Breaking Research News from sources other than Breastcancer.org
Comments
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6 Months vs 12 Months of Adjuvant Trastuzumab in Early Breast Cancer
- The Lancet This final report from a phase III trial provides data from patients with HER2-positive early breast cancer who were given 6 months versus 12 months of adjuvant trastuzumab. Therapy with 6 months of trastuzumab was not found to be noninferior to 12 months in this study.This study supports 12 months of trastuzumab as standard of care.
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Compassion fatigue hits not only professional caregivers. Other people get it, too.
Vicki tried to lighten the load of a friend who was facing a terminal illness. "As she got sicker, I tried to relieve every burden I could imagine," ...She did this while also caring for her parents throughout their illnesses and deaths. ...her contemporaries continue to face dreaded diagnoses, with many needing assistance. Finally, she rightfully asked herself, "How much more could I do without getting even more tired and sad?"
{Article discusses compassion fatigue among caregivers.}
{Washington Post allows a limited number of views per month without subscription.}
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The Business of Health Care Depends on Exploiting Doctors and Nurses
One resource seems infinite and free: the professionalism of caregivers.
{Opinion piece. A chilling and persuasive account of how the system - the business of healthcare - relies on physicians and nurses being rushed and doing work on uncompensated time - and how electronic medical records and administrative bloat exacerbate this problem.}
"The health care system needs to be restructured to reflect the realities of patient care. From 1975 to 2010, the number of health care administrators increased 3,200 percent. There are now roughly 10 administrators for every doctor..... Counting on nurses and doctors to suck it up because you know they won't walk away from their patients is not just bad strategy. It's bad medicine."
https://www.nytimes.com/2019/06/08/opinion/sunday/hospitals-doctors-nurses-burnout.html
{The New York Times allows a limited number of views per month without subscription.}
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Success of breast cancer candidate spurs interest in ADCs
The late-stage testing success of the antibody drug conjugate DS-8201 for breast cancer has spurred increased interest in developing ADCs for what some analysts say could be treatments that replace chemotherapy. Some 56 drug companies are working on ADC candidates, and the ADC market is expected to hit nearly $10 billion by 2025.The Economic Times (India)/Bloomberg (6/14)
{I think that there was discussion above about ES's with this therapy. I think that this is actually the same article referenced in one of the posts above.}
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Ultrasound, laser device detects and destroys circulating cancer cells
University of Arkansas for Medical Sciences researchers developed a device that uses ultrasound to detect circulating cancer cells and a laser to destroy the cells. An ultrasound transducer applied to the skin surface is able to detect sounds emitted by the cancer cells as they are heated by the laser, which then further heats them to kill them, the researchers report in Science Translational Medicine.New Atlas (6/17)
https://newatlas.com/cancer-cells-laser-ultrasound-detection-and-treatment/60158/
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CMS drafts rule to improve e-prescribing, prior authorizations
The CMS released a proposed rule that would update the electronic prescribing standards and prior authorization process for Medicare Part D. The proposed changes "would reduce the time it takes for a patient to receive needed medications and ease the prescriber burden by giving clinicians the flexibility and choice to complete prior authorization transactions electronically," CMS Administrator Seema Verma said.Becker's Hospital Review (6/17),Health Data Management (free registration) (6/17)
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Cancer indicator may also predict diabetes risk
Research links epidermal growth factor receptor to diabetes risk
A study in Diabetes Care showed that adults with the highest circulating levels of the epidermal growth factor receptor HER2/ErbB2 were at a higher risk for diabetes than those with the lowest levels. Swedish researchers used a cohort of 4,220 participants from the Malmo Diet and Cancer-Cardiovascular study and found that each 1-standard deviation increase in ErbB2 levels was tied to an increased diabetes risk in both men and women.Healio (free registration)/Endocrine Today (6/17)
Adults with larger amounts of the epidermal growth factor receptor HER2/ErbB2 are at a higher risk for diabetes compared with those with lower measures, according to findings published in Diabetes Care.
"In addition to breast cancer, circulating ErbB2 levels are positively associated with an increased risk of diabetes," the researchers wrote. "Our results are interesting and worth exploring regarding the potential role of ErbB2 in the development of diabetes and in novel therapeutic approaches."
Diabetes Care. 2019; doi:10.2337/dc18-2556.
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Guiding Cancer Control: A Path to Transformation webinar
On June 27, 2019, from 1 to 2 pm EDT, the National Academies of Sciences, Engineering, and Medicine will release its new report Guiding Cancer Control: A Path to Transformation in a webinar report release event.
This new report will look at cancer control efforts in the United States and will recommend a new approach to reduce the burden of cancer and improve quality of life for cancer survivors.
Authoring committee members participating in the webinar include:
Michael Johns (Committee Chair), Emory University
Ashleigh Guadagnolo, University of Texas MD Anderson Cancer Center
Joseph Lipscomb, Emory University
Mary McCabe, Weill Cornell Medical College and Columbia University School of Nursing
William Rouse, Stevens Institute of Technologyregister here (free):
{The National Academies of Sciences, Engineering, and Medicine offer numerous publications on cancer and other topics free of charge in PDF format or in print for a fee.}
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Impact of muscle volume on breast cancer outcomes
Prognostic impact of skeletal muscle volume derived from cross-sectional computed tomography images in breast cancer
This study analysed if the volume of muscle or the volume of fat in a patient with breast cancer had any impact on their survival. The study found that patients with breast cancer who had higher volumes of muscle survived better than patients with low volumes of muscle.
CONCLUSION: This study demonstrated that breast cancer patients with higher skeletal muscle volume showed more favorable prognosis.
https://www.ncbi.nlm.nih.gov/pubmed/30132218
DOI: 10.1007/s10549-018-4915-7 -
High Soy Intake May Cut Fracture Risk in Younger Breast Cancer Survivors
Findings seen among pre-/perimenopausal survivors of stage 0 to III breast cancer
- HealthDay
- Higher soy consumption is linked to fewer osteoporotic fractures in younger breast cancer survivors, according to a study published online May 21 in JNCI Cancer Spectrum.
- https://www.practiceupdate.com/C/85457/56?elsca1=emc_enews_topic-alert
- https://academic.oup.com/jncics/article/3/2/pkz017/5488692
- https://doi.org/10.1093/jncics/pkz017
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Thank you, Lumpie, for all your work on finding and posting these! That ultrasound device that can destroy CTCs sounds very promising!
My MO is very research oriented, but when I asked her about doing a CTC test, she said: "we know having higher levels of CTC in an early BC patient is associated with higher probability of relapse, but we don't know what to do about this yet". Now there may be a mechanism to destroy the CTCs!
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FarAwayToo: Ditto - my MO said the same thing: Even if we figure out that you have a high level of CTC's, we don't know what to do about it. That is not very comforting to patients. I am optimistic that, with further research, some version of CTC's will be used as a diagnostic tool and will become actionable.
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Rate of breast implant removal surgeries rising
The number of women having breast implants removed has increased almost 40% over the past decade, and they report an array of symptoms they say are linked to the implants, including headaches, fever, brain fog, rashes, chronic fatigue and joint pain. Dr. Dave Rankin of Aqua Plastic Surgery in Jupiter, Fla., said he performed at least 400 explant procedures in 2018 and he sees demand for explant surgeries outpacing demand for implants.WFTS-TV (Tampa, Fla.) (6/17)
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Make palliative care automatic for breast cancer, expert says
Palliative care should be "automatic, expected and a routine part of excellent breast cancer care," said Dr. Michael Rabow, a palliative care medical director at the University of California at San Francisco's Helen Diller Family Comprehensive Cancer Center. Progress has been made for patients with metastatic breast cancer, but palliative care remains underutilized overall. Medscape (free registration) (6/14)
https://www.medscape.com/viewarticle/913957
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New models may address cancer survivors' care coordination headaches
Because their medical histories are lengthy and complex, cancer survivors in particular struggle with poorly coordinated care that can compromise access to needed follow-up, writes Michelle Doose, an epidemiology researcher and cancer survivor. However, patient-centered medical homes, accountable care organizations and other emerging frameworks show promise for ensuring cancer survivors get well coordinated care that could also become a model for other patients. Scientific American (tiered subscription model) (6/2019)
https://blogs.scientificamerican.com/observations/cancer-survivors-deserve-coordinated-care/
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Lawmakers introduce data privacy proposal
The Protecting Personal Health Data Act, proposed by Sens. Lisa Murkowski, R-Alaska, and Amy Klobuchar, D-Minn., aims to create data protection standards and regulation not currently covered by HIPAA, including those from technologies such as health apps. The proposal would require HHS to create a national task force to protect health data and develop security standards for apps, consumer devices, software and services, and establish regulations to help enhance health data security and privacy. Health IT Security (6/17)
https://healthitsecurity.com/news/proposed-bill-would-close-hipaa-gaps-curb-health-app-privacy-risks
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Life And Debt: Two Health Professionals. Two Hurricanes. Two Heart Surgeries.
A physician married to a psychologist got very sick. As expenses mount, these providers are experiencing the woes of American health care from the other side.
https://www.huffpost.com/entry/life-and-debt-doctors-hurricanes-surgeries_n_5cee9494e4b0975ccf5ea272
{Financial and social toxicity of a medical crisis. Most of us can relate.}
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Traumatic injuries linked to later social dysfunction
(Reuters Health) - Nearly half of trauma patients, even those without brain injuries, experience social deficits that make it harder for them to interact with friends and stay involved in the community, a recent study suggests.
{This article reports on trauma patients but I believe that there are some studies out about the traumatic effects of a cancer diagnosis and the burdensome consequences of dealing with the whole process. Some may find this topic interesting, relevant.}
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Metformin, 1p diabetes pill, is new weapon against breast cancer
'A diabetes drug that costs as little as 1p a tablet can curb the growth of breast cancer by up to 76%, experts have found.
Scientists discovered that metformin, taken by millions of diabetes patients, dramatically alters the make-up of breast cancer stem cells by forcing them to become addicted to glucose.
This creates a treatment "sweet spot", enabling cancer drugs to target and kill the stem cells.
The Southampton University team found that treating breast cancer with a low dose of metformin before attacking it with cancer drugs called CtBP inhibitors produced a reduction of up to 76% in the growth of the disease.In results published in the journal Carcinogenesis, researchers showed that an eight-week programme of low-dose metformin, commonly used to treat type 2 diabetes, altered the metabolism of breast cancer stem cells.
Normally, the cells rely on both oxygen and glucose for the energy they need to grow and survive. But breast cancer stem cells are incredibly resilient, and can alter how they produce their energy depending on their surroundings.
To survive the metformin treatment, the stem cells switched their metabolism to become more reliant on glucose, which creates a new treatment "sweet spot".
r Jeremy Blaydes, a reader in cancer cell biology at Southampton University and the lead author of the report, said: "Our work has given us the first glimpse into how changes in metabolism can alter the behaviour of breast cancer stem cells and reveal new targets for therapy. "We hope these could lead to new treatment options for breast cancer patients who most need it."
The laboratory findings will allow combinations of metformin and CtBP inhibitors to be trialed in patients.
Baroness Morgan of Drefelin, chief executive of Breast Cancer Now, which funded the research, said: "While it's often brand new drugs that make the headlines, the repurposing of drugs used in other health conditions to develop new cancer therapies, or improve existing ones, is a really exciting research avenue."
The method could help all breast cancer patients, but experts say it could be particularly useful in halting the spread of triple negative breast cancers. -
If anyone has an answer to this it would clear things up for me. Why do cancer cells switch to getting their energy from glucose when Metformin is taken? Is it because the insulin is lowered so there is a switch to glucose? Kind of confused about the mechanism...
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I'm not sure completely, but I did find this:
Cancer cells need a lot of energy to grow and spread as fast as they do. However, an obstacle in the way of cancer's metabolic needs is a molecule called NAD+. This molecule turns nutrients into energy.
Cancer cells' use of sugar holds the key to their destructionRestricting cancer cells' glucose supply and interfering with their ability to metabolize it could help destroy them.
"In order to keep the energy-generating machinery running, NAD+ must be continuously generated from NADH," Benjamin explains, adding,"[B]oth metformin and syrosingopine prevent the regeneration of NAD+, but in two different ways."
Many cancer cells rely on glycolysis in their metabolism, which means that they break sugar down into lactate. When there is too much lactate, however, glycolytic pathways are blocked.
So, to avoid this, cancer cells dispose of lactate via special transporters, and this is where the drug combination comes in.
"We have now discovered," Benjamin points out, "that syrosingopine efficiently blocks the two most important lactate transporters and thus, inhibits lactate export. High intracellular lactate concentrations, in turn, prevent NADH from being recycled into NAD+."
Metformin, meanwhile, blocks the second of the two cellular pathways that help NAD+ regenerate. So, when metformin is combined with syrosingopine, NADH can no longer be recycled into NAD+. This, in turn, creates an energy shortage.
The energy shortage ultimately leads to the death of cancer cells, which no longer have an energy supply. The combination of the two drugs, therefore, "may prove a viable anticancer strategy," conclude the researchers.
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And this:
In living cells, glucose plays a major role to energy metabolism, taken up by specific glucose transporters (GLUT). Once inside the cell, it is converted to pyruvate through the glycolytic pathway generating a small amount of energy in the form of adenosine triphosphate (ATP). Pyruvate is then transported into the mitochondria, enters the tricarboxylic acid cycle and is oxidized through in the mitochondria respiratory chain (oxidative phosphorylation system [OXPHOS]), generating ATP. This aerobic process is a major source of energy supporting life. Mitochondria are frequently dysfunctional in type 2 diabetes, but most of the ATP in patients with type 2 diabetes is generated through OXPHOS.
Cancer cells, meanwhile, tend to synthesize more ATP through glycolysis than normal cells do. This metabolic shift to aerobic glycolysis is a hallmark of cancer, and is applied to a common clinical test for it, positron emission tomography. Recent studies have suggested that this metabolic shift could be to facilitate the uptake and incorporation of more nutrients into cell building blocks, such as nucleotides, amino acids and lipids, which are required for highly proliferating cells. Mitochondrial dysfunction in cancer cells might be behind this phenomenon, which is well appreciated after Otto Warburg proposed it could be the primary cause3. All in all, the mechanisms underlying the dysregulated cellular metabolism of cancer cells remain poorly understood. Whatever the mechanisms are, blocking these metabolic alterations is now emerging as a new therapeutic approach of cancer, and as such, some of the metabolic enzymes involved in the glycolytic pathway are currently considered as therapeutic targets. Glucose deprivation is currently considered as one of such therapeutic options.
Very recently, Madiraju et al.7 reported that metformin inhibits mitochondrial glycerophosphate dehydrogenase (mitoGPD), and thus alters the mitochondrial and cytosolic redox state, and reduces reactive oxygen species production. It is not clear how metformin inhibits complex 1 and mitoGPD or if the two mechanisms are interrelated. We are fully aware that there are other possible mechanisms for the anticancer effect of metformin, including stimulation of adenosine monophosphate-activated protein kinase (AMPK) and its upstream regulator, liver kinase B1 (LKB1), although they could well be secondary to its inhibitory effect on the mitochondrial function and the reduction of free radicals through inhibition of mitoGPD, as suggested by Madiraju et al.7
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Thanks so much! Still not clear but interesting nonetheless!
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I have been n metformin 1000 mg (2 x 500) since diagnosis as I had seen other articles showing reduced recurrences among women on the drug. I asked my MO and he prescribed it.
It seemed low risk and high potential benefit.
There are anti pinworm and anti tapeworm drugs which seem to target stem cells as well...
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Pain patients left in anguish by doctors 'terrified' of opioid addiction, despite CDC change
Ken Alltucker and Jayne O'Donnell, USA TODAYPublished 3:54 p.m. ET June 24, 2019 | Updated 4:33 p.m. ET June 24, 2019
https://www.usatoday.com/story/news/health/2019/06... -
Cannabinoids: Preclinical hope for breast cancer therapy
This review concluded that cannabinoids have been shown to inhibit tumor cell growth, cancer spread and blood vessel formation in multiple trials involving animal models and cell cultures. Clinical trials investigating the potential benefits of cannabinoids on the outcomes of breast cancer patients are warranted.
Overall, cannabinoids have been shown to block cancer cell proliferation and reduce cancer cell migration in all breast cancer subtypes.
THC (tetrahydrocannabinol), the most commonly investigated cannabinoid, has been found to reduce both the rate of tumor growth and the overall number of developing tumors in HER2-positive breast cancer through the reduction of cell proliferation and by increasing cancer-cell death. Some studies have also shown cannabinoids to decrease the formation of blood vessels within the tumor, which inhibits cancer growth.
https://www.cancertreatmentreviews.com/article/S0305-7372%2812%2900139-9/abstract
DOI: https://doi.org/10.1016/j.ctrv.2012.06.005
{This article is old - 2012 - but the topic was kind of interesting. There is a charge to access the full journal at this website.}
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VD3 mitigates breast cancer aggressiveness by targeting V-H+-ATPase
Author links open overlay panelhttps://www.sciencedirect.com/science/article/pii/...
Lumpie, please let me know if I duplicate anything, that’s what happened to me yesterday
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Salinomycin is an antiparasitic drug.
Salinomycin inhibits breast cancer progression via targeting HIF-1α/VEGF mediated tumor angiogenesis in vitro and in vivo
Author links open overlay panelJayantDewanganaSonalSrivastavaaSakshiMishraaAmanDiva
https://www.sciencedirect.com/science/article/abs/... -
Trump's Plan To Lower Your Hospital Costs: Here's What You Need To Know
President Trump signed an executive order Monday (6/24/2019) that he says would make such comparisons easier, and make the pricing process more transparent.The order directs agencies to draw up rules requiring hospitals and insurers to make public more information on the prices they hammer out in contract negotiations. Also, hospitals and insurers would have to give estimates on out-of-pocket costs to patients before they go in for nonemergency medical care. But just how useful the effort will prove for consumers remains unclear. If the executive order leads to finalized HHS rules, proponents say it could encourage competition and lower prices. Other health care analysts say much depends on how the administration writes the rules over the next several months — rules that govern what information must be provided and in what format. Trump's executive order already is running into opposition from some hospitals and insurers who say disclosing negotiated rates could drive up costs.
Interesting Q&A follows the introduction.
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