Targeted Radiation to Treat Brain Tumors May Be Best: Study

By Dennis Thompson
HealthDay Reporter

SUNDAY, May 31, 2015 (HealthDay News) — Using radiation on the entire brain to prevent new tumors from forming in patients whose cancer has spread to the brain can have a devastating effect on their ability to think and remember, compared with more targeted treatment, new findings show.

Nearly all patients who received whole-brain radiation therapy — 92 percent — experienced a decline in memory and verbal ability, researchers reported Sunday at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago.

By comparison, only 64 percent of patients who were given targeted radiosurgery, which focuses on a limited and tightly controlled area of the brain, experienced declines in mental ability.

“Essentially, the brain does not like to be irradiated,” said senior study author Dr. Jan Buckner, a professor of oncology at the Mayo Clinic in Rochester, Minn.

The study also found that patients who received whole-brain radiation therapy did not live any longer than those who went through more targeted radiation, even though they were less likely to experience recurring brain tumors.

Buckner and study author Dr. Paul Brown both said that’s because these patients end up dying from the primary cancer present elsewhere in their bodies that is also causing brain tumors. While they are alive, radiosurgery can be used to attack any new tumors that pop up.

“If patients develop new lesions, we just treat them with radiosurgery,” said Brown, a professor of radiation oncology at the University of Texas MD Anderson Cancer Center in Houston. “The risks and side effects outweigh the benefits of whole-brain radiation therapy.”

It’s estimated that each year as many as 400,000 Americans will experience cancer that spreads to the brain from other areas of the body, often the lungs or the breast. And about 200,000 of those patients will receive whole brain radiation therapy, according to background information with the study.

Whole-brain radiation therapy involves exposing the entire brain to 20-minute doses of radiation once a day for between 10 and 15 days, Brown said.

By comparison, radiosurgery involves very focused beams of radiation that can be aimed with millimeter precision and only involve a single treatment. Buckner likened it to the sunbeam produced by a magnifying glass.

Up to now, doctors have tended to treat cancer patients who have developed brain tumors that spread from other parts of the body by first using targeted radiosurgery to treat the lesions, and then using whole-brain radiation therapy to reduce the likelihood of future tumors cropping up, Brown said.

That strategy has been based on earlier studies that found whole-brain radiation is much better at preventing future brain lesions, and that tumors are more likely to recur in patients who receive radiotherapy alone, he said.

But based on these new findings, doctors likely will begin recommending whole-brain radiation therapy only for patients with aggressive brain cancer or with other cancers that tend to cause many brain tumors, said Dr. Brian Michael Alexander, a radiation oncologist at Dana-Farber Cancer Institute and a professor of radiation oncology at Harvard Medical School in Boston.

“This study will help shape treatment decisions for thousands of current and future patients,” he said. “As doctors, we want the very best for our patients, and sometimes giving less treatment offers the best result.”

Alexander said he has some cancer patients he has treated “for years” with targeted brain radiosurgery, zapping new lesions as they occur, without ever resorting to whole-brain radiation therapy.

In the study, 213 patients with cancer that had spread to their brains received radiosurgery, and then about half also received follow-up whole-brain radiation therapy. All of the patients had one to three small brain tumors, up to 3 centimeters in width.

Follow-up tests of mental ability found that patients who received whole-brain radiation therapy experienced a 30 percent decline in immediate recall, compared with 8 percent of patients who only received radiosurgery. Immediate recall is the ability to hold onto a small amount of information over a few seconds.

In addition, whole-brain radiation patients experienced a greater decline in short-term memory, an average 51 percent compared with a 20 percent decline in radiosurgery patients.

Verbal ability also took a hit, with whole-brain radiation patients experiencing an average 19 percent decrease compared with just 2 percent of radiosurgery patients.

Patients who underwent whole-brain radiation therapy also experienced significant declines in their quality of life compared with radiosurgery patients, Brown said.

Brown said doctors likely will begin recommending radiosurgery alone, combined with close monitoring, for many patients with brain tumors.

Whole-brain radiation therapy will be reserved for patients who have larger brain lesions, or who have more advanced cancer, he said.

“The role for whole-brain will be pushed back toward a patient’s later stages, when they have limited options at that point,” Brown said.

The study received funding from the U.S. National Institutes of Health.

Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

More information

For more on brain tumors, visit the U.S. National Institutes of Health.

---

from Health News / Tips & Trends / Celebrity Health http://ift.tt/1Kwu23X

Contact Lens Wearers May Have Different Eye Bacteria: Study

SUNDAY, May 31, 2015 (HealthDay News) — Changes in bacteria populations may be one reason why people who wear contact lenses are more prone to eye infections, a new study suggests.

“Our research clearly shows that putting a foreign object, such as a contact lens, on the eye is not a neutral act,” senior study investigator Maria Gloria Dominguez-Bello, a microbiologist at NYU Langone Medical Center, said in a Langone news release.

“What we hope our future experiments will show is whether these changes in the eye microbiome of lens wearers are due to fingers touching the eye, or from the lens’s direct pressure affecting and altering the immune system in the eye and what bacteria are suppressed or are allowed to thrive,” she added.

For the study, researchers took samples from nine daily contact lens wearers and 11 others who didn’t use contact lenses. They found that the types of bacteria in the eyes of the contact wearers more closely resembled those found on eyelid skin than in the eyes of those who don’t use contacts.

Specifically, the researchers found that the eye surface had a greater variety of bacteria than the skin directly beneath the eye. They also found that the eyes of contact lens users had three times the usual levels of certain bacteria than the eyes of those who didn’t use contact lenses.

The findings were to be presented Sunday at the annual meeting of the American Society for Microbiology, in New Orleans. Findings presented at meetings are typically considered preliminary until they’ve been published in a peer-reviewed journal.

“These findings should help scientists better understand the longstanding problem of why contact-lens wearers are more prone to eye infections than non-lens wearers,” Dominguez-Bello said.

That understanding could lead to better ways of preventing eye infections in contact lens wearers, the researchers said.

More information

The American Academy of Ophthalmology has more about contact lens-related eye infections.

---

from Health News / Tips & Trends / Celebrity Health http://ift.tt/1LWkPmJ

New Drug a Weapon Against Advanced Melanoma: Study

By Dennis Thompson
HealthDay Reporter

SUNDAY, May 31, 2015 (HealthDay News) — The life expectancies of people with advanced melanoma may be doubled or even quadrupled, thanks to a new drug that harnesses the power of patients’ immune systems to fight their cancer, researchers reported Sunday.

The drug, nivolumab (Opdivo), slowed cancer progression in melanoma patients by more than double, compared with an earlier immunotherapy drug called ipilimumab (Yervoy).

What’s more, the delay in cancer progression nearly quadrupled when the two drugs were combined, compared with taking ipilimumab alone, the researchers said.

But the combination therapy came with greater side effects, which may limit treatment in frail patients. However, the researchers noted that no deaths occurred during the large-scale, international clinical trial.

“This trial was conducted at 137 sites globally, and the safety guidelines that were in place clearly were able to handle these side effects,” said study author Dr. Jedd Wolchok, chief of the Melanoma and Immunotherapeutics Service at Memorial Sloan Kettering Cancer Center in New York City. “This treatment can be safely applied in a global setting.”

The findings were presented Sunday at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago; they were published simultaneously in the New England Journal of Medicine.

Nivolumab and ipilimumab both belong to a class of drugs called immune checkpoint inhibitors, which boost the immune system’s ability to attack and destroy cancer cells, the researchers explained.

Cancer cells flout immune attack by hiding behind processes that normally keep the immune system from running amok and targeting healthy cells.

Ipilimumab works by blocking a “switch” called CTLA-4 that cancer cells use to masquerade as normal cells. It was the first drug to be associated with an improvement in overall survival for patients with advanced melanoma, the researchers said in background information.

But nivolumab belongs to a second-generation set of immune checkpoint inhibitors that target a more cancer-specific “switch” called PD1. Another study presented earlier at the ASCO meeting showed that nivolumab is effective in treating lung cancer as well.

Both ipilimumab and nivolumab are FDA-approved for use in patients with melanoma that is advanced or cannot be removed by surgery.

To compare the effectiveness of the two drugs, the researchers randomly assigned 945 patients with previously untreated, advanced melanoma to receive ipilimumab, nivolumab or a combination of the two.

They found that nivolumab alone more than doubled the average time to disease progression, compared to ipilimumab — almost 7 months versus almost 3 months.

Patients did even better when ipilimumab and nivolumab were combined, receiving an average delay of 11.5 months before their disease progressed.

More patients also responded to therapy that included nivolumab. About 57 percent responded to the combination therapy, compared with 43 percent for nivolumab alone and 19 percent for ipilimumab.

Nivolumab also did a better job of shrinking patients’ tumors. The average patient experienced a 52 percent reduction in cancerous tissue with the combination therapy and a 34 percent reduction with nivolumab alone. On the other hand, patients treated with ipilimumab alone experienced only a 6 percent decrease in tumor size, the researchers said.

People responded best to nivolumab if their cancers contained a molecule called PD-L1, which is the means by which the tumors exploit the PD-1 “switch” to avoid detection by the immune system, the researchers found.

In fact, patients with PD-L1-positive tumors responded just as well to nivolumab alone as they did to the combination therapy, the study found.

On the other hand, those with tumors that had low levels of PD-L1 responded best to the combination therapy.

Using these drugs to unleash the immune system can cause other health problems, and the most common side effects in this study were diarrhea, rash, fatigue, itching and nausea.

About 36 percent of patients receiving the combination therapy had to drop out of the trial due to side effects, compared with about 8 percent for nivolumab and 15 percent for ipilimumab, the researchers said.

“The nivolumab and ipilimumab combination in this study came with greater side effects, which might offset its benefits for some patients,” said melanoma expert Dr. Steven O’Day, director of the Los Angeles Skin Cancer Institute. “Physicians and patients will need to weigh these considerations carefully.”

However, O’Day noted that 68 percent of patients who dropped out due to side effects ended up responding to the combination therapy, and half responded after the therapy had been suspended.

ASCO spokesperson Dr. Jyoti Patel said that doctors likely will be able to use the PD-L1 molecule to help detect patients who will benefit from nivolumab alone, so they won’t have to endure the side effects of the combo therapy.

“We are beginning to define which patients may benefit from one drug and which patients may benefit from multiple drugs,” said Patel, an associate professor of hematology/oncology at Northwestern University Feinberg School of Medicine in Chicago.

The study was funded by the drug’s manufacturer, Bristol-Myers Squibb.

More information

Visit the U.S. National Institutes of Health for more on melanoma.

---

from Health News / Tips & Trends / Celebrity Health http://ift.tt/1Jhk9bQ

Improved Therapies Have Extended Life Spans of Childhood Cancer Survivors

SUNDAY, May 31, 2015 (HealthDay News) — Treatment adjustments have significantly increased the life spans of childhood cancer survivors in the United States and Canada, according to new research.

Deaths among five-year survivors 15 years after diagnosis have been halved since the 1970s — falling from just over 12 percent to 6 percent, the study of more than 34,000 people revealed.

“Fifty years ago, only one in five children would survive cancer, and today over 80 percent are alive five years after diagnosis,” said the study’s lead author, Dr. Gregory Armstrong. He is a pediatric oncologist at St. Jude Children’s Research Hospital in Memphis, Tenn.

The researchers said changes in treatment that reduce long-term health risks — including heart and lung problems, and second cancers — is likely the reason for the positive trend. Modification of radiation and chemotherapy treatments has been particularly beneficial, the study authors said.

“Now, we’ve not only helped more children survive their primary cancer, but we’ve also extended their overall life span by reducing the overall toxicity of treatment in more modern eras,” Armstrong said.

The findings were scheduled for presentation Sunday at the American Society of Clinical Oncology (ASCO) annual meeting, in Chicago.

Up to 18 percent of people who survived cancer as children die within 30 years, previous research has shown. Although the risk of cancer worsening or returning levels off over time, death from other medical problems increases every year a person survives beyond their cancer diagnosis, the study authors explained in an ASCO news release.

This U.S. National Institutes of Health-funded study looked at data on the long-term health outcomes of five-year survivors of childhood cancer who received their diagnosis between 1970 and 1999. The researchers assessed death rates among the participants by analyzing a computerized index of death record information.

Five-year survivors were followed for an average of 21 years after diagnosis. The researchers found that 12 percent died during that time. Forty-one percent of these deaths were from other health-related causes, including the lingering effects of cancer therapy, the study authors said.

But total deaths from other health-related causes dropped from 3.5 percent to 2.1 percent in this time period, the findings showed. Children diagnosed more recently had a significantly lower risk of death from other health problems, including cancer or heart or lung disease, the study authors found.

Lower death rates were mainly attributed to fewer deaths from late effects of cancer treatment. This trend was most obvious among survivors of Wilms tumor, Hodgkin lymphoma, and acute lymphoblastic leukemia, the researchers said.

“While the modernization of cancer therapy has probably made the most significant difference, improvements in supportive care for survivors, and screening, detection and treatment of late effects, like new cancers and heart and lung disease, have played an important role in extending their life span as well,” Armstrong said in the news release.

Data and conclusions of research presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Cancer Institute has more about childhood cancer.

---

from Health News / Tips & Trends / Celebrity Health http://ift.tt/1LUWehv

Gene Therapy Shows Early Promise Against Deadly Brain Cancer

By Alan Mozes
HealthDay Reporter

SUNDAY, May 31, 2015 (HealthDay News) — Early trials of a new form of gene therapy may give hope to patients battling glioblastoma, the most deadly form of brain cancer.

Called AdV-Tk therapy, the new treatment involves two steps. As the researchers explained it, the first step involves taking DNA from the herpes virus and injecting it into tumor cells, and then attacking those DNA-tagged cells with a powerful drug.

In the second step, the drug helps spur the patient’s immune systems to eliminate more of the cancer cells over time.

All of the patients in the study had also undergone surgeries aimed at minimizing the tumor, the researchers noted.

The result, so far, has been a marked improvement in prognosis for the 48 patients participating in the preliminary trial.

“Glioblastoma is the most malignant brain tumor you can have,” said study co-author Dr. David Baskin, professor of neurosurgery with both Houston Methodist Hospital and the Weill-Cornell College of Medicine in New York City. “It’s almost always a death sentence, with median survival of about nine to 15 months, and the quality of life during the last five months is often quite poor.

“Surgery, along with chemotherapy and radiation, is the only current treatment option,” he added. “This cancer is like an octopus — it reaches into all parts of the brain [and] you can only ever get some of it out.”

However, “this particular gene therapy is better than anything else we have,” said Baskin, who also directs the Peak Brain Tumor Center at the Houston hospital. “By inserting a virus into the tumor, then attacking that virus with medication while also firing up the patient’s own immune system, you can get a real one-two punch treatment effect, and prolonged survival.”

He stressed that the treatment may not be a cure. “The [survival] numbers still stink,” Baskin said. “But they’re significantly better, which makes this a big advance.”

Baskin and his team are slated to present their findings Sunday in Chicago at the annual meeting of the American Society of Clinical Oncology.

The initial research spanned 2006 to 2010, when the investigators inserted harmless pieces of herpes simplex viral DNA into a cold virus. That modified virus was then injected directly into cancerous tissue. The researchers picked the cold virus because it’s known to spread widely and quickly in cells.

In the new clinical trial study, the 48 glioblastoma patients received the gene therapy after undergoing “aggressive” surgery aimed at reducing the tumor.

Each patient was then given an antiviral drug. The drug was designed to recognize and attack the inserted DNA fragment, and to “break open” any brain tumor cell into which the cold virus had spread.

The result, said Baskin, is that “suddenly the immune system starts killing anything that might have these proteins. So you put the Trojan horse virus in. Then, after you kill the virus the tumor cells explode, causing the immune system to hyper-activate without raising toxicity [to the patient].”

“It’s interesting and exciting, because the improvement [in survival] is significant,” Baskin said.

How significant?

Specifically, one-year survival rose from 57 percent to 67 percent; two-year survival rose from 22 percent to 35 percent; and the number of patients who lived at least three years rose from 8 percent to 19 percent, the study team found.

Overall, average survival improved by about eight months, researchers say.

“We’re not saying we have a cure, of course,” noted Baskin. “But we think we have something that makes a lot of sense conceptually, and is a real advance. And of course going forward we can try to get the numbers up even more by increasing the dose and finding additional targets. But even with what we have already, the improvement is big.”

Balveen Kaur is a professor of neurological surgery at Ohio State University in Columbus. She said that new approaches to fight brain tumors are sorely needed.

“All current FDA-approved therapies for brain cancer suffer from the drawback of having a lot of side effects, which limits their use and hence efficacy,” said Kaur, who is also the associate director of OSU’s Medical Center at the Comprehensive Cancer Center.

However, she cautioned that “while gene therapy has a lot of potential, it is important to keep in mind that the current study is a small study, with a few patients, and future randomized studies will be essential to identify if the treatment really works.”

Experts also note that findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

More information

Find out more about glioblastomas at the American Brain Tumor Association.

---

from Health News / Tips & Trends / Celebrity Health http://ift.tt/1LUWehr

Melanoma Treatment May Not Always Require Extensive Lymph Node Removal

By Dennis Thompson
HealthDay Reporter

SATURDAY, May 30, 2015 (HealthDay News) — Not all melanoma patients may need surgery to remove lymph nodes surrounding their tumor, a new clinical trial has found.

Cancer doctors usually remove all lymph nodes located near a melanoma tumor — the deadliest type of skin cancer — if they find that the cancer has spread to at least one lymph node.

But such surgery did not improve survival in a group of nearly 500 patients with very small tumors, according to findings scheduled for presentation Saturday at the annual meeting of the American Society of Clinical Oncology (ASCO), in Chicago.

“I think that our study is the beginning of the end of a general recommendation of complete lymph node dissection for patients with positive sentinel nodes,” senior study author Dr. Claus Garbe, a professor of dermatology at the University of Tubingen in Germany, said in an ASCO news release.

However, patients with advanced melanoma likely will continue to need all of the surrounding lymph nodes removed, as that is a well-established strategy for improving their survival, said Dr. Vernon Sondak, chief of cutaneous oncology at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla.

“Surgery is critical in those more advanced cases,” said Sondak, who was not involved in the new study.

But these findings suggest that some patients whose melanoma has been caught early might be able to avoid the surgery, if they agree to rigorous ongoing observation of their condition, Sondak said.

When a person is diagnosed with melanoma, doctors take samples from nearby lymph nodes to see if the cancer has spread, according to the American Cancer Society. This procedure is called a sentinel node biopsy.

If one of the lymph nodes has cancer, doctors perform more extensive surgery to remove all of the lymph nodes surrounding the tumor. The thought was that melanoma can spread throughout the body via the lymph nodes, and their removal would keep the cancer in check and improve survival, said Dr. Lynn Schuchter, a melanoma specialist at the University of Pennsylvania’s Abramson Cancer Center.

But doctors now suspect that melanoma can spread without going through the lymph nodes, and that removing the glands may be unnecessary for some patients, said Schuchter, who played no role in the new research.

Removal of large groups of lymph nodes carries the risk of debilitating side effects, including infection, nerve damage and lymphedema — an uncomfortable condition in which legs or arms swell because the lymph nodes aren’t there to transport fluid away from the extremities.

Lymphedema can occur in more than 20 percent of patients, and persist long-term in up to 10 percent of patients, the study authors said.

“Many patients already have been deciding not to have their lymph nodes removed, because of the concerns associated with lymphedema,” Schuchter said.

In the new study, 483 patients with stage 3 melanoma — meaning the cancer had begun to spread — and a positive lymph node biopsy had their primary tumor removed. They then were randomly assigned to observation only or removal of all nearby lymph glands.

During follow-up, in which half the patients were monitored for more than three years, the cancer had spread in 14.6 percent of patients in the observation group, compared with 8.3 percent in the group that had additional surgery to remove lymph glands.

But no statistically significant improvement in survival occurred between the two groups at three years or five years, the researchers reported.

“Doctors may want to discuss this finding with their patients to help them decide whether this procedure is right for them,” Garbe concluded.

Only patients with tiny, microscopic-size tumors were included in this study, the researchers said. Garbe agreed with Sondak that people with larger tumors still will need full removal of nearby lymph nodes.

Schuchter said this study suggests a new “maybe less is more” approach to cancer treatment.

“The trend has been to try to do the right surgery, and sometimes that means less surgery because of the complications associated with surgery,” she said.

She noted that data from larger trials in breast cancer patients already found no benefit in removing all nearby lymph nodes.

“Women with breast cancer now are not getting complete lymph node dissection,” Schuchter said. “I think we’re going to learn a similar lesson in melanoma.”

Studies presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

More information

For more on lymph nodes and cancer, visit the American Cancer Society.

---

from Health News / Tips & Trends / Celebrity Health http://ift.tt/1LPRA4Y

2 Drugs Show Promise Against Blood Cancers

By Dennis Thompson
HealthDay Reporter

SATURDAY, May 30, 2015 (HealthDay News) — Two new drugs have shown promise in slowing the march of two incurable blood cancers, researchers report.

One drug, ibrutinib, appears to greatly improve standard treatment for patients with recurring chronic-lymphocytic leukemia (CLL), the most common adult leukemia in Western countries.

Ibrutinib (Imbruvica) reduced the risk of cancer progression or death by 80 percent when combined with a chemotherapy drug called bendamustine (Treanda) and a targeted therapy drug called rituximab (Rituxan), compared to the other two drugs being used on their own, the researchers found.

“We found that if you add ibrutinib to the standard regimen, progression-free survival was significantly improved as a direct result of the ibrutinib,” said lead author Dr. Asher Chanan-Khan, a professor of medicine at the Mayo Clinic in Jacksonville, Fla.

Meanwhile, the second drug, obinutuzumab (Gazyva), helped double the average length of remission for patients with slow-growing forms of non-Hodgkin lymphoma.

“Unfortunately, there is yet no cure for indolent lymphoma, so the overall goal of treatment is to increase the amount of time patients remain symptom-free and in remission,” said study author Dr. Laurie Helen Sehn, an oncologist at the BC Cancer Agency in Vancouver, Canada. “The fact that this new approach doubled average remission time marks a major step forward for our patients.”

There’s no cure for either cancer, so the main goal of therapy is to put patients into remission and keep them in remission as long as possible, Chanan-Khan said.

Both findings were to be reported Saturday at the American Society of Clinical Oncology annual meeting, in Chicago. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

The ibrutinib trial involved 578 patients with recurring chronic-lymphocytic leukemia. They were randomly assigned to receive either the usual two-drug treatment, or ibrutinib alongside the standard treatment.

Ibrutinib works by interfering with the messaging signals that CLL requires to survive and proliferate, Chanan-Khan explained. It comes in a capsule taken by mouth once daily.

Patients’ chances of entering remission increased if they received ibrutinib by about 83 percent compared with 68 percent for standard therapy, Chanan-Khan said.

People who took ibrutinib also enjoyed longer periods of remission. After 18 months of follow-up, about 79 percent of patients who responded to ibrutinib remained in remission, compared with 24 percent who received standard combination therapy, according to Chanan-Khan.

Finally, the addition of ibrutinib reduced patients’ risk of death during the study. “If you look at the survival curve, the chance of dying from the disease, ibrutinib decreases it by 37 percent,” he said. “That’s pretty steep.”

And while patients faced side effects from all three cancer drugs, the researchers found that no new side effects emerged from combining the medications.

The obinutuzumab clinical trial included 396 patients with various types of slow-growing non-Hodgkin lymphoma, researchers said.

Obinutuzumab targets a protein on cancerous white blood cells, causing the cells to either die or become more sensitive to chemotherapy.

Patients were randomly assigned to receive just the chemotherapy drug bendamustine, or a combination of bendamustine and obinutuzumab.

After an average follow-up of 21 months, progression-free survival was 14 months for bendamustine alone versus 29 months for the combination therapy, the investigators found.

“I don’t think either one of these drugs are game changers. But these two studies do add weight to the promise they may hold when used in combination therapy for each disease,” said Dr. Merry Jennifer Markham, an assistant professor of hematology and oncology at the University of Florida, Gainesville.

Ibrutinib could be added to the existing front-line combination therapy for newly diagnosed CLL, if future research confirms these findings, Markham said. The drug has already been approved by the U.S. Food and Drug Administration, but only for CLL patients who have had one prior treatment.

On the other hand, “obinutuzumab is unlikely to become a standard front-line therapy based on this current study,” Markham said. She noted that rituximab still holds the title as the standard targeted up-front therapy for slow-growing non-Hodgkin lymphoma.

Both drugs are expensive and likely to increase the cost of therapy, Chanan-Khan pointed out. “When we load things onto an existing platform of treatment, it will jack up the cost. That is always the case,” he said.

“On the other hand, ibrutinib is capable of putting patients into extended remission,” he added, noting that CLL patients he used to see once a month now come in annually. “If a person goes into remission and stays in remission for a longer time, then what is the cost for that?”

The ibrutinib study received funding from Janssen Research & Development. And the obinutuzumab study received funding from Genentech and Hoffmann-La Roche.

More information

Visit the Leukemia and Lymphoma Society for more about blood cancer.

---

from Health News / Tips & Trends / Celebrity Health http://ift.tt/1LPRA4Q

Are 2nd Breast Cancer Surgeries Always Necessary?

SATURDAY, May 30, 2015 (HealthDay News) — Thousands of breast cancer patients in the United States might be spared a second surgery if more tissue was removed during initial breast-conserving, partial mastectomy surgery, a new study suggests.

Partial mastectomy, often called lumpectomy, aims to conserve breast tissue and stops short of a full mastectomy.

More than half of the nearly 300,000 women in the United States diagnosed with breast cancer each year undergo this type of surgery, according to researchers from the Yale Cancer Center in New Haven, Conn. However, after the procedure, 20 percent to 40 percent of these patients still have cancer cells at the edges of the areas where tissue was removed. That often means a second surgery, to ensure that no cancer remains.

The new study was led by Dr. Anees Chagpar, an associate professor of surgery at Yale School of Medicine, and included 235 patients with stage 0 to III breast cancer who underwent partial mastectomy in the normal way.

All of the women were then randomly selected in the operating room to have additional tissue removed or not.

Removing the extra tissue reduced by half the chances of requiring a second surgery, the researchers found.

“Despite their best efforts, surgeons could not predict where the cancer was close to the edge,” Chagpar noted in a Yale news release.

Removal of so-called “cavity shave margins” reduced the rate at which cancer cells remained in the tissue margin in half, “without compromising cosmetic outcome or increasing complication rates,” according to Chagpar, who also directs The Breast Center at Smilow Cancer Hospital at Yale-New Haven.

Her team said it will track outcomes for the patients for five years to assess how the removal of extra tissue affects the risk of a cancer recurrence.

“This randomized controlled trial has the potential to have a huge impact for breast cancer patients,” Chagpar said. “No one likes going back to the operating room, especially not the patients who face the emotional burden of another surgery.”

However, two experts not involved with the study cautioned that there are good reasons to be conservative when it comes to tissue excision in the operating room.

“Randomly removing additional breast tissue is not necessarily in the best interest of the individual patient and may lead to negative cosmetic outcomes over time,” said Dr. Susan Boolbol, chief of the division of breast surgery at Mount Sinai Beth Israel in New York City.

“When exploring ways to decrease the re-excision rate, we must be mindful of the fact that removing healthy, non-cancerous tissue does not help any patient and can potentially have a negative impact on their cosmetic outcome in the long term,” she added.

Dr. Stephanie Bernik is chief of surgical oncology at Lenox Hill Hospital, also in New York City. She acknowledged that “needing to go back for additional surgery to obtain clear margins after breast cancer surgery is an age-old problem.”

However, “more tissue removal can lead to a worse cosmetic result, even though this study did not find that to be true,” she added.

Emerging technologies may lead to more precise surgeries in the future, Bernik said. “Devices to evaluate margins ‘intra-operatively’ are now being brought into use as well,” she said. “All of these findings will ultimately help reduce the number of times a patient may have to return to the operating room.”

The study was published online May 30 in the New England Journal of Medicine and is also slated for presentation on Saturday at the annual meeting of the American Society of Clinical Oncology, in Chicago.

More information

The American Cancer Society has more about breast cancer surgery.

---

from Health News / Tips & Trends / Celebrity Health http://ift.tt/1LPRzOy

New Drug Keeps Common Breast Cancer Under Control Longer: Study

By Kathleen Doheny
HealthDay Reporter

SATURDAY, May 30, 2015 (HealthDay News) — Adding a new drug called Ibrance (palbociclib) to standard hormone therapy helped keep a common type of breast cancer under control measurably longer than the hormone therapy alone, a new study shows.

“Palbociclib stops cancer cells from growing,” said study author Dr. Nicholas Turner, team leader at the Institute of Cancer Research in London, England.

Adding the drug was so effective that the trial was stopped early so that those who were in the “control” group (taking an inactive placebo) could also be offered the drug.

The findings are to be published online in the New England Journal of Medicine, to coincide with a planned presentation Saturday at the American Society of Clinical Oncology annual meeting in Chicago. Pfizer, the drug’s maker, helped fund the study.

Turner’s team randomly assigned 521 women to get either Ibrance plus the standard hormone therapy known as fulvestrant, or fulvestrant with a placebo pill.

All of the study participants had advanced breast cancer, a type known as hormone receptor-positive and HER2-negative. Cancers that are hormone receptor-positive are fueled by estrogen or progesterone. Those that are HER2-negative do not have the growth-promoting hormone HER2.

All of the women had cancers that had spread (“metastatic” disease), and then worsened or relapsed after they had taken initial hormone therapy. The median age of the patients was about 57.

The researchers measured the average time it took for disease to progress to evaluate how well the new drug worked to control the cancer. The average time in the Ibrance/fulvestrant group was 9.2 months, compared to 3.8 months in the fulvestrant-alone group, the investigators found.

The new drug targets two key proteins that fuel the growth of this type of cancer, Turner said. Fulvestrant is a commonly used hormone therapy.

About 75 percent of all breast cancers are hormone receptor-positive, HER2-negative, according to Turner.

Patients on the combo treatment had a small increase in fatigue, hair thinning and mouth soreness compared to the solo-therapy group, Turner said. They were also more likely to get infections. Only a few women dropped out due to side effects.

A longer follow-up is needed to see the effect of the drug on the women’s overall survival, not just keeping the cancer under control, Turner said. The researchers are also studying the possibility of using the drug in women with early stage hormone receptor-positive breast cancer.

Dr. Joanne Mortimer, director of Women’s Cancer Programs at the City of Hope Cancer Center, in Duarte, Calif., called the study results impressive.

“Keeping your cancer under control for an additional five months is an important result,” she said.

The U.S. Food and Drug Administration granted Ibrance accelerated approval earlier this year for use in combination with the drug letrozole for women with advanced estrogen receptor-positive, HER2-negative breast cancer who had not yet gotten hormone therapy for their metastatic disease.

So, doctors could use Ibrance “off label,” Mortimer said. However, not all insurers may pay for it, she added. The drug is expensive, about $10,000 a month.

“Once this study is presented, most insurers will probably cover it,” Mortimer said.

More information

To learn more about breast cancer, visit the American Cancer Society.

---

from Health News / Tips & Trends / Celebrity Health http://ift.tt/1LPRBWE

Smokers May Need More Anesthesia, Painkillers for Surgery

FRIDAY, May 29, 2015 (HealthDay News) — Smokers and people exposed to secondhand smoke may require more anesthesia and painkillers during surgery than nonsmokers, according to a new study.

Turkish researchers looked at 90 women who underwent surgery to remove their uterus through an incision in the abdomen — a procedure called total abdominal hysterectomy. Smoking status was measured by levels of cotinine in the blood. Cotinine is a by-product of nicotine, the researchers said.

Compared with patients who didn’t smoke, those who smoked needed 33 percent more anesthesia throughout the operation. People exposed to secondhand smoke required 20 percent more anesthesia than nonsmokers, according to the researchers.

For painkillers, smokers needed 23 percent more medication than nonsmokers to achieve the same results. People exposed to secondhand smoke required 18 percent more pain medication than nonsmokers, the study revealed.

Nicotine may affect patients’ metabolism of anesthetic drugs in the liver, or may desensitize some of the nerve cells that sense pain, according to the study team led by Erdogan Ozturk, of the department of anesthesiology and intensive care at Bezmialem Vakif University in Istanbul, Turkey.

The study was scheduled to be presented Saturday at a European Society of Anaesthesiology meeting in Berlin. Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

More information

The U.S. National Library of Medicine has more about smoking and surgery.

---

from Health News / Tips & Trends / Celebrity Health http://ift.tt/1FfjDW1

8 Hot Ways to Sunburn-Proof Your Skin This Summer

Can’t wait to slip into a swimsuit and feel the warmth of the sun on your skin? Don’t go too bikini-bare, especially if you’re fair-skinned or planning to be out in the water a lot this summer: Nearly 5 million people are treated for skin cancer in the U.S. every year, according to the Skin Cancer Foundation, and sunblock only goes so far, especially if you’re not applying it properly or constantly. Why not just wear a rash guard—a long-sleeved athletic shirt designed for water wear—to block rays instead?

“Long sleeves at the beach?!” you’re saying? Hear us out.

RELATED: 6 Things Your Dermatologist Wants You to Know About Skin Cancer

“Clothing is the single most effective form of sun protection for the body because it offers a convenient and consistent shield,” says Skin Cancer Foundation vice president Susan H. Weinkle. “Rash guards are a great option because they help protect the chest, arms, stomach, and back from the sun’s UV rays. Many are lightweight, breathable, and quick-drying, so they are just as comfortable in and out of the water.”

RELATED: What Skin Cancer Looks Like

More to the point, there are tons of great stylish and even sexy options out there these days (and anyway, what’s less hot than a nasty, peeling sunburn?). Check out these cute picks that will keep you fashionable and burn-free during all of your summer water exploits.

Hot crop

The sporty, belly-baring DNKY Zipper Cropped Rash Guard ($82, zappos.com) has a convenient front zipper, making it super-easy to slip on and off.

Photo: Zappos.com

Unisex(y)

The Beth Richards Cara Rash Guard ($160, revolveclothing.com) serves up a dose of edge thanks to its mesh sleeves and all-black hue.

Photo: Revolvingclothing.com

Summer solstice

Made with Lycra Sport, the O’Neill Voda One-Piece 365 Surfsuit ($94, zappos.com) is slow to lose its shape, so you can don this tribal print beauty for several summer seasons.

Photo: Zappos.com

RELATED: Dive Into Your Best Body Ever

White bright

With a built-in bra, you can throw on the Robin Piccone Hannah Short Sleeve Mesh Rash Guard ($98, nordstrom.com) for a dip in the pool or pair it with your favorite cutoffs.

Photo: Nordstrom.com

Trendy traveler

An intricately beautiful pattern and 50+ UPF make the Gypsy Queen Rash Guard ($49.50, nordstrom.com) your perfect surfside accessory.

Photo: Nordstrom.com

Divine design

Side ties allow you to tailor the length (show a little or a lot!) on this tunic-style Land’s End Adjustable Rash Guard ($55, landsend.com) for a perfect fit.

Photo: Landsend.com

RELATED: Super Flattering Swimsuits

Lucky stripes

Consider the Nautica Safe Haven Zip Up Swim Tee ($65, zappos.com) your ode to the high seas. Bonus: The raglan cap sleeves and bold stripes will set you apart from your sail mates.

Photo: Zappos.com

Lacey lady

Show off your teeny-tiny bikini top through this über-feminine Tommy Bahama Crochet Lace Rash Guard ($96, tommybahama.com) while still shielding your skin from the sun.

Photo: Tommybahama.com

RELATED: Sun-Proof Your Skin From A to Z

from Health News / Tips & Trends / Celebrity Health http://ift.tt/1Qg8hXW