ASCO Updates Antiemetic Guidelines in Patients on Chemotherapy

Oncology Nurse Advisor reports that “the American Society of Clinical Oncology (ASCO) has updated their antiemetic guideline regarding the use of palonosetron and netupitant in combination to treat nausea and vomiting in patients receiving chemotherapy.” The update “committee recommends that patients receiving highly emetogenic chemotherapy regimens be offered a combination of a NK1 receptor antagonist, a 5-HT3 receptor antagonist, and dexamethasone, with netupitant and palonosetron plus dexamethasone (oral combination) also being an option for additional therapy.” Besides that, the “committee…did not recommend deviations from 2011 ASCO guideline at this time.”

The update is published in the Journal of Clinical Oncology.

Worrying While Waiting For Test Results May Better Prepare Patients For Good Or Bad News

The New York Times reports in its “Well” blog that a study published in the journal Emotion looked at how “people manage stress while waiting for high-stakes results.” The study revealed that during the waiting period, “those who tried coping techniques failed miserably at suppressing distress.” Once the news arrived, those who worried about the results “were more elated than their relaxed peers, if it was good; if bad, the worriers were better prepared,” the study found.

Media May Overhype Some Unproved Cancer Meds

According to USA Today , a report published online in JAMA Oncology indicates that “the media often use” words or phrases like “breakthrough,” “game changer,” or “miracle drug” when discussing “new cancer drugs, even when the drugs are unproved.”

The Washington Post  “To Your Health” blog reports that near the end of June, “not long after the annual conference of the American Society of Clinical Oncology,” researchers did a Google News search for “the phrase ‘cancer drug,’ along with nearly a dozen superlatives, such as ‘revolutionary’ and ‘miracle.’” Their “inquiry turned up 94 articles from 66 separate news outlets, referencing 36 different drugs.” The researchers found that “despite the glowing adjectives, half the treatments had not yet been approved by the Food and Drug Administration; a handful of them had not yet even been tested in humans.”

Modern Healthcare  “Vital Signs” blog reports that “when the researchers examined who made the superlative comments about the drugs, they found that while physicians (27%), patients (8%) and industry experts (9%) made several of the comments, 55% had no attribution—in other words, the superlative assertions were being made by the journalists themselves.”

HealthDay (10/30, Thompson, 22K) reports that “cancer patients are most harmed by this hype, said Dr. Lidia Schapira, editor-in-chief of Cancer.Net and an oncologist at Massachusetts General Hospital in Boston.”

 

Report Says PSA Tests Reduced Metastatic Prostate Cancer Rate, But Mammography Did Not Lead To Lower Rates Of Metastatic Breast Cancer

According to the AP (10/29), “A new report” published in the New England Journal of Medicine “raises fresh questions about the value of mammograms.” Researchers found that “the rate of cancers that have already spread far beyond the breast when they are discovered has stayed stable for decades, suggesting that screening and early detection are not preventing the most dangerous forms of the disease.” The report, however, showed a different trend for prostate cancer, as “the rate of advanced cases of that disease has been cut in half since screening with PSA blood tests came into wide use around 1988, and the average age at which men are diagnosed has fallen – from 72 to 70, the authors write.”

The Los Angeles Times (10/29, Kaplan) points out that the “data from the National Cancer Institute show that the rate of new cases” of metastatic breast cancer “has held steady at just under 20 per 100,000 women, despite the fact that widespread breast cancer screening programs were introduced in the 1980s.”

Modern Healthcare (10/29, Evans) reports that the authors “argue that current breast cancer screening may be ineffective because not all cancers metastasize identically, according to theories of how tumors spread.”

DCIS More Likely To Be Aggressive When Discovered In Older Women

HealthDay  reports that “while experts know the chances of finding” ductal carcinoma in situ (DCIS) “increase with age,” research published in Radiology “shows these cancers are more likely to be aggressive when discovered in older women.”

HealthImaging reports that the researchers wrote, “The discussion about upper age limits and minimal intervals in mammography screening should be focused on effectiveness of detection of invasive cancers.”

A RSNA press release noted the results are likely to provide fodder for further debate over the pros and cons of screening older women for breast cancer.

High-Dose Radiation Therapy Compared with Conventional Radiation Therapy

HealthDay recently reported that research suggests that “high-dose radiation therapy over a short period of time treats early stage breast cancer as well as longer, conventional radiation therapy does.” Investigators found that “eight years after treatment, there were no significant differences in survival among hundreds of patients who received intense radiation therapy over four weeks or standard radiation therapy over six to seven weeks.” The findings were presented at the American Society for Radiation Oncology annual meeting.

Radiation therapy significantly reduces the risk of local cancer recurrence and improves the chances of survival, but many breast cancer patients don’t get standard radiation therapy because it takes a long time and has higher costs, the researchers said.

Intense radiation therapy shortens treatment by weeks and is far less expensive for patients, the study authors explained.

ACS breast cancer screening guidelines unlikely to impact insurance coverage

Kaiser Health News (10/24, Andrews) reported that “the American Cancer Society’s new breast cancer screening guidelines, recommend[ing] that women start screening later and get fewer mammograms…is unlikely to affect insurance coverage anytime soon.” These “guidelines on their own likely won’t change insurer and employer decisions regarding coverage of screening for breast cancer, experts agree.”

USA Today (10/26) editorial criticizes the new American Cancer Society (ACS) mammogram guidelines. USA Today writes that the panel responsible for the guidelines “opted for recommendations that invite devastating consequences for some women.”

In an “Opposing View” in USA Today (10/26), Ruth Etzioni, a biostatistician, and Kevin Oeffinger, a physician, both members of the ACS panel that wrote the guidelines, write, “The recommendation that by age 45 women should undergo regular screening is designed to limit the numbers adversely impacted while benefitting as many as possible.”

The New York Times (10/26, Subscription Publication) also editorializes on the new guidelines, saying they present “another wrinkle for women who are trying to make informed decisions about their health care.” The Times argues that “when there is still such a dizzying array of expert opinion, it would be wiser to require insurers to continue covering all women starting at 40.”

The Washington Post (10/24, Lerner), Barron H. Lerner, a professor in the division of medical ethics at New York University’s Langone Medical Center, wrote that “the ACS is to be applauded,” as “its new guidelines are based on the actual scientific value of early detection, not the organization’s needs and prior beliefs.”

Protesting for Metastatic Breast Cancer Research

It is estimated that 150,000-250,000, Women & Men in the U.S. are living with Metastatic Breast Cancer.  1430 people die every single day from MBC. 24% of these people are alive 5 years from Diagnosis. AND, only 7% of $15-BILLION dollars from 2000-2013, by the major government and non-profit funders in the US and the UK was spent on Metastatic focused Research. This is unacceptable, and change needs to happen.

I met an amazing woman, Beth Caldwell, who is one of the leaders of this MetUp Protest. Beth, is a young mother, metastatic breast cancer thriver, and passionate advocate. Beth, explains life as a MBC patient, the lack of funding & awareness it receives, and what we intend to do to change it. Tomorrow is one step of this process. You can see her video here: http://bit.ly/1N9a7KT and her Huffington Post article here: http://huff.to/1Ii99IL

METUP is a diverse, non-partisan group committed to direct action for a viable cure for breast cancer. We protest and demonstrate; we meet with government and health officials and researchers; we support research into metastatic disease; and we speak out against the sexualizing of breast cancer. We are convinced that the deaths of women and men from metastatic breast cancer are a paramount issue, and we pledge ourselves to oppose all who deny the reality of the 522,000 people who will die from metastatic breast cancer globally every year while waiting for a cure to be found.

Legislative Goals

    1. We want the SEER database modified to begin tracking when someone with early stage disease metastasizes, so that every woman and man with metastatic disease is counted.
    2. We want additional research funding for all cancer types. The National Institute of Health (NIH) now only funds about 8% of the grant applications it receives. We want that number increased to at least 25%.
    3. We want at least 30% of federal breast cancer research dollars to be spent on metastatic disease, with a focus on translational research.

Today, I will be joining over 220 Women & Men, to advocate that more funding for breast cancer gets allocated for Metastatic Research. This protest, AKA “DIE-IN” will take place on the West Lawn of Capital Hill, in Washington, D.C. We will make our voices heard, our bodies seen, and our passion for this change to happen. We will also be meeting with legislators to ask for their support.

I am honored to be here today, representing the many lives of women and men who have passed way too soon. And, to be that voice — advocating for change.

More to come soon!

Family Grows Pink Pumpkins to Raise Money for Breast Cancer Research

Olson, 27, and her parents, Joel and Rhonda Olson, are selling pink pumpkins and are donating part of the proceeds to breast cancer research.

“We’ve had great-grandmothers with breast cancer. We’ve had really close friends of the family get breast cancer,” Jerica Olson said. “Everybody can relate, so we thought we’d do our part to help out.”

Their farm is one of more than a dozen growers in Minnesota that grows pumpkins for the Pink Pumpkin Patch Foundation, a nonprofit created in 2012 that sends money raised from pink pumpkin sales to breast cancer research organizations.

Nationwide, hundreds of growers produce pumpkins for the organization.

Olson said her father heard about the Pink Pumpkin Patch Foundation on the radio, and she was tasked with researching the opportunity.

The family decided to move forward with a grower’s contract and bought 1,000 pink pumpkin seeds.

The pumpkins come in a variety of sizes and start off as a light peach or salmon color. They seem to gain more vibrancy as they sit in the sun, and some also feature blue or green swirls, Olson said.

“They look like cotton candy,” she added.

Each pumpkin will sell for $5, with $1 of the price being donated to the Pink Pumpkin Patch Foundation — 75 cents more than the growing contract requires.

So far, Olson said she has received a very positive response from the community, especially from cancer survivors. Some customers share their stories, including a woman who was buying a pumpkin for a 6-year-old girl diagnosed with breast cancer.

“When you hear about stuff like that, you feel like you have to do something,” Olson said.

Plans are already being made to plant more pink pumpkins at the Olson farm next year.

Computer-Aided Detection (CAD) Does Not Improve Accuracy of Digital Screening Mammography

Even more concerning, radiologists tended to miss more cancers when using CAD, lead author Constance D. Lehman, MD, PhD, codirector of the Avon Comprehensive Breast Evaluation Center at Massachusetts General Hospital, Boston, told Medscape Medical News.

Mammo2It is possible that radiologists reading with CAD are overly dependent on the computer and ignore suspicious lesions if they are not flagged by CAD, she said.

The study was published online September 28 in JAMA Internal Medicine. It joins two earlier studies that suggested that CAD had little, if any, impact on breast cancer detection. The studies raised concerns that CAD may increase recall and biopsy rates.

“The naysayers of these two studies had some valid criticisms,” Dr Lehman noted. One study included an older Medicare population, and the other paired CAD with outdated film mammography. “So I thought maybe we will find that there is some benefit, so it was a bit surprising that there was none at all,” Dr Lehman said.

The researchers compared the accuracy of digital screening mammography interpreted either with CAD (n = 495,818) or without CAD (n = 129,807) among 323,973 women. A total of 271 radiologists from 66 centers in the National Cancer Institute–funded Breast Cancer Surveillance Consortium interpreted the mammograms. On the basis of tumor registry data, a total of 3159 breast cancers were identified within 1 year of screening.

CAD failed to boost sensitivity or specificity of digital screening mammography, the researchers report.