stage of the disease that will have no effect on the patient’s prognosis. As a result, he warns that patients may be opting for surgery and mastectomy too quickly. A trial of its use in early breast cancer patients found that the technique did not reduce the number of women returning for further surgery after initial surgery failed to remove all potentially cancerous tissue. The number who consequently had a mastectomy was seven times higher (seven per cent compared to one per cent) in those who had an MRM, while there was no evidence that the increased rate of more aggressive surgery had saved lives. Mr Kell stated that MRM’s ‘routine use in the management of patients with early stage breast cancer may be unwarranted. We have no evidence to support a clear benefit in this setting.’ In response, however, a spokesperson from Breast Cancer Care highlighted that MRI scans are not routinely used on these patients and that few women are likely to be affected by the issues raised by Mr Kell. To read The Telegraph and The Daily Mail’s reports on Mr Kell’s comments, please click here or here.

Breast Cancer Genes are passed on by fathers too…

As we know, a family history of cancer can play an important role in determining the risk of cancer development. In women diagnosed with breast and ovarian cancer, as many as 30% will have a family history of the disease and 5 to 10% will carry the BRAC1 or BRAC2 genes. While emphasis is often put on the mother’s family tree, a study published this week in the online edition of The Lancet Oncology is encouraging us to think more about our father’s family history of breast and ovarian cancer. The study suggests that overlooking paternal family history can lead to some women’s risk of cancer development being underestimated.

Using patient records to compare referrals of patients with maternal and paternal family histories of breast and ovarian cancer, researchers at the Princess Margaret Hospital in Toronto, Canada, found that women with a familial predisposition on the mother’s side were five times more likely to be referred to a specialist. The breast cancer genes BRAC1 and BRAC2 however are carried by both men and women and have the same 50% chance of being passed on by each sex, a fact of which many are unaware. Researchers wrote: “deficits in knowledge among healthcare providers and the general population about the inheritance patterns of BRCA1 and BRCA2 gene mutations could result in missed opportunities for genetic testing and cancer prevention in individuals with a paternal family history.” Commenting on the study’s findings, Elizabeth A. Poynor ,MD, at Lenox Hill Hospital in New York, said: “the study reinforces the importance of obtaining the appropriate three generation family history of cancer and other illnesses as well as the importance of educating primary care providers and women about cancer risk identification.” To read the article in full, click here.

Laura Smith 28^th October 2010

l.smith@cancerkin.org.uk