Tag Archives: Cancer

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Private cancer therapy ‘crowdfunding rise’

There has been a big leap in the number of cancer patients turning to crowdfunding to pay for treatments not available on the NHS, figures seen by BBC Radio 5 live suggest.

Data from JustGiving shows that 2,348 appeals were set up by cancer patients or their loved ones in 2016, a seven-fold rise on the number for 2015.

Over £4.5m was raised by these appeals in 2016 compared with £530,000 in 2015.

Doctors say the number of patients bypassing the NHS is “very worrying”.

‘Strength and generosity’

Liz Sheppard, a mother-of-three from Mansfield, was diagnosed with small cell stomach cancer – a rare form of the disease – in November 2015.

She has now raised over £135,000 online to help pay for immunotherapy, which she is receiving at a private centre in London.

She has already spent around £60,000 of the money on immunotherapy, and says she is responding well to the treatment.

She told the BBC: “I’m able to get out and lead as normal a life as possible. Certainly I’m not bedridden.

“If it wasn’t for people’s generosity and kindness, I wouldn’t be where I am now. It’s not something I could have self-funded. Without that money I wouldn’t be here. It means everything.

“I’m a mother. I look at my children every day and they keep me going.

“And the messages people leave when they make a donation can be motivating in themselves. You can draw a lot of strength from them.”

A spokesman for NHS England said: “More people than ever before are surviving cancer thanks to improved NHS care… and together with NICE (the National Institute for Health and Care Excellence) we have also launched a new-look cancer drugs fund, meaning patients will be able to access promising, new and innovative treatments much quicker.”

According to the detailed figures released by the platform JustGiving, USA, Germany and Mexico topped the most popular destinations for patients travelling abroad for treatments last year.

More than a fifth of those looking for treatment (404 people) raised £1,393,490 in donations to travel to the United States for care.

Germany followed in second place with 142 people crowdfunding £368,530 (a 461% increase from 2015), whilst 23 people raised £69,660 to travel to Mexico for treatment (a 224% increase from 2015).

Immunotherapy was the most popular treatment crowdfunded on the JustGiving platform in 2016.

The therapy uses the body’s own immune system to fight off cancer. It has been shown to work in certain cases, but not all. And some are still in the very early stages of research.

The treatments people have funded are not always considered to have the backing of sufficient scientific evidence by NHS experts.

Charles Wells, chief operations officer for JustGiving, said: “Over the last 12 months, we’ve seen more and more people crowdfunding on JustGiving to raise money for cancer treatments that aren’t available on the NHS.

“It can be a practical way for friends, family and the community to come together and help, as well as providing a lifeline for people by giving them access to pioneering treatments when they’ve been given a cancer diagnosis.”

‘Funding pressures’

Consultant oncologist Dr Clive Peedell expressed concern about the rise in the number of patients bypassing the NHS to fund their own treatment.

He told BBC Radio 5 live: “The NHS is clearly financially under pressure at present, but cancer therapy has received preferential funding compared with other diseases and conditions.

“The system for approving effective new cancer drugs is not perfect, but is much improved.

“The vast majority of proven effective treatments for cancer are funded by the NHS.

“This includes immunotherapy for a number of indications including lung cancer, which is my own field.

“However, funding pressures are likely to pressurise the current system even further and we could see it break down in future.

“It is therefore very worrying to see this trend of crowdfunding for cancer drugs.

“It would be interesting to review all the cases to find out how many are genuinely appropriate.

“I worry that some patients may be trying to access treatment that may not be beneficial.

“Worse still, there may be significant extra costs involved, especially if patients pay privately or travel abroad.”

The NHS England spokesman said it was investing £130m in state-of-the-art radiotherapy equipment, alongside £200m of funding over two years to improve local cancer services.

Source BBC News

 

Chemical found in condoms and babies dummies ‘probably causes cancer’ says WHO

A chemical found in babies’ dummies, rubber gloves and condoms ‘probably causes cancer’ according to The World Health Organisation. MBT, a chemical used in the manufacturing of rubber is found in numerous household items, including, soft playground surfaces made of ‘rubber crumb’, medical catheters, car tyres, rubber insoles, air beds, elastic bands, babies’ dummies and swimming caps and goggles.

Rubber crumb, which is made from recycled tyres, is also a key component of the all-weather 3G football pitches, which it is claimed contain mercury, lead, arsenic and other toxic chemicals.

At a meeting in Lyon, France, 24 experts from eight countries described the chemical as an ‘encyclopaedia of carcinogens’. The WHO’s International Agency for Research on Cancer reviewed data on the substance, including a study of workers at a Welsh chemical factory. The research, by professor Tom Sorahan, of Birmingham University, linked MBT to bladder cancer, bowel cancer and a type of blood cancer. But because the workers were also exposed to other chemicals, it was not possible to determine whether MBT was to blame.

Professor Hans Kromhout, a member of the committee that reviewed the chemical, said: “It has been identified in gloves and baby bottle teats and soothers. It has recently been identified in inhalable road dust with the wearing of rubber tyres the most likely source of this contamination.”

While the chemical has been found to raise the risk of cancer in animals, reporting their findings in the journal Lancet Oncology the WHO ruled there was a strong possibility it was also harmful to people.

According to Mail Online, a spokesman said: “MBT is used mainly in manufacturing rubber products. The most important exposures are to workers in the chemical and rubber industries. The general public may be exposed to small amounts of MBT by skin contact with some rubber goods, such as gloves and footwear, or by inhaling tyre dust in urban air. Risks to the public at large from these types of exposures have not been studied.’

While campaigners have urged people to ask retailers if MBT – full name 2-mercaptobenzothiazole – was in products before buying them, a leading British expert on chemical exposure urged the public not to worry, explaining that items of everyday usage were unlikely to pose a threat.

Professor Sorahan said that while large amounts of MBT in factories could be dangerous, the small amounts used in everyday products were not likely to be harmful. “I doubt whether MBT is a health issue for the general population but workers manufacturing or using the chemical need to be protected,” he explained.

But Dr Michael Warhurst of campaign group CHEM Trust, said: “We need the regulatory system to work faster to protect us. People would be right to be concerned about this, and to ask retailers whether this chemical is present in products that they have bought.”

Could this be cancer’s magic bullet?

London – Have scientists found the great breakthrough for cancer therapy? The medical research world is abuzz this week with the news that an experimental treatment has banished blood cancer symptoms in 94 percent of patients.

What’s more, this success rate was seen in patients who were expected to live only months because such conventional cancer treatments as chemotherapy had failed to save them.

The results are being hailed as amazing and, if the trial’s success can be replicated on a much larger scale, could prove a pivotal moment in the history of cancer treatment.

Scientists at the Fred Hutchinson Cancer Research Centre in Seattle are claiming the medical victory after they treated several dozen patients with a cancer of the white blood cells called acute lymphoblastic leukaemia (ALL).

Also read: Living drug may wipe out cancer

Normally, only 40 percent of patients aged between 25 and 64 survive for five years after being diagnosed with ALL.

The rate is even lower among people aged 65 or older, at a dismal 15 percent, according to Cancer Research UK.

The American scientists’ new therapy involves genetically modifying a key weapon in the patients’ natural immune defence system, called T-cells.

These normally hunt and kill cells in our bodies that are infected with bacteria, or such viruses as cold and flu.

Crucially, the genetic modification effectively teaches the T-cells to recognise cancer cells as enemies to be destroyed.

As well as seeing the 94 percent success rate in ALL patients, when the researchers tried the treatment – called immunotherapy – on people with other blood cancers, they improved the condition of more than 80 percent of patients.

In more than half of those patients, the cancer appeared to have gone completely. As one of the lead investigators, oncologist Dr Stanley Riddell, says: “This is unprecedented in medicine, to be honest, to get response rates in this range in patients with these very advanced cancers.”

One further hope is that these “trained” T-cells will be able to stay in the body for years – acting as a form of vaccination against any returning cancers.

Another new immunotherapy study indicates that such modified T-cells can stay in the body for at least 14 years.

Professor Chiara Bonin says that her research at a Milan hospital demonstrates that it is possible to create cells that still “remember the cancer and are ready for when it comes back”.

Seasoned cancer experts are not ready to break out the champagne just yet, however, because the past two decades have seen many new therapies hailed as “magic bullets” for cancer subsequently not living up to their promise.

This is because they have cured far fewer patients than was first hoped or their side effects have proved too dreadful to inflict on patients.

In fact, one of the first scientists to use immunotherapy to fight cancer was New York surgeon William Coley in the 1890s.

He was inspired to do this by a patient with a rare cancer who staged an unexpected recovery after suffering a serious bacterial infection.

Coley believed this infection had provoked the patient’s immune system to attack anything that looked alien, including the cancer cells.

He then began vaccinating other cancer patients with bacteria, believing that, in a minority of cases, this spurred the immune system to destroy tumours.

His work was greeted with scepticism, however, and was then overtaken by the development of radiotherapy and chemotherapy as powerful cancer treatments – if not without their side-effects.

Now, William Coley’s ideas are being explored anew, but attempts to develop immunotherapy into a modern anti-cancer weapon have been dogged by the fact that tinkering with the human immune system is still fraught with danger.

These perils were highlighted in 2006, when six volunteers were admitted to Northwick Park Hospital in Middlesex after the disastrous trial of a drug that worked by modifying the immune system, and which was intended to treat such diseases as multiple sclerosis.

The six healthy young men’s immune systems began attacking their own bodies. They were rushed into intensive care with organ failure after experiencing serious reactions within hours of taking the drug.

The worst-affected lost his fingers and toes. What’s more, all the men were then told that they would be likely to develop cancers or auto-immune diseases as a result of their exposure to the drug.

Dr Riddell is open about the potential dangers of his newly-announced immunotherapy treatment: “There are reasons to be optimistic, there are reasons to be pessimistic.”

Indeed, during his trial, there were problems with some patients whose immune systems appear to have overreacted; 20 developed a condition called cytokine release syndrome.

Cytokines are messenger cells in the immune system that can go out of control when the system is overstimulated.

In turn, they can drive the immune system to overreact further, inflaming healthy cells throughout the body.

In Dr Riddell’s trials, the affected patients suffered symptoms of fever, dangerously plummeting blood pressure and nerve damage. Two of his patients died.

Dr Riddell believes, however, that lowering the dose of T-cells can reduce the risk of side effects.

There are other reasons why we should welcome such work with some caution, particularly since the results are very recent and there is a risk that the patients’ symptoms could reappear in future.

Indeed, cancers are notorious for returning months and even years after patients have been given the all-clear. This is not least because tumour cells can hide, dormant, deep in patients’ tissues to evade attack, and reactivate themselves later.

Professor Peter Openshaw, British Society for Immunology president, says that Dr Riddell’s research is “exciting” but believes we must be patient as its findings are explored further.

Intriguingly, he believes that, although this latest research used immunotherapy as a last-ditch treatment, it may best be used early on, just after patients have been diagnosed with their cancer.

The professor has also warned that immunotherapy may not work on many types of cancer, because the tumour cells they produce do not carry consistent identifying markers that the genetically modified T-cells can recognise and then attack.

Instead, the cells are able to change and adapt to threats.

“Such cancers can evade and escape immunotherapy by evolving their cells very quickly,” says Professor Openshaw.

Certainly, the tests causing so much excitement so far have targeted only certain blood cancers, and the researchers acknowledge they need to see how long their patients remain in remission.

It will also take at least five years to get this treatment into standard use.

Dr Riddell agrees immunotherapy requires much further development and that, even then, it will not be a panacea for every cancer. Nevertheless, his excitement is undimmed.

“Much like chemotherapy and radiotherapy, it’s not going to be a save-all,” he says. “However, I think immunotherapy has finally made it to becoming a pillar of cancer therapy.”

And for that, we may be both hopeful and grateful.

Source The Independent

Cancer ‘vaccine’ that remembers disease and fights it years later is developed by scientists

Researchers engineer immune cells so they boost body’s natural defences to fight tumours and stand guard for lifetime – acting effectively like vaccine

Scientists say it is like having a “living drug”, which is constantly vigilant to the return of cancer and quickly removes it from the body.

A new study, presented at the American Association for the Advancement of Science annual meeting in Washington, has proven for the first time that engineered “memory T-cells” can persist in the body for at least 14 years.

Professor Chiara Bonini, a haematologist at San Raffaele Scientific Institute and Vita e Salute San Raffaele University in Milan, said: “T-cells are a living drug, and in particular they have the potential to persist in our body for our whole lives.

“Imagine when you are given a vaccine as a kid and you are protected against flu or whatever for all of your life. Why is that? It’s because when a T-cell encounters the antigen and gets activated, it kills the pathogen but also persists as a memory cell.

“Imagine translating this to cancer immunotherapy, to have memory T-cells that remember the cancer and are ready for when it comes back.”

In a trial at a Milan hospital, ten patients who had bone marrow transplants were also given immune-boosting therapy which included the memory T-cells. They were found to be there 14 years later.

Immunotherapies, which harness the body’s own immune system, look set to replace cell-damaging chemotherapies. But one of the biggest challenges is to make these changes last long enough that the cancer cannot come back.

The Milan study proved for the first time scientists have shown that these cells can survive in the body well beyond the original cancer treatment.

Prof Bonini and colleagues are now working on a new wave of immune cells that can use sensor molecules known as antigen receptors to track down and wipe out a wide variety of types of cancer. When the cells are combined with the memory cells it should produce a treatment which effectively vaccinates the body against cancer.

“When a T-cell encounters the antigen and gets activated, it kills the pathogen but also persists as a memory cell,” she said. “Some of these memory T-cells will persist through the entire life of the organism, and so if you encounter the same pathogen – say if the same strain of flu comes back ten years later – then you have memory T cells that remember it from ten years earlier and kill it quickly so you don’t even know you’re infected.”

Daniel Davis, professor of immunology at the University of Manchester, said it was an “important advance” in cancer treatment.

“The implication is that infusing genetically modified versions of these particular T-cells, the stem memory T-cells, could provide a long-lasting immune response against a person’s cancer,” he said.

“Immunotherapy has great potential to revolutionise cancer treatments and this study shows which type of T-cells might be especially useful to manipulate for long-lasting protection.

“This research area is hot – no question about that. Our detailed knowledge of T-cells is paying off here with important new ideas for tackling cancer.”

In a separate presentation at the AAAS, a team of US scientists showed that their T-cell immunotherapy treatment for leaukaemia had an “unprecedented” success rate of 94 per cent in patients who had been given only months to live.

US scientists said they had achieved “extraordinary” results in early clinical trials.

Stanley Riddell, of the Fred Hutchinson Cancer Research Centre in Seattle, said balancing the different types of immune cells and then equipping them with cancer-sensing molecules had saved the lives of leukaemia patients for whom all other treatments had failed.

His team treated 26 patients whose acute lymphoblastic leukaemia was so advanced they had only two to five months to live. After 18 months, 24 of the patients were in complete remission.

“These are in patients that have failed everything,” Professor Riddell said. “This is extraordinary. This is unprecedented in medicine to be honest, to get response rates in this range from very advanced patients.”

Source The Telegraph

Nine in ten cancers caused by lifestyle

Up to nine in ten cancers are caused by environmental and external factors such as smoking, drinking, sun exposure and air pollution, a new scientific study has found.

Previous research suggested that random cell mutations played a significant role in the development of tumours, a finding dubbed the ‘bad luck hypothesis.’

But scientists now believe that outside influences have a far greater impact, meaning many cancers may be more preventable than previously thought.

The finding is likely to prove controversial as it suggests that people could slash their risk of ever getting cancer if they just made lifestyle changes such as keeping out of the sun, exercising or cutting down on cigarettes.

One British statistician said that the results showed that between 70 and 90 per cent of cancers would not occur if we could ‘magic away’ all the external risk factors.

It follows on from a study published earlier this year which suggested that 65 per cent were inevitable and driven by random mistakes in cell division which are completely outside of our control.

The more times cells divide, the greater the chances that a mutation can occur, leading to cancer, Johns Hopkins University said in January, and claimed it explained why areas of the body where cell division occurred more quickly, such as the colon, were more likely to develop tumours.

However the new study, by Stony Brook University in New York, suggests that cancer incidence is far too high to be explained away by simple mutations in cell division.

Put simply, if random mutations were to blame, there would be far fewer cases of cancer than there actually are.

Yusuf Hannun of Stony Brook University New York, US, said: “Here we provide evidence that intrinsic risk factors contribute only modestly to cancer development.

“The rates of mutation accumulation by intrinsic processes are not sufficient to account for the observed cancer risks.”

The researchers also looked at previous studies which have shown how immigrants moving from low cancer incidence to countries with high cancer incidence soon

develop the same tumour rates, suggesting the risks are environmental rather than biological or genetic.

Nearly 75 per cent of the risk of colorectal cancer is now believed to be due to diet.

Likewise 86 per cent of the risk of skin cancer is down to sun exposure while 75 per cent of chance of developing head and neck cancers is due to tobacco and alcohol, according the the new research.

Although some rare cancers can be driven by genetic mutations, the most prevalent diseases are down to environmental factors, they conclude. They say it is important that these ‘extrinsic’ factors are taken into account in cancer prevention and research.

The government even set up its ‘100,000 Genomes Project’ to try and find the genetic causes of many rare diseases and cancers. But the new study shows the project is unlikely to help the majority of cancer sufferers.

Around 330,000 people are diagnosed with cancer each year and 161,000 will die, according to statistics from Cancer Research UK.

It was previously thought that fewer than half of cancer could be prevented by lifestyle changes, but the new research suggests it could be far higher.

Prof Kevin McConway, Professor of Applied Statistics, The Open University, said research provided ‘pretty convincing evidence’ that external factors play a major role in many cancers.

“For many common types of cancer, this study concludes that at least 70 per cent to 90 per cent of the cancers are due to external risk factors – roughly speaking, that 70 per cent to 90 per cent would not occur if we could magic away all the risk factors,” he said.

“ Even if someone is exposed to important external risk factors, of course it isn’t certain that they will develop a cancer – chance is always involved.

“But this study demonstrates again that we have to look well beyond pure chance and luck to understand and protect against cancers.”

Prof Paul Pharoah, Professor of Cancer Epidemiology, University of Cambridge, said: “These findings do not have any implications for cancer treatment, but they do tell us that most cancers would be preventable if we knew all of the extrinsic risk factors that cause disease.

“This is not really novel in itself, and we already know for many cancers some major avoidable risk factors.

“It is important to realise that these results do not tell us anything about the absolute risks of any given cancer.

The research was published in the journal Nature.

Source The Telegraph

Thousands of cancer patients ‘too poor to celebrate Christmas’

Thousands of people with cancer will feel “cold and lonely” this Christmas because they do not have enough money to celebrate or heat their homes, a charity has said.

Almost 170,000 people in the UK with cancer are unable to join in special family events such as Christmas due to a lack of cash, according to Macmillan Cancer Support.

Its survey of almost 1,000 people living with cancer found 9% had to miss out on visiting family and friends because they could not afford it.

Other research of more than 1,600 people who have been in touch with Macmillan found 28% were unable to adequately heat their home in winter due to money worries.

The charity has previously found 83% people with cancer are on average £570 a month worse off as a result of their diagnosis.

Reasons include being too ill to work, needing new clothes for a changing body shape, needing to heat the home (cancer patients are more likely to feel the cold) and extra costs such as transport to hospital appointments.

Macmillan said the government must rethink its plan on welfare, which it said would take £30 a week away from people with cancer who are too ill to work.

Lynda Thomas, chief executive of the charity, said: “It’s heartbreaking that people who are going through cancer, which is likely to be one of the most difficult times of their life, are also having to wake up on Christmas Day in the cold, alone, without being able to have Christmas dinner or buy presents for their loved ones.

“Having cancer is an isolating time and being cut off financially because of a diagnosis makes life even harder. People with cancer can lose hundreds of pounds each month because of their diagnosis.

“It is incomprehensible that the government is pressing ahead with proposals to cut the benefits of people with cancer who have been medically assessed as unable to work by around £30 a week.

“This will make life even more difficult for this vulnerable group of people with cancer.”

Gemma Savory, 31, from the West Midlands, was diagnosed with bowel cancer last year.

She said: “I was made redundant soon after my diagnosis and despite receiving benefits it just wasn’t enough to cover all the extra costs that come with cancer. I can’t imagine anyone surviving if their benefits are cut further.

“In the end I had no other option but to find work during my treatment instead of recovering from this devastating illness at home.

“I didn’t choose to have cancer and it doesn’t even seem fair that I have to worry about this as well as having undergone gruelling radiotherapy, chemotherapy and major surgery.

She added: “Last Christmas was a real struggle but fortunately my wonderful colleagues helped me through it by selling Christmas cards, which helped raised enough funds for me to celebrate Christmas Day.

“The financial impact of cancer is hard at the best of times but at Christmas it’s so much worse.”

A Department for Work and Pensions spokesman said: “The vast majority of those with cancer will not be affected by the changes and won’t be expected to look for work, and no one already claiming employment and support allowance will be worse off under these reforms.

“People facing a cancer diagnosis will continue to get the support they need through the benefits system.”

Source The Guardian

One million women could benefit from HRT, says NHS menopause guidance

NHS guidance on treatment of the menopause could lead to many thousands more women being offered hormone replacement therapy (HRT) in the UK.

The guideline from the National Institute for Health and Care Excellence (Nice), unveiled on Thursday, seeks to reassure women and their GPs about the safety of HRT.

Studies suggesting a link with breast cancer, published in 2002 and 2003, led to a halving of the numbers of women taking the drugs.

Nice says the guideline could benefit more than a million women, many of whom could be prescribed HRT as the most effective treatment for debilitating symptoms, which include hot flushes, night sweats, insomnia and mood swings.

The aim, says Nice, is for women to not suffer in silence and feel able to discuss their options with their doctor or practice nurse and make an informed decision.

Cancer scientists, however, have expressed concern that the effect of the guideline might be to rehabilitate HRT without sufficient recognition of the long-term potential harm. Prof Valerie Beral, an Oxford epidemiologist who leads the Million Women study which linked HRT to breast and ovarian cancer, told the Guardian that the risks were clear.

“About one million UK women are currently using hormones for the menopause,” she said.

“Among them, about 10,000 extra breast cancers are estimated to occur in the next 10 years [40,000 in total, instead of 30,000 if the women had not used the hormones]. Also about 1,000 extra ovarian cancers are estimated to occur among them in the next 10 years [6,000 in total].”

The Nice guideline committee says that women should be able to make up their own minds as to whether the benefits of relieving menopause symptoms would outweigh any potential risks. GPs or practice nurses should explain the risks, taking into account a woman’s individual circumstances.

For example, breast cancer risks rise for those who are overweight or drink regularly.

“Women can cope with lots of side effects as long as they know about them,” said Prof Mary Ann Lumsden, chair of the committee. “The thing that really bothers them is if they haven’t been told.”

Dr Imogen Shaw, a GP with a special interest in gynaecology on the committee, said many women’s needs were not being met. “There are still a lot of women out there who have no idea there is any treatment.”

Shaw said women have told her of having to get up twice in the night to change the sheets, which are soaked with sweat, and of setting off for work after a shower, having dried their hair, only to arrive with a wet scalp and make-up running down their face.

“If this is interfering with your life and you are not coping with these symptoms, go and talk to your GP or a practice nurse,” she said.

The guideline is the first on the menopause, which women go through at an average age of 51.

An estimated 1.5 million women, around 80% of those experiencing the menopause, have some symptoms and 20% suffer more severely.

One woman in 100 experiences a premature menopause before the age of 40. Those women would particularly benefit from hormonal therapy, Nice says.

It advises that tests for hormone levels to establish whether women over 45 have reached the menopause should be discontinued as they are unreliable and a waste of money.

It says women who have had breast cancer and have menopausal symptoms should be referred to a specialist to see what treatment is suitable for them.

According to Nice, there are treatments other than HRT than can alleviate some, but not all, of the symptoms.

These include cognitive behaviour therapy (CBT) for low mood.

The guideline says antidepressants should not be given unless a woman has a diagnosis of depression.

There is some evidence that alternative therapies such as black cohosh and St John’s wort can help with some symptoms, but they warn that they do not come in standard preparations and that they can interact with other medicines.

The Medicines and Healthcare Regulatory Authority (MHRA), which licenses drugs in the UK, recommends that the lowest effective dose of HRT should be given to women for the shortest possible time – advice Nice repeats.

Dr Helen Stokes-Lampard, spokesperson for the Royal College of GPs, said the guideline would be very helpful to health professionals.

“Many women are understandably concerned about the link that has been made between HRT and increased risk of breast cancer and other conditions, such as thromboembolism,” she said.

“But it is important to remember that these issues are closely related to prolonged use of HRT in older women and these risks reduce substantially after treatment is stopped.

“Ultimately, any decision to prescribe HRT needs to come out of a discussion between GPs and individual patients about their unique circumstances, the pros and cons of treatments, and how to achieve the best possible health outcome.”

Dr Claire Knight, Cancer Research UK’s health information manager, said: “We know that using hormone replacement therapy increases the risk of developing breast, ovarian and in some cases womb cancer, but HRT can also offer effective relief from menopausal symptoms.

“What these new guidelines from Nice reiterate is that there are many factors at play in a woman’s choice to use HRT or not and women need clear, evidence-based information around the risks and benefits to help them make an informed decision. If you are considering starting or stopping HRT, speak with your doctor.”

Source The Guardian

Older people do not reject cancer treatment, study finds

Older people are no more likely than younger patients to reject cancer treatment, a leading charity has found, amid warnings that pensioners are too often denied the option of surgery.
Research by Macmillan Cancer Support shows that just 12 per cent of patients over the age of 75 declined treatment – compared to between 14 and 15 per cent of younger cancer sufferers.
The charity said the figures, from a study of more than 1,000 cancer sufferers, showed that “unacceptable” differences in the treatment of patients in different age groups, could not be explained by patient preference.
Previous studies have shown that the chance of undergoing cancer treatment drops dramatically with age.
Although there have been widespread fears that the differences reflect a reluctance by the NHS to offer treatment to older people, it has been impossible to rule out the possibility that pensioners themselves were refusing surgery.
Hundreds of women from poorer backgrounds die needlessly from breast cancer each year because they are less aware of symptoms and are diagnosed later when treatment is less effective, a study has found. 
The new study of adults aged 55 and over shows that 12 per cent of those aged 75 or over opted not to have certain types of treatment, compared with 15 per cent of those aged 55 to 64 and 14 per cent of those aged 65 to 74.
The findings, disclosed ahead of the National Cancer Research Institute (NCRI) annual cancer conference in Liverpool this week, also show older cancer sufferers were far more likely than younger patients to defer to those treating them.
In total, 68 per cent of those aged 65 thought that “healthcare staff know what’s best” for them, when it comes to decisions about cancer care compared to 58 per cent of those aged 55-64, the Ispos MORI survey of more than 1,000 cancer sufferers found.
Last year research on 367,000 patients who underwent cancer surgery found startling variations in the levels of treatment carried out among different age groups.
Almost no prostate cancer surgery was carried out on men over the age of 75, though more than one in four cases under the age of 55 received the treatment.
Women with ovarian cancer over the age of 75 are half as likely to have surgery as those under 55, according to the study by Cancer Research UK.
Jagtar Dhanda, head of inclusion at Macmillan Cancer Support said: “Our research shows that someone’s age doesn’t affect how likely they are to want cancer treatment. We found that even people in their 80s and 90s are just as likely to want life extending or saving treatment as those in their 50s.
“Yet the sad reality is that in England patients older than 65 are less likely to receive it. As a result survival for older patients lags behind our European neighbours. This simply isn’t acceptable and we must demand better.”
Too often, older people were not offered surgery and other potentially life-saving treatments because they were not properly assessed, with doctors simply assuming their age meant they were not strong enough to cope with treatment, the charity said.
“A lack of access to proper assessments for older people in the NHS is an important factor,” he said.
“It means staff can be left to make decisions about whether an older person is suitable for treatment without all the information they need. Because of this, decisions end up being based on a patient’s age rather than their physical capacity or desire to receive treatment.”
A ban on age discrimination in NHS services was introduced in 2012.
A Department of Health spokesman said:”Decisions should always be based on clinical need and it is entirely wrong to deny people treatment because of their age, which is why we have made it illegal.
“The Independent Cancer Taskforce recognised the needs of older cancer patients as a key theme in its report and NHS England is working to reduce any variation in cancer care. “
Professor Sean Duffy, National Clinical Director for Cancer at NHS England said: “Cancer treatment should always be based on what is right for each patient, not their age, and clinicians must make an objective assessment when deciding what course of action is appropriate.
“The report from the independent Cancer Taskforce included a specific recommendation to better understand why older patients have worse cancer outcomes and look at ways in which we can make sure they are getting access to the most appropriate treatment for them. We are working with others across the health system to take this forward.”
Source The Telegraph

Heat-triggered ‘grenades’ hit cancer

Scientists have designed microscopic “grenades” that can explode their cancer-killing payload in tumours.
The team will present its findings at the National Cancer Research Institute conference next week.
They plan to use liposomes – tiny bubbles of fat which carry materials round the body – to release toxic drugs when their temperature is raised.
The “grenades” are intended to avoid side-effects by ensuring the drugs target only the tumour.
Experts said such technology, which has been effective in animal experiments, was the “holy grail of nanomedicine”.
Cancer scientists are trying to harness the transporting abilities of these fatty spheres by getting them to carry toxic drugs to tumours.
“The difficulty is, how do you release them when they reach their target?” Prof Kostas Kostarelos, from the University of Manchester, told the BBC News website.
The Nanomedicine Lab in Manchester has designed liposomes that are water-tight at normal body temperature. But when the temperature increases to 42C they become leaky.
“The challenge for us is to try to develop liposomes in such a way that they will be very stable at 37C and not leak any cancer drug molecules and then abruptly release them at 42C,” Prof Kostarelos added.

Warming

He suggests heat pads could be used to warm tumours on the body surface such as skin, head or neck cancers.
Probes can heat tumours inside the body, and there is also discussion about using ultra sound to warm tumours.
In early tests on mice with melanoma there was “greater uptake” of drugs in tumours using the thermal grenades. And that resulted in a “moderate improvement” in survival rates.
Prof Kostarelos said similar techniques were being trialled in patients and this “is not a fantasy.”
Prof Charles Swanton, the chairman of the conference, said targeted liposomes were a “holy grail of nanomedicine”.
He added: “These studies demonstrate for the first time how they can be built to include a temperature control, which could open up a range of new treatment avenues.
“This is still early work but these liposomes could be an effective way of targeting treatment towards cancer cells while eaving healthy cells unharmed.”
Source BBC News

The 116 things that can give you cancer – the full list

The World Health Organisation said processed meats are among the most carcinogenic substances along with cigarettes, alcohol, sunbeds and arsenic.
After Monday’s bombshell news from the World Health Organisation that bacon, ham and sausages are carcinogenic, you can be forgiven for wondering just what exactly is safe for you to come into contact with – let alone eat.
Handily, the International Agency for Research on Cancer – a body that collects and publishes cancer figures worldwide – has a list of the 116 substances and activities (for some of them are more verb than noun) that are now considered to cause cancer.

Carcinogenic exposure circumstances

1 Tobacco smoking: The most common exposure to the stimulant, prepared from the leaves of the tobacco plant, is through burning it and smoking it from a cigarette or hookah pipe into the mouth and then releasing it. Smoking’s history dates back to as early as 5000–3000BC when the agricultural product began to be cultivated in South America.
2 Sunlamps and sunbeds: A tanning bed, a device that emits ultraviolet radiation for a cosmetic tan, can give humans overexposure to UV radiation, which can cause skin cancer, cataracts, and premature skin ageing.
3Aluminium production: Increased lung and bladder cancer risks have been reported in workers in aluminium reduction plants. The fumes of chemicals the workers may inhale, and exposure to coal-tar pitch volatiles for long periods during the process, can cause cancer.
4 Arsenic in drinking water: The highly toxic chemical which is used to make certain alloys used in the manufacturing industry, can get into the drinking water supply, particularly in ground water. Arsenic is known to cause skin cancer, and linked to causing liver, lung, kidney, and bladder cancer.
5 Auramine production: Auramine can be used as an antiseptic agent as well as to make dyes. A study found there to be an excess of bladder tumours among men engaged in the manufacture of auramine, through inhaling harmful agents, such as formaldehyde and sulphur, during the manufacturing process.
6 Boot and shoe manufacture and repair: Linked to increased risk of nasal cancer and leukaemia, due to exposure to suspected carcinogens such as leather dust, benzene and other solvents, yet the risk of cancer in shoe manufacturing may vary depending on the duration and level of exposure.

7 Chimney sweeping: Cleaning chimneys of soot and dust, historically done by small boys who could climb the chimney but now done mechanically, could cause a very specific form of cancer – termed “chimney sweep” cancer. It could be caused by inhalation and accidental ingestion of coal and burnt wood fumes and residue.

8 Coal gasification: Studies of the cancer levels of workers who had occupational exposure to coal gasification – when coal is reacted with oxygen, steam and carbon dioxide to form a gas – showed there to be an excess of lung cancer.
9 Coal tar distillation: Derived from coal, coal-tar pitch is a thick black liquid that remains after the distillation of coal tar. It is used as a base for coatings and paint, in roofing and paving, and as a binder in asphalt products. Both coal tar and coal-tar pitch contain many chemical compounds, including carcinogens such as benzene. Human exposure to coal tars can be through inhalation, ingestion, and absorption through the skin. The general population can be exposed to coal tars in environmental contaminants.
10 Coke (fuel) production: Workers at coking plants and coal-tar production plants – where coal is refined to be used as a solid fuel – may be exposed to coke oven emissions, and have an excess risk of dying from lung cancer and kidney cancer.
11 Furniture and cabinet making: Furniture makers are shown to have a statistical increase in nasal cancer risk, with excessive exposure to wood dust, according to studies.
12 Haematite mining (underground) with exposure to radon: Mining hematite, an underground source of iron, workers are simultaneously exposed to radon – a radioactive carcinogen, which can cause a large increase in the risk of lung cancer.
13 Secondhand smoke: Otherwise known as passive smoking, a non-smoker’s risk of getting lung cancer can increase by a quarter by breathing in other people’s smoke. It may also increase the risk of cancers of the larynx (voice box) and pharynx (upper throat). It’s estimated that every year, secondhand smoke kills over 12,000 people in the UK from lung cancer, heart disease, stroke and the lung condition chronic obstructive pulmonary disease.
14 Iron and steel founding: Studies of iron and steel founding workers in various parts of the world showed them to have a significantly increased risk for lung cancer. Exposures in the iron and steel founding industry are complex and include a wide variety of known genotoxic and carcinogenic substances including metals and formaldehyde.
15 Isopropanol manufacture (strong-acid process): People in the isopropanol manufacturing industry may face an increased risk of developing cancer due to exposure to suspected carcinogens, such as diisopropyl sulphate, isopropyl oils and sulphuric acid. The colourless, flammable chemical compound with a strong odour has a wide variety of industrial, household and pharmaceutical uses. Isopropyl alcohol solution is found in rubbing alcohol, hand sanitiser, and disinfecting pads.
16 Magenta dye manufacturing: The production of magenta dyes – purplish-red in colour and among the first synthetic dyes to be produced in the 1850s – has chemicals linked to bladder cancer. Yet some carcinogenic chemicals were banned from hair dyes in the 1970s.
17 Occupational exposure as a painter: Studies have found a link between work as a painter and risk of cancer. Deaths such as bladder cancer and leukaemia in such cases could have been from an exposure to benzene – a chemical at high levels that can cause cancer and found in paint production – mixed with other organic solvents. Cases of lung cancer may be from exposure to particles containing lead chromate and to asbestos in the paint trade.
18 Paving and roofing with coal-tar pitch: Paving with coal tar and coal-tar pitch may contain many chemical compounds, including carcinogens such as benzene.
19 Rubber industry: Harvested mainly in the form of the latex from certain trees, the manufacturing process of stretchy material can cause the risk of developing cancer, caused by chemicals. Studies examining countries with workers in the rubber industry showed they were more likely to have cancers such as bladder cancer, lung cancer, and leukaemia.
20 Occupational exposure of strong inorganic acid mists containing sulphuric acid: The liquid aerosols formed by condensation of sulphuric acid vapour, which is highly corrosive, can cause a higher risk of getting lung cancer.

Carcinogenic mixtures

21 Naturally occurring mixtures of aflatoxins: Such toxins produced by certain species of fungi, are among the most carcinogenic substances known, and linked to increased risk of liver cancer.
22 Alcoholic beverages: Alcoholic beverage consumption as a cause of breast, colorectal, larynx, liver, oesophagus, oral cavity and pharynx cancers, and as a probable cause of pancreatic cancer, as classified by the IARC.
23 Areca nut: Areca nut is a mild stimulant, akin to coffee, that is chewed with betel leaf. It is known to cause increased risk of mouth and oesophageal cancer.
24 Betel quid without tobacco: A leaf indigenous to Asia, is chewed with areca nut as a stimulant and can increase the risk of oral cancer.
25 Betel quid with tobacco: Betel can increase the risk of oral cancer.
26 Coal-tar pitches: This thick black liquid contains many chemical compounds, including carcinogens such as benzene.
27 Coal tars: Coal tar, a bi-product of coke production, contains many chemical compounds, including benzene.
28 Indoor emissions from household combustion of coal: Coal is one of the most well-known carcinogens in the public consciousness, due to the prevalence of cancer in miners. It is a risk if coal dust produced from old-fashioned coal-burning fires is inhaled.
29 Diesel exhaust: There is a cancer risk from inhaling exhaust fumes produced by a diesel internal combustion engine. Over 30 components of diesel oil are listed at various levels of carcinogenic by the IARC.
30 Mineral oils, untreated and mildly treated: The World Health Organisation classifies untreated or mildly treated mineral oils as group-1 carcinogens to humans. Highly refined oils are classified as group-3, meaning they are not suspected to be carcinogenic, yet due to insufficient findings, cannot be classified as harmless.
31 Phenacetin, analgesic mixtures containing: Studies on this pain- and fever-reducing drug, now banned in some countries link it with renal, pelvic and other urothelial tumours in patients.
32 Plants containing aristolochic acid: Used in Chinese herbal medicine for centuries, this plant extract is found to cause kidney disease and urothelial cancer.
33 Polychlorinated biphenyls (PCBs): This synthetic compound, widely used in electrical equipment in the past, was banned at the end of the 1970s in many countries because of environmental concerns. Studies of PCBs in humans have found increased rates of melanomas, liver cancer, gall bladder cancer, biliary tract cancer, gastrointestinal tract cancer, and brain cancer, and may be linked to breast cancer. PCBs are known to cause a variety of cancers in animals.
34 Chinese-style salted fish: Diets that are very high in salt-cured meats and fish, or pickled foods – which are more common in parts of Asia and northern Africa – can increase the risk of nasopharyngeal cancer, related to the upper part of the throat behind the nose. These foods can be very high in nitrates and nitrites, which react with protein to form nitrosamines. These chemicals can damage DNA.
 The hydraulic fracturing test site operated by Cuadrilla in Balcombe, England Facebook Twitter Pinterest
 A police officer stands guard on the perimeter of the hydraulic fracturing test site operated by Cuadrilla in Balcombe, England. Photograph: Leon Neal/AFP/Getty Images
35 Shale oils: The development of shale gas, including fracking, may release toxic chemicals into air, water and soil during the process. Chemicals used in fracking are known to be of concern and have been linked to an increased risk of cancer. Benzene, acrylamide, and formaldehyde are all listed by the IARC as human carcinogens.
36 Soots: Coal dust, principally from the burning of coal, had contributed to a specific chimney sweep cancer that was prevalent in the 19th century.
37 Smokeless tobacco products: Tobacco chewed as a stimulant, sometimes with other leaves such as betel, is specifically linked to cancers of the larynx and the mouth.
38 Wood dust: Awareness of wood dust as a carcinogen and cause of nasal cancer is on the rise. In 2011 a cabinet maker’s widow successfully sued for £375,000 after her husband’s death.
39 Processed meat: Meat that is cured or treated in some way, either for preservation or taste. Examples include ham, bacon and sausages. It was ranked as dangerous as tobacco in October 2015 by the World Health Organisation (WHO), with specific links to bowel cancer.
Carcinogenic agents and groups of agents
40 Acetaldehyde
41 4-Aminobiphenyl
42 Aristolochic acids and plants containing them
43 Arsenic and arsenic compounds
44 Asbestos
45 Azathioprine
46 Benzene
47 Benzidine
48 Benzo[a]pyrene
49 Beryllium and beryllium compounds
50 Chlornapazine (N,N-Bis(2-chloroethyl)-2-naphthylamine)
51 Bis(chloromethyl)ether
52 Chloromethyl methyl ether
53 1,3-Butadiene
54 1,4-Butanediol dimethanesulfonate (Busulphan, Myleran)
55 Cadmium and cadmium compounds
56 Chlorambucil
57 Methyl-CCNU (1-(2-Chloroethyl)-3-(4-methylcyclohexyl)-1-nitrosourea; Semustine)
58 Chromium(VI) compounds
59 Ciclosporin
60 Contraceptives, hormonal, combined forms (those containing both oestrogen and a progestogen)
61 Contraceptives, oral, sequential forms of hormonal contraception (a period of oestrogen-only followed by a period of both oestrogen and a progestogen)
62 Cyclophosphamide
63 Diethylstilboestrol
64 Dyes metabolized to benzidine
65 Epstein-Barr virus
66 Oestrogens, nonsteroidal
67 Oestrogens, steroidal
68 Oestrogen therapy, postmenopausal
69 Ethanol in alcoholic beverages
70 Erionite
71 Ethylene oxide
72 Etoposide alone and in combination with cisplatin and bleomycin
73 Formaldehyde
74 Gallium arsenide
75 Helicobacter pylori (infection with)
76 Hepatitis B virus (chronic infection with)
77 Hepatitis C virus (chronic infection with)
78 Herbal remedies containing plant species of the genus Aristolochia
79 Human immunodeficiency virus type 1 (infection with)
80 Human papillomavirus type 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 66
81 Human T-cell lymphotropic virus type-I
82 Melphalan
83 Methoxsalen (8-Methoxypsoralen) plus ultraviolet A-radiation
84 4,4’-methylene-bis(2-chloroaniline) (MOCA)
85 MOPP and other combined chemotherapy including alkylating agents
86 Mustard gas (sulphur mustard)
87 2-Naphthylamine
88 Neutron radiation
89 Nickel compounds
90 4-(N-Nitrosomethylamino)-1-(3-pyridyl)-1-butanone (NNK)
91 N-Nitrosonornicotine (NNN)
92 Opisthorchis viverrini (infection with)
93 Outdoor air pollution
94 Particulate matter in outdoor air pollution
95 Phosphorus-32, as phosphate
96 Plutonium-239 and its decay products (may contain plutonium-240 and other isotopes), as aerosols
97 Radioiodines, short-lived isotopes, including iodine-131, from atomic reactor accidents and nuclear weapons detonation (exposure during childhood)
98 Radionuclides, α-particle-emitting, internally deposited
99 Radionuclides, β-particle-emitting, internally deposited
100 Radium-224 and its decay products
101 Radium-226 and its decay products
102 Radium-228 and its decay products
103 Radon-222 and its decay products
104 Schistosoma haematobium (infection with)
105 Silica, crystalline (inhaled in the form of quartz or cristobalite from occupational sources)
106 Solar radiation
107 Talc containing asbestiform fibres
108 Tamoxifen
109 2,3,7,8-tetrachlorodibenzo-para-dioxin
110 Thiotepa (1,1’,1”-phosphinothioylidynetrisaziridine)
111 Thorium-232 and its decay products, administered intravenously as a colloidal dispersion of thorium-232 dioxide
112 Treosulfan
113 Ortho-toluidine
114 Vinyl chloride
115 Ultraviolet radiation
116 X-radiation and gamma radiation
Source The Guardian