Category Archives: cancer

October: Breast Cancer Awareness Month is here

When examining cancer morbidity and mortality, if you separate the sexes, acknowledging that men also get breast cancer, among women, breast cancer is the top culprit.

The first step is to make sure that there is widespread awareness for the disease, both among the public, but also in government. That way, men and women can conduct breast exams, and try to get as early a diagnosis as possible.

Secondly, governments around the world can set aside more funding, both for breast cancer research, as well as for breast cancer treatments. At least in the developing world, the disease is not as debilitating as it once was.

Just the other day, we found out everyone’s sweetheart Julia Louis-Dreyfus came forward letting us all know she has been diagnosed with breast cancer. Thus, you have a clear view of a disease that spares neither the rich, nor the poor, and does not care for any other classification.

It is also the hope that a cure for breast cancer can be extended to other cancers. This has happened to a certain extent with some of the medication and therapies.

Therefore, join me this month, as I try to rack up a few posts on Breast Cancer – the statistics, therapies, diagnosis, prevention and more.

New Drug Approved: abemaciclib

Let us start with good news for today. “abemaciclib” is a new drug just approved by the FDA for breast cancer therapy. You can read about it in the reference. However, let’s break it down a bit here.

CDK (cyclin-dependent kinase) inhibitor

For starters, abemaciclib belongs to a class called CDK Inhibitors. There are two other drugs in this class, that were also approved for the treatment of a specific sub-type of breast cancer, the “receptor-positive, HER2-negative breast cancer”. This is one of the good things about breast cancer research and treatment today. Breast cancer has been typed and classified genetically enough that we have left behind the “let’s throw stuff on the wall and see what sticks” mostly.

Of course, there is more work to be done. To exemplify that, abemaciclib, is specific to patients who are on endocrine therapy and the disease continues to progress. Not only that, while the drug is to be administered along with another drug, fulvestrant, it has been specifically been approved to be used as a monotherapy (standalone treatment) for patients who have previously had both endocrine therapy and conventional chemotherapy, but in whom, breast cancer has metastasized.

While this can all certainly seem overwhelming, it is an example of both how far we have come, and how far we have to go.

Key Takeaways

Some key takeaways for the Breast Cancer Awareness Month, something, which I will try to repeat as many times as possible:

  1. Awareness is supreme. Awareness helps us to be rid of fear, and to get women to quicker and earlier diagnoses, which is a very important consideration in survival.
  2. Governments and private philanthropies should focus on provide funding for all cancer research in general, and breast cancer in particular. This is where awareness comes into play again.
  3. Support medicine, clinical research and science in general. We need to be able to genetically weed out breast (and hopefully, ALL) cancer, not just do things based on family history and other factors. This is a lofty, achievable goal. We do it with other diseases, we need to be able to do this with cancer as well.
  4. Prevention, is always better than cure. Therefore, along with awareness, must come campaigns that urge people to live healthier lifestyles – less drinking, avoiding cigarettes, avoid harmful drugs, eating well, exercising and more.

Subscribe and Support Please!

Did you enjoy this post? Please subscribe for more updates, using the sidebar. Have ideas or blog posts you’d like to see here? Contact me at yamanoor at gmail dot com.

References: 

  1. The approval of abemaciclib: https://www.medpagetoday.com/HematologyOncology/BreastCancer/68204?xid=nl_mpt_%20SRCardiology_2017-09-30&eun=g101584d0r&pos=3311133
  2. Image, Courtesy Pexels: https://www.pexels.com/photo/awareness-cancer-design-pink-579474/

 

Brief: WebMD publishes a very useful interview on the link between talcum powder use and cancer

It has been a busy couple of months for me, with several projects that have required juggling, so I have not been able to post anything on Women’s Health issues. However, given the most recent verdict against Johnson & Johnson on a case filed by a woman with Ovarian Cancer, resulted in Millions of Dollars being awarded to her.

Any time this happens, of course, it causes a stir, as it should. However, I am not going to spend time on this post talking about the merits of courts allowing companies like J&J and many of the drug companies try to get away by not fighting lawsuits as a class, etc. Those discussions are for my other blog, and will go on for a long time. Plus, in this case, we cannot prove a causal relationship between talcum powder use and cancer, yet.

So, I want to touch very briefly on three takeaways from the interview, and suggest you get the rest from the horse’s mouth:

  1. Correlation is not always a result of causation. We may never find lasting proof that talcum powder use causes cancer. This is an important thing to remember.
  2. There appears to be no medical benefit at all from using talcum powder.
  3. So, given the correlation and the lack of any benefit, it is best to stop using talcum powder! This is what the Doctor interviewed in the article suggests! Sound advice, it would appear!

Please read the rest here: http://www.medscape.com/viewarticle/884700?pa=Vor1qEPNxHeNOj5AKsX1Hl55HifEoXQauwdv%2BVDi5uqIdvEbMsfStGAJbHUGqkcC8SIvl8zjYv73GUyW5rsbWA%3D%3D

Image, Courtesy, Pexels: https://www.pexels.com/photo/rear-view-of-woman-with-arms-raised-at-beach-during-sunset-320007/

GOC2: A PRO study on open vs. minimally invasive endometrial cancer surgeries

MDedge and MDLinx separately alerted me to a very interesting study based on GOC 2 (Gynecological Oncology), a Canadian research program. In this particular study (cost comparisons  apparently will be reported separately – MDedge has a video of an interview of the study lead), open surgery for Endometrial Cancer was compared to laparoscopic and robotic surgery techniques. The study was reported at the Society of Gynecologic Oncology 2017 Meeting.

This study is another example where women were recruited across multiple sites, and they answered survey questions, and thus, is a Patient Reported Outcomes (PRO) study on Quality of Life (QOL) following procedures of varying invasiveness.

As a reference, Endometrial Cancer represents about 3.6% of all new cancer cases in the US, occurring as new cases in an estimated 61,380 women in 2017, with a projected mortality for about 10, 920 women. The 5 year survival rate is approximately 81.3%, making Quality of Life an important concern for survivors. An NCI link is available below if you wish to explore more.

The Current Study

Patients with confirmed stage I or stage II endometrial cancer  were recruited across 8 centers in Canada. 106 patients from the open surgery arm, and 414 from the minimally invasive surgery arm participated, with the breakdown amounting to 168 laparoscopic and 246 robotic surgery patients.

Approximately 80% of patients completed the QOL questionnaires. Only about 25 – 50% of the patients responded to the sexual-function questionnaires. Those responding were found to be young, pre-menopausal and sexually active.

The study itself was not randomized, but adjustments were made to accommodate this.

Also, quoting Dr. Ferguson from MDedge below, about sexual function:

Both of the surgical groups “met the clinical cutoff for sexual dysfunction” on the Female Sexual Function Index questionnaire, she said.

Results

The results can be viewed as three distinct sets:

  1. There was no statistical significance in QOL or sexual function, between laparoscopic and robotic procedures.
  2. At 3 weeks, patients in all groups fared better in terms of pain, but Quality of Life was worse for Open Surgery Patients. Novel to this study, this extended to the 3 month period as well, both clinically and statistically. (Please watch video on the MDedge link)
  3. While fewer patients responded to the questionnaires on sexual function, there was no significant difference between the open and minimally invasive surgery groups for up to 26 weeks. I am puzzled by this honestly. If you have reduced Quality of Life, your sexual function ought to be reduced. If it is not, then how would you have a significant difference in one case and not the other? The lower number of responses might be the confounding factor here, and honestly as the paper sits behind a paywall, there is only so much I can glean from reading articles and the abstract.

References:

  1. The MDedge Article (along with the video): http://www.mdedge.com/oncologypractice/article/134206/gynecologic-cancer/video-pain-and-impaired-qol-persist-after-open
  2. Abstract 51 from SGO: https://www.sgo.org/wp-content/uploads/2016/12/SGO-AM17-abstract_titles.pdf
  3. Some Endometrial Cancer Statistics: https://seer.cancer.gov/statfacts/html/corp.html
  4. Image Courtesy of Pexels: https://www.pexels.com/photo/woman-sitting-by-the-seashore-during-day-89820/