Late diagnosis and lack of treatment access may contribute to poor UK lung cancer survival

Monday 11 February 2013

Cancer Research UK Press Release

The UK’s one-year lung cancer survival lags behind Australia, Canada, Denmark, Norway and Sweden according to a new international study* published today (Monday).

One-year survival from non-small cell lung cancer (NSCLC) – the most common form of the disease – ranged from 30 per cent in the UK to 46 per cent in Sweden. Survival was also relatively low in Denmark (34 per cent).

The research – carried out by the International Cancer Benchmarking Partnership (ICBP) – included more than 57,000 lung cancer patients diagnosed in 2004-07 and looked at the proportion of them who lived for longer than one year and at their stage at diagnosis.

The stage of a cancer indicates how big it is and how far it has spread.

UK survival figures were amongst the lowest at all stages compared to the other countries. This suggests lung cancer patients in the UK may not be getting the best available treatment, whatever the stage of their disease at diagnosis.

The proportion of patients diagnosed at an early stage of disease was slightly lower in the UK and Denmark than in the other four countries, suggesting that delayed diagnosis is playing a role.

In Denmark and the UK only one in seven patients with NSCLC were diagnosed at the earliest stage of disease (Stage 1**), compared with one in five in Sweden and Canada. One-year survival for patients with the earliest stage disease in the UK was 72.5 per cent, 16 per cent lower than in Sweden.

For small-cell lung cancer (SCLC), which is less common but more aggressive than NSCLC, the UK also had lower survival overall, and at each stage of diagnosis - except those patients where stage was unknown - than the other countries.

The comparisons used routinely collected population-based data. This allows a more accurate picture of lung cancer survival than is gathered from clinical trials. But international comparisons are complex because countries differ in how they collect information on stage at diagnosis, how fit the patients are and which diagnostic tests and treatments are available. All of these things could be contributing to the differences in lung cancer survival.

Dr Sarah Walters, lead author from the Cancer Research UK Cancer Survival Group at the London School of Hygiene and Tropical Medicine, said: “This is the first international population-based study of lung cancer survival by stage at diagnosis, and it includes nearly 60,000 patients. We’ve shown that wide international inequalities in lung cancer survival occur, even between patients who were diagnosed at the same stage of disease. This indicates that the quality of stage-specific treatment may differ even between these six wealthy countries with universal access to health care.

“It is clearly important to include stage at diagnosis in future international studies of cancer survival. Such comparisons would be easier if stage data were systematically recorded in the medical records, and coded in the cancer registries using international standard classifications.”

Sara Hiom, director of early diagnosis at Cancer Research UK, said: “This study and the ongoing work of the ICBP are hugely important. We’re learning more about the differences in cancer survival between countries and what might explain them. We need this information if we’re to help improve the outcome for cancer patients.

“This research should remind us that while great progress is being made in the diagnosis and treatment of cancer in the UK, we mustn’t be complacent. Around 35,000 people still die from lung cancer each year in the UK and that’s far too many.  We would like to see ongoing improvements in data collection and the use of uniform systems for data on stage, in order to improve the accuracy of global comparisons.”

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More evidence that beta blockers help stop cancers from spreading

Wednesday 30 January 2013

US researchers have taken a step forward in understanding how beta blockers may slow the spread of cancer.

The study is the latest in a series of findings that suggest the drugs, commonly used to treat conditions such as heart disease, high blood pressure, glaucoma and migraines, might also have a role to play in cancer treatment.

Previous studies have shown lower rates of death from various cancers among people who take beta blockers for long periods for other conditions, leading researchers to speculate that the drugs could help treat patients.

The new research, published in Nature Communications and led by Professor Anil Sood at the MD Anderson Cancer Center in Texas, focused on a molecule on the surface of cells, known as the beta-adrenergic receptor, or ADRB - the target of beta blocker drugs.

Working in a mouse model of ovarian cancer, the researchers showed that signals sent from ADRB into the cell’s interior activated a key cancer protein called Src.

This in turn switched on a variety of processes linked to the spread of the disease.

The effect was counteracted by giving the mice propanolol, a commonly used beta blocker, and this also appeared to slow the growth of the cancers.

“This is a major step forward in understanding [beta blockers’] biology and impact,” said Professor Sood. “It opens the door to study drugs that could inhibit this unique signalling pathway".

To add further weight to their findings, the researchers looked at medical records from a large database called the Adverse Event Reporting System. They found that patients’ chances of dying from cancer were reduced by 17 per cent if they were also taking beta blockers for other conditions.  

This echoed the findings of recent studies into lung cancer and ovarian cancer.

Dr Des Powe, a Nottingham-based researcher running a Cancer Research UK-funded study into beta blockers and breast cancer, agreed the evidence was becoming more and more compelling.

“Evidence has been building for several years that beta blockers could be used to help treat certain cancers – notably some forms of breast, bowel, lung, melanoma and ovarian cancer, and possibly prostate cancer.

“These cancers seem to have a more favourable prognosis in people who regularly take beta blockers, and trials are underway to find out more. On top of this, labs around the world have begun to work out exactly why and how this may be happening.”

But he cautioned that there was still a way to go before beta blockers – prescription drugs with known side effects – were proven safe and suitable for patients undergoing cancer treatment.

“This is an idea that needs to be fully tested in the clinic to be sure,” he warned.

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Cancer death rates over a third higher in men than women

Tuesday 29 January 2013

Cancer Research UK Press Release

Men are over 35 per cent more likely to die from cancer than women in the UK, according to a new report1 released today .

The report showed that 202 men per 100,000 died from cancer compared to 147 per 100,000 women in 2010.

And this difference is even starker when breast cancer and sex-specific cancers such as prostate, testicular and ovarian cancers are removed from the analysis – men were then 67 per cent more likely to die from the disease.

The analysis also showed that men are almost twice as likely as women to die from liver cancer and almost three times as likely to die from oesophageal cancer.

This contrast in cancer death rates between the sexes may be down to more men being diagnosed with types of cancers that are harder to treat such as cancers of the bladder, liver and oesophagus.

The report – presented at the Men’s Health Forum conference in London and produced by Cancer Research UK, the Men’s Health Forum and the National Cancer Intelligence Network – also highlighted that men of a working age, under 65, were 58 per cent more likely to die from cancers that affect both men and women.

Cancer is the leading cause of death in men in the UK with around 82,500 men losing their life to the disease every year.

Professor Alan White, chairman of the Men’s Health Forum and co-author of the report based at Leeds Metropolitan University, said: “The impact cancer has on younger men is often overlooked, but these are men whose life is cut too short by the disease. Our report highlights just how big a problem cancer is and highlights the need to understand the reasons why men are more likely to die of cancer. It’s crucial that the NHS leads the way in taking a more proactive approach to prevent men both getting and dying from cancer prematurely.

“The Men’s Health Forum is campaigning for a better explanation for these differences and more male-focused cancer prevention work so that fewer men are struck down by cancer.”

Research has previously shown that more than 40 per cent of cancers in men could be prevented by changes to lifestyle. A second report, also released today at the conference by Cancer Research UK, highlights the impact various lifestyle factors have on a man’s risk of developing cancer. It shows that smoking remains the largest preventable cause of cancer, responsible for 36,500 cancers in men every year.

After smoking, being overweight, drinking alcohol and poor diets are the most important causes of cancer in men.

Catherine Thomson, Cancer Research UK’s head of statistics and co-author of the reports, said: “Our work highlights the cancer toll for men across the UK. This needs action and Cancer Research UK is supporting a range of research into men’s cancers. We’re one of the UK’s largest funders of research into prostate and testicular cancers and this work is leading to new and better treatments.

“Men can help stack the odds of avoiding cancer in their favour by quitting smoking, cutting down on alcohol and eating plenty of fruit and vegetables.”

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Women smokers' death risk soars

Thursday 24 January 2013

Women who smoke are now far more likely to be killed by their habit than they were in the 1960s, a major US study has found.

The increased risk in these women - partly a result of changing smoking habits - outweighs improvements in medicine that have cut overall death rates the last 50 years.

In the 1960s, women in the US who smoked were almost three times more likely to die from lung cancer than women who had never smoked. This surged to almost 26 times the risk between 2000 and 2010. A similar pattern is seen for another smoking-related disease called chronic obstructive pulmonary disease (COPD).

The increased impact of smoking is in part down to the fact that women today generally start their habit earlier - so have been smoking for longer.

Changing smoking habits may also play a part, as people today tend to smoke cigarettes designed to promote deeper inhalation.

The study involved more than 2.2 million men and women aged 55 and older and included data from 1959 to 2010.

Daily cigarette smoking in men peaked in the 1970s, whereas it did not peak until the 1980s in women. This is why it is only now that women's risk from smoking is starting to match that of men.

The findings strongly confirm the claim that "if women smoke like men, they will die like men," say the researchers, led by Dr Michael Thun from the American Cancer Society.

Another study in the same journal - the New England Journal of Medicine - found that persistent lifetime smokers lost an average of around a decade of life compared with people who had never smoked.

But the study, led by Dr Prabhat Jha from the University of Toronto in Canada, also confirmed that quitting smoking at any age reduces death rates from all major diseases caused by smoking. And giving up the habit altogether was far more effective than reducing the number of cigarettes smoked.

Smokers who quit by the age of 40 avoided nearly all of the excess smoking-related risk of death from lung cancer and COPD.

Claire Knight, health information manager at Cancer Research UK, said: "These studies add to the huge body of evidence from over 50 years of research showing the dreadful toll smoking takes on your health. Smokers lose an average of 10 years of their life so, if you're a smoker, the best thing you can do for your health is to quit.

"It's never too late to stop smoking, but the sooner you do, the more of those years you could get back."

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National audit reveals improvements in lung cancer care

Wednesday 5 December 2012

Lung cancer care in the UK is continuing to make incremental improvements, according to a major NHS audit.

Patients are benefiting from improved standards of treatment - including more receiving surgery aimed at curing their disease, according to the latest instalment of the National Lung Cancer Audit.

Cancer Research UK said the improvements, which build on last years results, "are to be applauded" but need to be sustained.

The first audit was published in 2004 with the aim of allowing individual NHS trusts and Cancer Networks to compare their record on delivering treatment with that of others across the UK.  

By pooling their data, the institutions are able to learn from one another, improving their standard of clinical care and, ultimately, patient outcomes.

The latest audit is based on data for 38,500 patients first seen in hospitals in Great Britain in 2011, accounting for around 93 per cent of total new cases.

The review shows that three in five lung cancer patients now receive active treatment such as chemotherapy or radiotherapy, compared with less than half (45 per cent) in 2005.

Around 15 per cent of all patients diagnosed with lung cancer or mesothelioma now receive an operation to try to cure their condition, prolong their life or at least alleviate symptoms, compared with nine per cent in 2005.

While the overall surgical figures may seem low, most lung cancer patients go to hospital with very advanced cancer, meaning a curative operation is no longer an option.

In total, 96.2 per cent of lung cancer cases were discussed by a specialist team of health professionals - known as multidisciplinary teams - compared with 95 per cent in 2009, and only 86 per cent at the audit's inception.

NHS guidelines state that everyone diagnosed with lung cancer should be under the care of a multidisciplinary team, as they are key to accurate diagnoses and choosing the best treatment.

Dr Mick Peake, who led the audit, said: "The performance of hospitals has improved consistently year on year over the period of the audit and this is making a really positive impact on patient care and outcomes."

But he said the level of variation shown in the report means that there is still "significant room for improvement" to bring all hospitals up to the standard of the best.

Sarah Woolnough, executive director of policy and information at Cancer Research UK, welcomed the continued improvements in lung cancer care highlighted in the audit, which she said are to be applauded.

But she said lung cancer survival rates remain extremely low, with only nine per cent of adults in England surviving their lung cancer for five years or more, and variation in services persist in some parts of the country.

"Progress in treating lung cancer must be maintained, so we must all continue our efforts to improve services, alongside sustained research, prevention and early diagnosis to better tackle this horrible disease," she added.

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Lung cancer UK price tag eclipses the cost of any other cancer

Wednesday 7 November 2012

Cancer Research UK Press Release

THE COST of lung cancer to the UK economy is £2.4 billion* each year, far higher than the cost of any other cancer. This highlights the urgent need to continue to reduce the number of young people who become addicted to tobacco – as smoking causes more than eight in 10 lung cancers in the UK. The research is presented at the NCRI Cancer Conference in Liverpool today (Wednesday).

The same Oxford University study found that the total annual cost of all cancers to the UK economy is £15.8bn. Half (£7.6bn) of the total economic cost of cancer to the UK is due to premature deaths and time off work, followed by healthcare costs (35 per cent, £5.6bn) and unpaid care to cancer patients by friends and family (16 per cent, £2.6bn). Health care spending represents a cost of £90 per person in the UK population.

Each lung cancer patient costs the UK healthcare system £9,071 annually.** This compares with £2,756 for bowel cancer, £1,584 for prostate cancer and £1,076 for breast cancer survivors. The average healthcare*** spend on each cancer patient in the UK is £2,776.

Research author, Dr Jose Leal, at the Health Economics Research Centre, University of Oxford, said: “Lung cancer costs more than any other cancer – mainly because of potential wage losses due to premature deaths from people in employment - about 60 per cent of the total economic costs – and high health care costs. The death rate from the disease remains high at 56 deaths per 100,000 people in the UK population annually, and almost a quarter of these occur before retirement.

“Our research shows that cancers impact the economy as a whole - and not just the health service. Premature deaths, time off work and unpaid care by friends and family account for 64 per cent of all cancer costs (£10.2bn) in the UK in 2009. These wider costs should be taken into account when deciding research priorities. Cancers with the highest economic cost could offer the highest expected returns from investment in research.”

Each year in the UK in the UK 41,500 people are diagnosed with lung cancer and almost 35,000 people die from the disease. Around 157,000 children aged 11-15 start smoking in the UK each year, enough to fill over 5,000 classrooms.

Dr Jane Cope, director of the NCRI, said: "These figures remind us that cancer has a cost, not just in professional healthcare but also in loss of earnings for patients, and for loved ones who give up work to look after them. Since 86 per cent of lung cancer deaths are linked to smoking, we can reduce these financial and societal costs by helping people to stop smoking."

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Three-in-one 'supermolecule' could detect cancer early, help destroy tumours and monitor treatment

Tuesday 6 November 2012

Cancer Research UK Press Release

The same protein could potentially be targeted to detect precancerous breast cells; deliver radiotherapy to destroy tumours; and monitor the effectiveness of treatment, according to a Cancer Research UK study presented at the NCRI Cancer Conference in Liverpool today (Tuesday).
 
Oxford University scientists at the Cancer Research UK/MRC Gray Institute for Radiation Oncology and Biology showed in the laboratory that a technique monitoring high levels of a protein called Gamma H2AX, found in many pre-cancerous cell types including breast, lung and skin cancer, could be used to detect cancer early.

The team took microscopic images of fluorescent ‘flag’ molecules attached to an antibody which ‘homes in’ on and attaches to Gamma H2AX, to identify areas of DNA damage*. The fluorescent ‘snap shots’ of Gamma H2AX revealed the location of pre-cancerous breast cancer cells at a very early stage.

Professor Katherine Vallis, who led the study at the Cancer Research UK/MRC Gray Institute for Radiation Oncology and Biology at Oxford University, said: “This early research reveals that tracking this important molecule could allow us to detect DNA damage throughout the body. If larger studies confirm this, the protein could provide a new route to detect cancer at its very earliest stage – when it is easier to treat successfully.”

Previously the team modified an antibody to target Gamma H2AX and deliver radiotherapy to breast cancer cells which contained high levels of the protein. This form of radiotherapy works by boosting DNA damage until cells can no longer repair mistakes – and die.

The results confirmed that the radioactive antibody killed breast cancer cells and slowed tumour growth.

Prof Vallis added: “We need to confirm these findings in larger studies before we know if this approach could benefit patients. But these initial results show that it may be possible to track down cells with high levels of DNA damage, and destroy them before they became cancerous.

“One day we may be able to scan the body to map out the radioactive antibodies that have attached to the Gamma H2AX molecule. This could also allow doctors to paint a useful picture of how effective a treatment is.”

Dr Julie Sharp, Cancer Research UK’s senior science information manager, said: “This important study reveals that targeting this  key molecule could provide an exciting route for new ways to detect cancer at an earlier stage – and help to deliver radiotherapy and monitor its effect on tumours.

“Thousands of cancer patients in the UK, and millions worldwide, benefit from radiotherapy every year. Cancer Research UK has invested heavily in research such as this to explore new ways to improve this vital treatment.”

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Skin rash predicts survival benefit from latest lung cancer drug

Tuesday 16 October 2012

Cancer Research UK Press Release

ELDERLY patients with advanced non small cell lung cancer (NSCLC)  who developed a rash within 28 days of receiving the targeted drug erlotinib (Tarceva) survived on average 6.2 months, compared to 4.1 months for patients who were given a placebo, results from a major phase III Cancer Research UK-funded trial show today (Tuesday). 

And for patients who, in addition to developing the painless rash, also carried mutations in the epidermal growth factor receptors (EGFR) on the surface of their cancer cells, the survival time was even greater at 10.4 months.

Around eight in 10 cases of this form of lung cancer occur in people aged 60 and over, and the average age of patients in the UK is 72 years. Many of these elderly patients are diagnosed at a late stage and already have other illnesses, meaning they are often too frail to be treated with conventional chemotherapy. This means that palliative care is usually the only option available to them.

These trial results show that giving erlotinib to these patients can significantly improve survival, if they develop a rash due to the drug. The findings are published in the journal Lancet Oncology today.

Chief investigator Professor Siow Ming Lee, clinical researcher for Cancer Research UK at the UCL Cancer Institute and consultant at the UCL Hospital Trust, said: “The vast majority of NSCLC patients are elderly and diagnosed at a late stage, often leaving them too frail to cope with the rigours of chemotherapy. Until now, the only option for these patients has been palliative care. But these trial results offer potential hope, with six in every 10 patients who received erlotinib developing a rash that signalled whether or not they were benefitting from this drug treatment. This is extremely encouraging and represents a significant step forward for this group of patients, who often only have a short time left to live.

“Interestingly, we found that women who developed a rash after taking erlotinib tended to survive longer than men. And smokers were less likely to develop a rash than non-smokers or former-smokers, when treated with erlotinib. Further studies to understand the link between skin rash and erlotinib response are urgently needed to find ways of exploiting this relationship for maximum benefit.”

Six-hundred and seventy patients took part in the study from 78 hospitals around the UK, conducted by Cancer Research UK and the UCL Cancer Trials Centre. They were randomly assigned to receive tablets containing either erlotinib or a placebo. All patients had advanced stage NSCLC, the majority were aged over 75 and almost all had two or more other medical conditions and were not suitable for chemotherapy treatment.

Liz Woolf, head of Cancer Research UK’s patient information website, CancerHelp UK, said: “Lung cancer kills more people in the UK than any other type of cancer - around 96 people every day - with smoking being the biggest preventable cause of this disease. And with the majority of cases diagnosed in older patients with advanced disease, we urgently need treatments that are suitable for these often very ill patients. But equally, we need ways of determining which patients are not likely to benefit, so that they can be spared the side effects that unavoidably accompany such powerful drugs.

“We hope these important trial results will in future mean that more people can benefit from the valuable extra months of life that erlotinib can bring some patients, who would otherwise have very few treatment options.

“Cancer Research UK is in a unique position to help develop new potential treatments like this, while also trying to reduce the tobacco toll by discouraging our children from taking up smoking in the first place. Our campaign for the introduction of plain packaging for cigarettes is essential if we are to beat cancer by targeting it at its source.”

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Trio of studies outline 'genomic landscape' of non-small cell lung cancer

Friday 14 September 2012

Researchers have painted the most detailed picture yet of the faulty genes involved in non-small cell lung cancer (NSCLC), one of the world's most hard-to-treat cancers.

The work, published as three papers in the journals Cell and Nature, could ultimately lead to lung cancer patients being given treatments tailored to their tumour's genetic features, the researchers say.

As well as finding genetic faults never previously linked to NSCLC, the scientists found that tumours from smokers had different genetic faults, and much more DNA damage, than tumours from non-smokers.

A researcher involved in two of the studies, Dr Ramaswamy Govindan of Washington University School of Medicine, said further research to fully understand the "genomic landscape" of lung cancer will help identify new targets for therapy.

The studies looked at different forms of NSCLC, the most common type of lung cancer.

NSCLC is an umbrella term for different sub-types of NSCLC called squamous cell carcinoma, adenocarcinoma and large cell carcinoma. These respond to treatment in a different way to the other main type of lung cancer, small cell lung cancer.

Two of the studies, published in Nature and Cell respectively, analysed the genetic code of tumours from 178 patients with lung squamous cell carcinomas, and 183 with lung adenocarcinomas.

In a third, smaller, study, also published in Cell, scientists analysed 17 NCSLC tumours from smokers and from patients who had never smoked. The researchers, led by Dr Govindan and Dr Richard Wilson of Washington University School of Medicine, found that smokers had 10 times as many genetic changes in their tumours than tumours from non-smokers.

In non-smokers, the researchers found at least one mutated gene that can be targeted with drugs currently on the market or available through clinical trials. Across all patients, the team identified 54 genes that could be targeted by existing drugs.

Dr Wilson and Dr Govindan were also involved in the squamous cell carcinoma study, the findings of which mirrored that of their smaller study. They found a wide array of genetic changes in different squamous cell carcinoma tumours, many of which could be targeted with existing drugs.

Dr Wilson predicts that the standard approach to treating cancer will be based on the genes that are found to be altered, rather than the organ in which it originates. For example, instead of calling it 'lung cancer', doctors may call it 'EGFR cancer's, after the faulty gene driving the tumour's growth.

"For example, if genome sequencing revealed that a lung cancer patient has a mutation known to be sensitive to a drug that works in breast tumours with the same genetic alteration, you may want to use that agent in those lung cancer patients, ideally as part of a clinical trial," he says.

"In the coming years, we hope to be treating cancer based more on the altered genetic make-up of the tumour than by the tissue of origin," he added.

The adenocarcinoma study also discovered differences between the alterations in the genes found in tumours from smokers and non-smokers, as well as finding altered genes that had not previously been linked to cancer before.

"This is the largest genomic study of lung adenocarcinoma to date," says study author Alice Berger of the Broad Institute. "Our results are a testament to the power of large-scale next-generation sequencing technology to expand our understanding of tumour biology."

Professor Charles Swanton, a Cancer Research UK expert, said: "Together these studies provide the most detailed picture yet of the landscape of genes involved in non-small cell lung cancer, a disease that can be very tough to treat successfully."

Professor Swanton pointed out that the fact lung cancers from smokers have 10 times the genetic damage of non-smokers, shows the harmful effects of smoking and reinforces that smoking is by far the biggest single preventable cause of cancer.

"The studies also confirm recent work by Cancer Research UK and others which have shown that cancers aren't made up of just one type of identical cell but in fact consist of different sub-clones within one tumour," he said.

"This helps explain how tumours may become resistant to drugs and why we need to find ways to target the 'mission critical' gene faults that are shared by the majority of tumour cells.

"It's also encouraging that the researchers have discovered gene faults that have never before been linked to lung cancer - this gives us new avenues for research into future treatments," he added.

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Discovery could lead to targeted treatment for small-cell lung cancer

Friday 7 September 2012

US researchers have discovered two molecules inside cells that may be important in the development of ‘small cell’ lung cancer (SCLC).

The lab-based research could be a first step towards new targeted treatments for this hard-to-treat disease, according to the scientists.

Small-cell lung cancers account for about eighteen out of every 100 cases of lung cancer.

The study, published in the journal Cancer Discovery, looked at differences between small cell cancer cells and non-small cell lung cancer (NSCLC) cells.

The results showed the molecules PARP1 and EZH2 – both types of protein – were present at significantly higher levels in SCLC cells.

Although people with SCLC initially respond to chemotherapy, the disease can often come back, according to study researcher Dr Lauren Byers, from the University of Texas.

The only currently approved treatments for SCLC are older chemotherapies, whereas newer-generation targeted drugs have been developed for NSCLC.

“Because most targeted therapies directly act on proteins, identifying if certain proteins are over-expressed in SCLC could have therapeutic applications,” Byers said.

Professor Siow-Ming Lee, Cancer Research UK's lung cancer expert based at the University College London Cancer Institute and Hospitals, said the work was at an early stage but was noteworthy, as there has been little change in treatment of SCLC over the past 20 years.

“This lab work suggests that clinical studies using treatments to block the proteins PARP and EZH2, together with chemotherapy, warrant further investigation. Scientists have already developed drugs that block PARP, which have shown some promise in treating breast and ovarian cancers – it will be interesting to see if these benefits extend to SCLC too," he added.

To identify the molecular differences, Byers and her colleagues examined the levels of about 200 proteins that are known to be involved in driving cancer growth.

“We discovered that SCLC and NSCLC have dramatically different protein profiles in terms of which proteins are ‘turned on’ and are driving the behaviour of these cancers,” Byers said.

“In small cell lung cancer, proteins that were present at higher levels included several DNA repair proteins such as PARP1 and a protein involved in cancer stem cell renewal, EZH2.”

According to Byers, the results show that, as with many targeted drugs, it is possible that combining PARP inhibitors with other drugs may significantly improve treatment.

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Lung cancer discovery confirms drug target's potential

Thursday 12 July 2012

A protein called Rac1 plays a key role in the development and spread of lung cancer, according to a research group in the US.

The finding adds to growing evidence that drugs targeting Rac1 could one day prove effective treatments.

Rac1 is a protein involved in controlling when and how cells move around the body. Faults that cause it to become hyperactive, or present in high quantities, have previously been linked to several types of cancer, including melanoma and lung cancer.

The researchers showed in mice that when the protein is overactive it can trigger a normal process called epithelial-mesenchymal transition, (EMT) that renews organs and other tissues, by switching cells from one state to another.

Cancer cells can hijack this process and use it to spread from the initial tumour to other sites around the body.

Researchers believe that turning off EMT could help stop cancers from spreading.

The researchers also showed that a protein called matrix metalloprotease 3 (MMP3) could switch on Rac1, and that this process could be accelerated by chemicals found in cigarette smoke.

Commenting on the research, Professor Owen Sansom, deputy director of Cancer Research UK's Beatson Institute, and an expert on Rac1, said the work added further weight to the protein's importance in cancer.

"This is an important new piece in a complex jigsaw puzzle," he said.

"It adds to the growing evidence that the Rac1 protein is hyperactive in several types of cancer - notably lung cancer and melanoma. And it backs up the idea that targeting Rac1 with drugs would be an effective way to treat these diseases.

"Excitingly, there are several experimental drugs currently being developed that can target this protein.

"Given the urgent need for new treatments for skin and lung cancer, we sincerely hope that these can be brought to human trials quickly and successfully."

Lead researcher Dr Radisky, from the Mayo Clinic in Florida, said: "Our study points to EMT as a key step in lung cancer progression during the earliest stages of cancer development.

"Normal cells recognise when they are dividing too rapidly and turn on programmes that block inappropriate cell division. Here we found that early-stage lung cancer cells switch on EMT in order to bypass these controls."

The research is published in Science Translational Medicine.

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Asbestos and shift work boost work-related cancer deaths to over 8,000 a year

Wednesday 20 June 2012

Cancer Research UK Press Release

Around 8,000 cancer deaths in Britain each year are linked to occupations - especially those where asbestos, diesel engine fumes or shift work is involved - a new study shows today. This equates to around 5 per cent of all cancer deaths in Britain.

The study1, funded by the Health and Safety Executive and published in the British Journal of Cancer, also found that just under half of these deaths were among male construction workers who are most likely to come into contact with asbestos as well as other important carcinogens such as silica and diesel engine exhaust.2

Researchers used a list of work-related cancer causing substances identified by the International Agency for Research on Cancer (IARC) to calculate the impact of work on cancer cases and deaths. And they found that around 13,600 new cancer cases are caused by risk factors related to work each year.

After asbestos, the main work-related risk factors were night shift-work – linked to around 1,960 female breast cancer cases, mineral oil from metal and printing industries – linked to around 1730 cases of bladder, lung and non-melanoma skin cancers, sun exposure – linked to around 1540 skin cancer cases, silica exposure – linked to 910 cancer cases and diesel engine exhaust – linked to 800 cases.3

And researchers warned that these estimates of cancer cases and deaths linked to occupation are likely to be conservative and could be even higher as new work-related risk factors are identified or the understanding of potential risk factors becomes more definite.4

In addition there are now more cases of cancer than there were back in 2004.

Lead author Dr Lesley Rushton, an occupational epidemiologist based at Imperial College London, said: “This study gives us a clear insight into how the jobs people do affect their risk of cancer.

“We hope these findings will help develop ways of reducing health risks caused by exposure to carcinogens in the workplace.

“The cancer with the greatest number of cases and deaths linked to work is lung – a disease which is hard to detect early and has poor survival. Over 30 occupational exposures have been identified by IARC as definite or probable lung cancer causing substances.

“One of the best ways we can beat the disease is by preventing it in the first place. Smoking has the single biggest impact on lung cancer risk, but work-place risks are also having a significant effect.”

Asbestos remains the most important occupational risk factor. Even though it is no longer used in construction, maintenance on old buildings can still be a risk for workers today. And the number of asbestos-related cancers will continue to rise as they can take a long time to develop.

Researchers said that some of the risk factors had an effect on cancer beyond the workplace – for example, asbestos can be found in some households and diesel engine exhaust contributes to air pollution.

Sara Hiom, director of information at Cancer Research UK, said: “It’s very worrying to see so many people developing and dying from occupation-related cancers. A large proportion of the deaths are a result of exposure to asbestos in past decades and improved safety measures should mean that in the next generation or so we will see this number tail off dramatically.

“The Health and Safety Executive has commissioned a review of the evidence on shift work and cancer – at the moment it’s still only classified as a probable cause of cancer. Once the review is complete in 2015, we will have a more definite understanding of the role it may play in influencing cancer risk.

“At this point, we expect the government and employers to take fast and appropriate action to minimise the risks faced by workers and Cancer Research UK will be watching this closely.

“Not smoking is the single most important thing that can reduce the likelihood of developing cancer - to put this in perspective, there are around 43,000 cancer deaths due to smoking in the UK each year. Maintaining a healthy weight, cutting back on alcohol and taking plenty of exercise can also have a big impact on reducing the risk of cancer.”

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Cancer Research UK initiative attracts innovative targeted cancer trials to the UK

Thursday 31 May 2012

Cancer Research UK Press Release

A Cancer Research UK initiative to improve cancer gene testing has prompted two pharmaceutical companies to plan pioneering international trials into targeted cancer treatments in the UK.

Cancer Research UK’s Stratified Medicine Programme launched last year in a bid to test tumour samples from 9,000 UK patients across six different tumour types to help further research into new targeted therapies.

Each tumour sample is being tested for a range of gene faults linked to cancer, and the information entered into a database that will allow researchers to compare the results of treatment to specific faults within cancer cells.

As a result of the programme, Roche and Bristol-Myers Squibb are working with Cancer Research UK to run trials in the UK that rely on this testing. The Roche trial will look at whether patients with a range of cancers could benefit from the targeted skin cancer drug vemurafenib. The Bristol-Myers Squibb trial is seeking health authority and ethics approval.

Doctors will be able to use the Stratified Medicine testing to see if any of their patients have the specific faults in their tumour, which would make them suitable to join these trials.

Michelle Rashford, medical director, Roche UK said: “The stratified medicines programme run by Cancer Research UK is an exciting initiative, as the opportunity to test tumour samples for a range of biomarkers is an important step in the continued development of personalised medicines.  Our VE-Basket study of vemurafenib in patients with V600 mutation positive cancers across different disease areas will allow us to identify patients that may benefit from treatment, and get closer to the goal of truly targeted medicines that provide better patient outcomes, reduce unnecessary side effects and ultimately deliver life-saving and life-prolonging treatments.”  

Oracle has also signed an agreement with Cancer Research UK to provide Oracle Health Sciences Translational Research Center software that will allow such information to be integrated and analysed much more efficiently, helping drive forward research into targeted cancer treatments.

Neil de Crescenzo, senior vice president and general manager at Oracle Health Sciences, said: “As we move toward the next generation of care, the ability to integrate and meaningfully analyse data will be a critical component in the ability to deliver more targeted, personalised therapies.

“We are delighted to work with Cancer Research UK to provide the analytical foundation needed to unlock real value from their data to support new insights at the molecular level, as they seek to expand on the genetic testing of tumours to enable more advanced, targeted and effective treatments for cancer patients.”

Cancer Research UK’s programme is a partnership with AstraZeneca, Pfizer, the Technology Strategy Board (TSB), and a range of other universities, hospitals and companies in six collaborations funded by the TSB: a total investment of £18 million. More than 2600 patients have so far enrolled, putting the programme on target to finish recruiting at the end of next summer.

David Willetts, Minister for Universities and Science, said: “This is an excellent example of collaboration between the research base and industry. It shows how Cancer Research UK is driving forward the delivery of significant benefits for patients. Two further pharmaceutical companies have got onboard and decided to carry out clinical trials - this is evidence of the attractiveness of the UK as a location for science and innovation."

James Peach, director of Cancer Research UK’s stratified medicine programme, said: “We’re delighted that our programme has helped bring these two highly innovative cancer trials to the UK, where we hope they will be of benefit to patients.

“Being able to quickly and efficiently identify patients on the basis of the faults within their tumour is a key step in developing targeted cancer treatments. This will be particularly important in relation to rare cancer types, where the target gene faults may only be present in a relatively small number of patients making it more difficult to do research.

“Patients are the heart of this work, so I’d like to thank the thousands of them who have volunteered, as well as the donors who enable this vital work to take place, and the dedicated teams in the 21 hospitals and three genetics labs across the UK that make it happen every day.”

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Cancer Research UK to investigate new drug combination in lung cancer

Thursday 17 May 2012

Cancer Research UK Press Release

Cancer Research UK’s Drug Development Office has opened the first trial of a new drug combination in patients with advanced solid tumours and in a subset of patients who have non-small cell lung cancer. This trial will combine two compounds that aim to starve the tumours while simultaneously blocking cancer cell growth.

The study will take place across three UK hospitals. The Churchill Hospital, Oxford is the lead centre. The trial of up to 48 patients will run in two stages. In the first stage patients with any solid tumour will each receive a drug called vandetanib and an investigational drug called selumetinib (AZD6244, ARRY142886). In the second stage patients with non-small cell lung cancer (NSCLC) will receive the combination.

This is the first time the compounds have been trialled together. It is hoped that combining these treatments will increase the number of cancer ‘weakspots’ targeted at the same time.

Lung cancer is the second most common cancer in the UK. Survival rates for all types of lung cancer are still low. Fewer than 10 per cent of lung cancer patients will live for at least five years after diagnosis.

Non-small cell lung cancer accounts for around 85 per cent of all lung cancer cases. Around 30,000 people are diagnosed with this form of the disease each year in the UK.

Chief investigator, Dr Denis Talbot, consultant medical oncologist at Oxford University Hospitals NHS Trust and Cancer Research UK clinician at The University of Oxford, said: “Therapies for lung cancer often become ineffective because the disease becomes resistant to treatment, so we’re delighted to launch this trial to test a new approach that we hope will help people with this common disease.

“There is progress being made in the treatment of lung cancer but survival rates still remain low. This is because the majority of patients – up to two thirds – are diagnosed once the cancer has already spread to other organs when it’s more difficult to treat successfully.
“We hope that this new approach may eventually contribute to increased survival for lung cancer patients.”

The trial is funded, managed and sponsored by the charity’s Drug Development Office with the drugs provided by AstraZeneca. This trial will establish an appropriate dose and schedule of these drugs in combination and investigate how effective it is at treating patients.

Dr Nigel Blackburn, director of drug development at Cancer Research UK’s Drug Development Office, said: “There’s an urgent need to develop new drugs which may provide additional options for these patients. This important trial may bring new opportunities for future lung cancer patients by combining two treatments to tackle the disease simultaneously, providing a two-pronged treatment approach for this hard to treat disease.

“The launch of this first trial is exciting news and we’ll be watching the results with great interest.”

For more information on the trial, please visit www.cancerhelp.org.uk or call the Cancer Research UK cancer information nurses on 0808 800 4040.

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NICE recommends new targeted lung cancer treatment

Thursday 10 May 2012

A new treatment for a type of non-small-cell lung cancer (NSCLC) has been made available on the NHS.

The National Institute for Health and Clinical Excellence (NICE), the UK's healthcare guidance body, today recommended erlotinib (Tarceva) as an option for those with NSCLC whose cancer is caused by mutations in a gene called EFGR, and which has spread to the lymph nodes or further round the body.

Director of the Centre for Health Technology Evaluation at NICE, Professor Carole Longson, said of the draft: "NICE has already recommended a drug called gefitinib for the first-line treatment of EGFR mutation-positive NSCLC, which is now the treatment that most patients receive."

She added that at the moment, there is no available trial data to compare gefitinib and erlotinib directly, but clinical specialists told the committee that the medication is similar, and has the same effect.

"We are pleased to be able to recommend another treatment option for this stage of the disease," she added.

James Peach, director of Cancer Research UK's Stratified Medicines Programme, welcomed the news, but warned that the NHS needed to focus on making sure gene tests were available for the drug.

"This is great news for patients who have the form of lung cancer that this drug targets. Erlotinib is one of several new drugs developed to treat tumours that carry a fault in the EGFR gene, which our researchers first linked to cancer in 1984.

"While it isn't a cure, erlotinib can allow patients to spend precious extra time with their families. But to use this new generation of drugs effectively, we need a properly organised way of delivering gene tests in the NHS, so that these treatments can be given to all suitable patients - and we're working with the NHS to make this happen through our Stratified Medicines Programme."

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People fail to list persistent cough as a lung cancer warning

Monday 30 April 2012

Cancer Research UK Press Release

An astounding lack of public awareness about lung cancer has been revealed in a Cancer Research UK study, published today.

When almost 1500 people were asked to list possible warning signs of the disease that is the most common cause of cancer death - only 77 people (five per cent) mentioned a cough that doesn’t go away. Just two people mentioned a painful cough and only three listed a change in an existing cough as a possible symptom of lung cancer.

Less than 10 per cent of those asked mentioned a persistent chest infection, tiredness or unexplained weight loss. And under 15 per cent mentioned persistent chest pain.

Almost 80 per cent failed to mention coughing up blood and 63 per cent did not list shortness of breath.

Sara Hiom, Cancer Research UK’s director of information and an author of the study published in the journal Thorax, said:  “It’s very worrying to see from our survey results that when asked to think of lung cancer symptoms many common ones simply don’t come to mind for most people. A diagnosis of lung cancer is devastating, but if the disease is caught in its earliest stages treatment can improve survival.  

“We can help improve diagnosis by raising awareness of the signs people should look out for and when to get them checked by a doctor.”

When asked to list risk factors for lung cancer, under 13 per cent mentioned exposure to cigarette smoke (passive smoking). Although almost 85 per cent listed “being a smoker” as a risk factor - this suggests that 15 per cent of the British population don’t link smoking with lung cancer.

According to the study, people from poorer backgrounds had lower levels of symptom and risk factor awareness. Smokers, who are most at risk of lung cancer, showed no greater awareness of symptoms than non-smokers.

Jean King, Cancer Research UK’s director of tobacco control, said: “Given the shockingly low levels of awareness among smokers and non-smokers alike it is even more vital that we do all we can to stop a new generation growing up addicted to tobacco.

“That is why we are urging the government to put tobacco in plain packaging to stop the glossy lure of cigarette packets from seducing youngsters into smoking. Research shows how the tobacco industry relies on the power of the pack to attract brand conscious teenagers to buy their product. It’s their only legal form of marketing, and removing this silent salesman will give millions of children one less reason to start smoking.”

Eight out of 10 smokers in Britain start by the age of 19 and the habit will kill half of those who continue to smoke long-term. In 2010 tobacco caused 86 per cent of lung cancer cases. Smoking causes nearly a fifth of all cancer cases in the UK and more than a quarter of all cancer deaths.

Tobacco has killed an estimated 6.5 million Britons over the last 50 years. But today one in five British adults still smokes.

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Existing drugs could treat smokers' lung cancer

Thursday 26 April 2012

Cancer Research UK Press Release

A common cancer drug and a drug used for a rare condition affecting the heart could together treat an aggressive form of lung cancer called non-small cell lung cancer (NSCLC), according to a study published in Cell today.

Faults in a gene called Ras are caused by smoking and are found in nearly half of all NSCLC patients, especially those with aggressive cancers.

Ras has been considered ‘undruggable’ because of its unique, intricate structure.

Scientists at Cancer Research UK's London Research Institute have now screened lung cancer cells for unique weaknesses associated with the faulty Ras gene, and have shown that these cells are dependent on another gene, GATA2.

By studying GATA2’s function, they revealed that it acts through two pathways – and drugs are already in use that can disrupt these pathways.

The Cancer Research UK scientists showed that by blocking the cell’s proteasome – the part of a cell responsible for breaking down proteins – and a protein called Rho kinase, they can stop the activity of GATA2. This in turn stops the growth of tumours with faulty Ras genes.

Bortezomib (Velcade), a drug for malignant myeloma, targets the proteasome. And a drug called Fasudil, which is used to treat a vascular condition affecting the heart called pulmonary hypertension, blocks the activity of Rho kinase.

The researchers used this combination of drugs to treat mice with NSCLC caused by faulty Ras genes - the type of lung cancer caused by smoking. They compared the organs before and after treatment and found the drugs had reduced the proportion of the lungs covered by tumours by around 99 per cent.

Dr Julian Downward, lead author from Cancer Research UK’s London Research Institute, said: “The results we saw in our initial studies were extremely promising. It's very unusual to see such a striking effect - an organ affected by cancer almost completely cleared of the disease.

"It's too early to say whether this combination of drugs will be effective in patients with lung cancer but plans are underway already to test this theory in a clinical trial.

"If the trial is successful, it will be an extremely exciting step forward in the treatment of lung cancer, and potentially other types of cancer too.

"Ras is one of the most important genes in cancer, and when it goes wrong it can cause extremely aggressive cancers. Nearly a quarter of all cases of cancer are driven by faulty Ras. And in some types of cancer – notably pancreatic cancer – it’s more like nine out of 10 cases.

"So far we've just studied mice with lung cancer caused by faulty Ras. But by targeting the biology behind Ras, this combination of drugs holds the potential to treat a wider range of cancers."

Professor Michael Seckl, Cancer Research UK’s lung cancer clinician based at Imperial College London, said: "Lung cancer kills more people in the UK than any other type of cancer, accounting for around 35,000 deaths each year.

“There are so few effective lung cancer treatments available at the moment, so it’s really encouraging to hear that existing drugs may provide the answer.”

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: "This study is exciting because it suggests that drugs already in use could treat not only this deadly cancer, but other hard-to-treat cancers like pancreatic cancer.

"Cancer Research UK has boosted its research on these cancers in the past few years, so it's really encouraging to see our scientists making important advances in understanding the biology of cancer. We can immediately build on these results and hope they will lead to a huge step forward in treating the disease.”

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Molecule linked to lung cancer growth and spread

Tuesday 24 April 2012

A molecule called matrix metalloproteinase-10 (MMP-10) could fuel the growth and spread of a common form of lung cancer, according to US lab work.

MMP-10 is required for the growth of 'stem cells' in non-small cell lung cancer, say scientists at the Mayo Clinic in Florida.

Cancer stem cells are thought to be behind the growth of many cancers, and are often resistant to radiotherapy and chemotherapy.

Shutting down MMP-10 stopped signs of stem cell activity and blocked tumour growth in mice.

MMP-10 also helped tumours to spread, or metastasise.

The findings, published in the journal PLoS ONE, suggest that MMP-10 may also be crucial to the survival of other types of cancer.

Dr Alan Fields, from the Mayo Clinic's department of cancer biology, said that MMP-10 plays a "dual role" in cancer - stimulating both the growth of cancer stem cells and their ability to spread.

He added: "This helps explain an observation that has been seen in cancer stem cells from many tumour types, namely that cancer stem cells appear to be not only the cells that initiate tumours, but also the cells that give rise to metastases."

Dr Fields said the discovery that lung cancer stem cells express MMP-10 and use it for their own growth was unexpected, because most known metalloproteinase genes are expressed in the cells and tissue surrounding a tumour - the tumour's so-called microenvironment.

The findings also show that cancer stem cells produce much more MMP-10 than other tumour cells.

Dr Fields said: "MMP-10 acts to keep these cancer stem cells healthy and self-renewing, which also helps explain why these cells escape conventional chemotherapy that might destroy the rest of the tumour.

These findings indicate that high levels of MMP-10 may also play a crucial role in the survival of other cancer stem cells.

A similar link appeared between MMP-10 and the metastatic behaviour and stem-cell like properties of bowel cancer, melanoma, breast, renal, and prostate cancers.

Dr Gillian Murphy from Cancer Research UK's Cambridge Research Institute said it was "unusual and interesting" that MMP-10 might have a role in maintaining tumour stem cells in lung cancer, rather than just the cells surrounding the cancer.

She added: "The MMP enzymes are involved in many processes in the body, and lots of work has already shown they have many roles in cancer. But this is the first indication that they don't just control processes in the tissues surrounding a tumour, but actually might control cancer cell behaviour. It will be exciting to learn exactly what MMP-10 is doing, as this work only shows the enzyme could be involved in regulating cancer cells, not how it's involved.

"MMP-10 also has a major role in wound healing, and perhaps there's a link between how it helps the body repair injury and how it's involved in cancer."

She said that a "big hurdle" to moving this work from the lab into patients will be the challenge of designing a drug that blocks MMP-10. The molecule has a lot of close 'cousins' structurally and "it has been very hard to design specific chemical inhibitors so far".

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Lung cancer cases keep going up in women

Friday 13 April 2012

Cancer Research UK Press Release

Lung cancer cases continue to rise in women with more than 18,000 UK women diagnosed with the disease in 2009 according to the latest Cancer Research UK figures released today (Friday).

Rates of the disease have risen to 39.3 for every 100,000 UK women from 22.2 for every 100,000 in 1975 when there were fewer than 8,000 cases.

Lung cancer is still more common in men with more than 23,000 cases in 2009 but rates in men have been falling fast. Male lung cancer incidence is now 58.8 per 100,000 UK men compared with 110 in 1975.

Cases of lung cancer mirror smoking rates around two to three decades earlier as more than 80 per cent of cases are caused by tobacco. And the differences in lung cancer cases for men and women reflect the smoking patterns in previous decades for each sex.

Smoking rates for women in Great Britain were highest throughout the "Mad Men" era of the 1960s, with around 45 per cent of women smoking. This has since fallen to 20 per cent.

More than 65 per cent of men smoked during World War II and throughout the rest of the 1940s with lung cancer rates in men peaking around 30 years later in 1979 at nearly 115 men out of every 100,000. Now, 22 per cent of men are smokers.

The new figures also reveal that the total number of UK lung cancer deaths stands at almost 35,000. 19,410 men and 15,449 women died from the disease in 2010.

Until the late 1990s, lung cancer was the most common cancer in the UK. In 1997 it was overtaken by breast cancer, but still accounts for 14 per cent of all new cancer cases in men, and 11 per cent in women.

Several publications have been important in highlighting the dangers of smoking, helping reduce the number of smokers and ultimately lung cancer incidence.

The British Doctors’ Study – partly funded by Cancer Research UK – ran from 1951 to 2001 and was the first to show that smoking increases the risk of lung cancer. It went on to clearly show the benefits of quitting. The 1962 Royal College of Physicians’ report, Smoking and Health, helped change the perception of smoking and raised awareness of smoking-related diseases. This report also set out key recommendation on how to reduce smoking rates – such as removing tobacco advertising from TV.

Successful anti-smoking measures - such as the tobacco advertising ban and the legislation making public places smokefree - have also meant the number of smokers has continued to drop. Large shops and supermarkets have recently removed tobacco from sight, with smaller retailers doing the same in 2015.

The next step is to reduce one of the remaining means of tobacco marketing to children. The government is due to consult on removing all branding from tobacco packaging. This would mean the glitzy, brightly-coloured packs would become a uniform colour, size and shape. Further measures at EU level could introduce large picture warnings on the front and back of the pack.

Jean King, Cancer Research UK’s director of tobacco control, said: “These latest figures highlight the deadly impact of tobacco. The continuing rise of lung cancer in women reflects the high number of female smokers several decades ago when attitudes were different. Tobacco advertising hasn’t appeared on UK television since 1965, but that didn’t stop the marketing of cigarettes. New, more sophisticated marketing techniques have lured many hundreds of thousands into starting an addiction that will kill half of all long term smokers.

“It’s vital that the UK closes one of the last remaining loopholes that portrays smoking as something glamorous and normal, rather than the lethal product it truly is. Ending the packet racket and putting all cigarettes in plain packs with large health warnings is crucial. No one wants to see children take up smoking, and while plain packs won’t stop everyone from smoking, it will give millions of children one less reason to start.”

Sara Hiom, Cancer Research UK’s information director, said: “Lung cancer continues to claim far too many lives. More than four in five cases of the disease are caused directly by smoking. But this means nearly one in five cases is not. It's really important that anyone with a cough that lasts for three weeks or a worsening or a change in a long-standing cough get this checked out.

“Also, it’s never too late to give up smoking – you will reduce your risk of developing lung cancer and other serious diseases. Your GP or local pharmacy can advise you where to find your local NHS support services.”

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Age affects risk of being diagnosed with cancer at advanced stage

Friday 2 March 2012

Cancer Research UK Press Release

Older women with breast cancer face a higher risk of being diagnosed with the disease at a late stage, while the risk of an advanced stage diagnosis of lung cancer decreases with age, a new study shows today.

Researchers from the University of Cambridge and the Eastern Cancer Registration and Information Centre (ECRIC) said the study showed that efforts to diagnose cancer early need to be better tailored to different age groups.

The study, published in the British Journal of Cancer*, used ECRIC data on stage – a measure of how advanced the cancer is when diagnosed.

The research aimed to find whether there was a link between age or socio-economic background and being diagnosed with advanced stage cancer.

Researchers looked at around 17,800 women with breast cancer and over 13,200 patients with lung cancer in the east of England who were diagnosed between 2006 and 2009.

They found that compared to women aged 65-69, women aged 70-74 had a 21 per cent increased chance of a late stage breast cancer diagnosis.

The chance of an advanced breast cancer diagnosis became higher as women got older – even accounting for the effect of screening. For example, it was 46 per cent higher in women aged 75-79.**

In contrast, it was less likely that older patients would be diagnosed with advanced stage lung cancer than younger patients.

Compared with people aged 65-69, people aged 70-74 were 18 per cent less likely of be diagnosed with late stage lung cancer and this chance decreased further with age - for people aged 75-79 it was 26 per cent lower.

For breast cancer, the study also found that late stage diagnosis was more common in women from deprived backgrounds. For lung cancer, late stage diagnosis was more common in men.

Dr Georgios Lyratzopoulos, study author based at the University of Cambridge, said: “Patient awareness of the signs of breast cancer is known to be lower among older women and this may explain why breast cancer is diagnosed later among this age group.

“But it is puzzling why older patients have a lower risk of advanced stage lung cancer. More research is needed to better understand this pattern.”

The researchers added that the strong likelihood of older women being diagnosed with late stage breast cancer was worrying given that the risk of the disease increases with age.***

Dr David Greenberg, study author based at ECRIC, said: “Collecting staging data has proved difficult in the past but this data is vital to understanding how to improve the diagnosis of cancer. ECRIC has the most complete information on stage. A modernisation programme for cancer registries aims to improve the collection of such information nationwide by end of 2012.”

Sara Hiom, director of information at Cancer Research UK, said: “If cancer is caught early, patients usually have a better chance of beating the disease as more effective treatment options are available.
“We have made great progress in improving cancer survival rates in the last 40 years, but there is still more work to be done to help more people survive cancer.  
“Collecting information on stage at diagnosis is vital to do this and we must think how to target messages appropriately to the right audiences.
“Cancer Research UK works to raise symptom awareness, and encourage and enable people to go visit their doctor as soon as their notice anything unusual for their bodies.”
 

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EU cancer death rate expected to fall again

Wednesday 29 February 2012

Researchers predict that the proportion of the European Union (EU) population that dies from cancer will continue to drop in 2012.

The falling rates of cancer death are due to a decline in men smoking, and to progress in cancer prevention, early detection and treatment, according to the authors of the report, published in the journal Annals of Oncology.

The new figures were described as "encouraging" by Cancer Research UK, but also highlight a trend of rising lung cancer death rates in women.

Overall, cancer death rates for 2012 will be 139 per 100,000 for men and 85 per 100,000 for women. This is a 10 per cent fall for men and a seven per cent fall for women, compared with rates from five years ago

But the total number of people dying of cancer is set to increase, as the EU population ages.

The report forecasts that around 1.28 million people will die from cancer this year - 717,398 men and 565,703 women. In 2007 this figure was around 1.26 million.

All cancers were included in the overall tally. The researchers also looked individually at cancers of the stomach, intestine, pancreas, lung, prostate, breast, and uterus (including cervix), and leukaemias.

The report predicted substantial reductions in breast cancer death rates, not just in middle-aged and older women, but also in younger women.

Overall breast cancer death rates are tipped to fall by nine per cent to 14.9 per 100,000 women, while deaths among women aged 20 to 49 will fall by 13 per cent to 6.3 per 100,000 women.

Study leader Professor Carlo La Vecchia, from the University of Milan, said: "The fact that there will be substantial falls in deaths from breast cancer, not only in middle age, but also in the young, indicates that important advancements in treatment and management are playing a major role in the decline in death rates."

A total of 88,000 women in the EU are expected to die of breast cancer in 2012, making it the leading cause of death overall in women.

But they predict lung cancer will be the biggest cause of death among women in the UK and Poland, with rates of 21.4 and 16.9 per 100,000 women respectively.

And lung cancer will continue to be the biggest cause of death among men in the EU with a rate of 37.2 per 100,000. But this is a 10 per cent fall on the 41.3 figure from 2007.

Catherine Thomson, head of statistical information at Cancer Research UK, said the study is in line with previous research "which shows that generally death rates from cancer in the UK are predicted to fall".

She added: "This is true for breast and bowel cancers and lung cancer in men - reassuring news that highlights the impact of men stopping smoking, the introduction of new therapies and diagnostics, and how the NHS has improved treatment delivery.

But she said that climbing lung cancer death rates in women were worrying.

"Smoking prevention is the key to reducing lung cancer rates as over eight out of 10 lung cancer cases are caused by smoking. Most smokers start under the age of 18, so efforts to dissuade both boys and girls from starting to smoke in the first place must be continued," she continued.

"One important step is to remove the displays of cigarettes in shops - which is being rolled out in large stores and supermarkets in April. Tobacco companies have used the cigarette pack to appeal to new smokers over recent years. Cancer Research UK is also urging the government to remove all branding from tobacco packets and sell this deadly product in plain, standardised packets with large health warnings front and back."

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5,200 classrooms of UK kids start smoking every year

Wednesday 22 February 2012

Cancer Research UK Press Release

Every year around 157,000 children aged 11-15 start smoking – that’s enough to fill 5,200 classrooms or make up nearly 14,000 junior football teams.

These shocking figures, revealed in a new analysis by Cancer Research UK, highlight the ongoing scale of the tobacco problem, and underline the importance of sustained action to discourage young people from starting to smoke, including by introducing plain packaging for all tobacco products as soon as possible.

And almost one million children – those aged 15 and under – in  the UK have tried smoking at least once – around 27 per cent of children.

Preventing young people from being tempted to try smoking is vital as eight out of ten adult smokers start before they turn 19.

Children who smoke just one cigarette by the age of 11 are around twice as likely to take up smoking over the next few years than those who do not experiment with smoking.

We already know that for children aged 12 in 2009 1 per cent smoked regularly, 2 per cent smoked occasionally and 2 per cent said they used to smoke.

A year later in 2010 it has been calculated that among the same age group of children, now aged 13, 3 per cent smoked regularly, 2 per cent smoked occasionally and 4 per cent said they used to smoke.

Starting to smoke at a young age carries additional risks of lung damage.

Half of all long term smokers will die from tobacco related illness. Around 100,000 people are killed by smoking in the UK each year.

That is why Cancer Research UK is petitioning the government to bring in plain packaging of tobacco so children are less likely to be seduced by the sophisticated marketing techniques designed to make smoking attractive to youngsters.

Jim Richardson, 56, from Prudhoe in Northumberland started smoking when he was about 15 and was diagnosed with advanced and inoperable lung cancer in 2010. Father of four Jim is now desperate to help prevent more young people from starting smoking.

“I started smoking because it was considered cool,” he said. “ Back then, my friends thought it odd if people didn’t smoke. I smoked about 20 a day but I quit cigarettes when I was 21 after the birth of my first son Jimmy.  But I didn’t stop smoking. Instead I switched to cigars because I was lured in by the persuasive advertising campaign ‘Happiness is a Cigar Called Hamlet.’ I honestly thought they were mild and not harmful.

“In 2010 I woke up one morning full of aches and pains which I assumed was the start of flu. I’d always been very fit so I decided to nip it in the bud by going to the doctor. My GP was concerned by some blood tests so I had an X-Ray which revealed a shadow on the lung and this turned out to be lung cancer.

"The toughest day of my life was sitting each of my children down and telling them I had lung cancer. I have three grandchildren too and I was devastated that I might not see them growing up. My prognosis was pretty poor but I began treatment immediately.

"To my absolute joy and gratitude the treatment seems to be working. Looking at the CT scans I know that the chemotherapy followed by radiotherapy reduced my cancer to a tiny fraction of its size and I feel as if I’ve been given a second chance.

"I know first-hand how horrific lung cancer is and how it’s almost always preventable by not smoking in the first place. My wife Di and I run children’s day nurseries and out-of-school clubs in Hexham and Prudhoe caring for young children. I would hate to think that any of the hundreds of children we have looked after might ever go through what I have because they were tempted by one glitzy packet attempting to make smoking look cool. I’ve worked out that I’ve spent £90,000 on a habit that was slowly killing me. There’s absolutely nothing cool about that.”

All forms of tobacco have health risks associated with them including cigars.

Jean King, Cancer Research UK’s director of tobacco control, said: “Far too many young people start smoking every year. We must act to bring this number down.

“The tobacco industry spends a great deal of money on designing cigarettes and their packets so they seem glamorous, appealing, fashionable and attractive in an effort to recruit more customers. With advertising outlawed, the cigarette packet is now the most important marketing tool the tobacco industry has.

“Our research has shown that selling all cigarettes in standardised packs will help reduce the appeal of smoking and give children one less reason to start smoking.”

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Gene test could identify early stage lung cancer patients who may benefit from extra chemo

Friday 27 January 2012

Researchers in the US have developed a gene test that could predict which patients with non-small cell lung cancer (NSCLC) still have a low chance of surviving despite having their disease diagnosed early (stage 1).

The findings, published in the Lancet, will allow new trials to find out whether these patients could benefit from additional (‘adjuvant’) chemotherapy after surgery, as although chemotherapy after surgery is an extra option for patients with later stages of the disease, it has not been shown to improve survival in early stage patients, and can cause considerable side effects, especially for older patients.

Treatment for lung cancer - the second most common cancer in the UK after breast cancer - varies depending on how advanced the disease is when it is diagnosed.

About 12 per cent of people diagnosed with NSCLC are diagnosed with stage I cancer, which is defined as a cancer smaller than five cm that has not spread to any other part of the body.

For patients with stage I NSCLC, the routine treatment is surgery only, and this cures around two-thirds of patients.

While additional chemotherapy is an extra option for patients with later stages of the disease, it has not been shown to improve survival in early stage patients, and can cause considerable side effects, especially for older patients.

This study by Dr Michael J Mann and Professor David M Jablons, of the University of California, San Francisco (UCSF) Thoracic Surgery Division, measured the activity of 14 genes in tumour tissue taken from 361 patients diagnosed with stage I NCSLC.

The pattern of gene activity levels was then analysed, and compared to the patients' outcomes. From this, the researchers were able to find genetic 'fingerprints' for people at high, medium and low risk of the cancer coming back.

To confirm these findings, the researchers then repeated the test on a further 433 stage I NCSLC patients from hospitals around California, and on 1,006 patients from hospitals around China, who were diagnosed with stage I, II or III disease.

The authors found that the test was the "strongest predictor" of patients' fates compared with standard criteria such as age and smoking status. It also outperformed guidelines used to identify high-risk patients with early stage disease.

Professor Siow Ming Lee, Cancer Research UK's lung cancer expert, said the findings were "encouraging".

"If this finding is confirmed in larger studies, a test to detect this profile could be used to carry out new clinical trials to find out whether adjuvant chemotherapy would help treat such poor prognosis early stage patients.

But he cautioned that the test needed to be shown to work in much larger groups of patients, and that questiones remained over some aspects of the study.

"It isn't clear whether the patients in the validation arms of the study had the stage of their tumour accurately measured by the current standard of care - PET-CT scanning and/or endobronchial ultrasound," he added.

"It's also possible that this gene profile is an indication of more aggressive disease, and that these patients would be unlikely to benefit from chemotherapy. To find out, it would be useful to look at people with later stage disease who have this profile, and who received chemotherapy after surgery, and see whether it actually affects survival.

"Chemotherapy can be too harsh for many elderly lung cancer patients, who often have other problems besides cancer. It's too early to recommend adjuvant chemotherapy for stage I patients until this gene signature is shown to lead to improved treatment in randomised trials," he said.

In an accompanying comment article in the same issue of the Lancet, Dr Yang Xie and Professor John Minna, from the Southwestern Medical Center in Texas, also called for more research. "Further studies will tell whether the genes in this new assay are of functional relevance and whether they also will provide information on how a lung cancer patient will respond to adjuvant therapy," they wrote.

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New genetic fault linked to lung cancer in non-smokers

Thursday 22 December 2011

Korean scientists have discovered a gene fault that may be behind thousands of cases of lung cancer worldwide, particularly in non-smokers.

The research, published in the journal Genome Research, could underpin the development of future tailored treatments for these patients.

Although smoking is responsible for most lung cancers, nearly one quarter of all lung cancer patients have never smoked.

Using gene sequencing technology, the team from Seoul National University in South Korea found a previously unknown gene fault caused by two separate genes being joined together - a so-called 'gene fusion' - in a case of lung adenocarcinoma on a 33-year-old man who had never smoked and had no history of cancer in his family.

The group sequenced and compared the genome of the patient's cancer and normal tissue, but found no faults in genes that were already known to be associated with lung cancer, such as EGFR, KRAS, and EML4-ALK mutations.

The researchers also analysed the RNA molecules inside the patient's cancer cells. RNA acts as a messenger carrying instructions from DNA to control the production of proteins. Analysing RNA can reveal gene rearrangement events that are difficult to detect by DNA sequencing and which may be causing the cancer.

From the RNA sequencing analysis, the researchers built a list of possible mutations and narrowed it down to a single gene fusion that could be a cancer-causing event.

The scientists found that two previously separate genes called KIF5B and RET had fused to form a hybrid gene in the lung tumour cells.

When the team looked at 20 other people with lung cancer, they found that two of them also had the gene fusion in their tumour, indicating that the fusion event is relatively common.

The report's authors predict that the KIF5B-RET fusion occurs in about six per cent of all lung adenocarcinoma cases.

"We showed that genome sequencing technology could reveal a previously hidden cause of human cancer, which can be used as a therapeutic target for personal cancer therapy," said the report's senior author Dr Jeong-Sun Seo.

They concluded the fault is likely to be a promising target for treatment, but that further epidemiological studies are needed to more accurately define how often the KIF5B-RET gene fusion occurs in lung cancers.

Professor Siow-Ming Lee, a Cancer Research UK lung cancer specialist at the University College London Cancer Institute and Hospitals, said the work was at an early stage, but could represent the first step towards developing a new targeted treatment for some lung cancers.

He also said: "Tobacco is responsible for the vast majority of lung cancers, but non-smokers can also develop the disease, and the cause of many such cases remains unknown.

"If it is confirmed that around 6 per cent of lung adenocarcinomas have this gene fusion, then thousands of people around the world may benefit from any future treatment developed to target this abnormal gene.

"We've already started to personalise treatment for lung cancer patients - for example, drugs like gefitinib, erlotinib and crizotinib work best in patients with specific tumour gene faults. This work is yet another step towards an era of more precise and targeted cancer treatment."

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First patients enrolled in project to improve NHS cancer gene testing

Monday 21 November 2011

Cancer Research UK Press Release

Cancer Research UK has started recruiting patients for a pioneering initiative to demonstrate how genetic tests could be used within the NHS to help match cancer patients to the most appropriate treatment, while building a database of information for research into new targeted therapies.

The charity’s multi-million pound Stratified Medicine Programme ultimately aims to establish a world-class NHS genetic testing service for cancer patients in the UK. This means that, as and when new targeted treatments become available, doctors will have access to the tests they need to help them decide which drugs are best for their patients.

Medical staff in seven of Cancer Research UK’s existing Experimental Cancer Medicine Centres (ECMCs) will be asking up to 9,000 patients to participate in the first phase of the Programme, which covers six different tumour types: breast, bowel, lung, prostate, ovarian and melanoma skin cancer.

The ECMCs are: The Institute of Cancer Research (ICR) in London, Leeds, Edinburgh, Cambridge, Cardiff, Glasgow and Manchester, collectively covering more than 20 hospitals across the UK.

Patients will be asked to give consent for a small sample of their tumour to be sent to one of three leading NHS genetic testing labs – based at The Institute for Cancer Research in London, Cardiff All Wales Regional Molecular Genetics Laboratory and the West Midlands Regional Genetics Laboratory in Birmingham – where DNA will be extracted and analysed for a range of molecular faults linked to cancer.

This information will be stored alongside other relevant clinical information to allow researchers to compare the success of different treatments in relation to specific faults within cancer cells.

So although the Programme will not alter patients’ treatment at this stage, it’s hoped it could help scientists design better targeted treatments in the future.

Wendy Payne, 55, who is being treated at Addenbrooke's Hospital in Cambridge, is one of 240 patients who are so far taking part in the programme. She was diagnosed with ovarian cancer in March 2011 after a CT scan.

Mrs Payne said: “I was very keen to take part in the Stratified Medicine Programme because I think much more can and should be done to help patients get the right drugs in future.

“Finding out I had cancer was terrifying but it’s incredible to think that the tumour which could have killed me can now be used to develop more targeted drugs in future. Even though I won’t benefit from that research, it’s comforting to think that my experience with cancer will be helping others who are diagnosed in future.”

Cancer Research UK, AstraZeneca and Pfizer are funding the £5.5 million programme. The charity’s share is being funded through its Catalyst Club - a pioneering venture to raise £10 million to propel forward the use of personalised cancer treatment, including Cancer Research UK’s Stratified Medicine Programme.

The initiative is closely aligned with the government’s Technology Strategy Board (TSB)’s £6 million investment in the development of tests for analysing a tumour’s genetic profile and secure software that can link this information to relevant clinical information.

James Peach, director of Cancer Research UK’s Stratified Medicine Programme, said: “In the ten years since the Human Genome Project was completed we’ve made huge progress in unraveling the genetic basis of cancer and understanding what drives it at a molecular level. We know that prescribing certain drugs according to the genetic basis of the tumour can improve the chances of successful treatment. And by hardwiring research into the day-to-day care of cancer patients, we can harness the power of the NHS to bring personalised medicine a step closer to reality.

“This programme marks the beginning of the journey, and there is much to be done before we can bring the benefits of personalised medicine to every cancer patient. But I’m confident that within the next few years we’ll see personalised medicine changing the face of cancer treatment and saving many more lives from cancer.”

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More lung cancer patients would survive for longer if surgery rates increased

Monday 14 November 2011

Cancer Research UK Press Release

Many more lung cancer patients would survive for longer if they had surgery to remove the disease, according to research published in the European Journal of Cancer.

Researchers from the National Cancer Intelligence Network (NCIN) and King’s College London examined information on 77,349 lung cancer patients diagnosed between 2004 and 2006 in England and looked at how many had surgery to treat the disease.

They found that in those areas of England where more lung cancer surgery took place more people survived the disease.

There was also great variation across the country among the percentage of patients who had surgery.

During the three years of the study, the researchers estimate that over 5,400 lives could have been extended if every area in England was operating on the same proportion of patients as the area with the highest surgical rates.

The latest lung audit data shows 14 per cent of lung cancer patients in England have surgery to treat lung cancer. But this means England generally has lower surgery rates for lung cancer compared to other European countries and the United States which have surgery rates of around 20-30 per cent.

Around 40,000 people are diagnosed with lung cancer each year, but fewer than 10 per cent survive the disease for five years.

Dr Mick Peake, study co-author and clinical lead for the National Cancer Intelligence Network (NCIN), said: “Our results give an indication that there’s a problem with the number of lung cancer patients who are having surgery. The estimate of the numbers of lives prolonged is based on a snapshot in time. But do highlight the potential to extend the lives of many lung cancer patients in the future if we are able to increase rates of lung cancer surgery across all areas to that of the highest. Surgery really is the key to improving survival for lung cancer, a disease which has one of the lowest survival rates for cancer – despite being the second most common cancer.

“For the majority of lung cancer patients, surgery is the only way to give them a chance of being cured, but England still lags behind the rest of the world when it comes to operating on these patients.

“There are many things that influence a surgeon’s decision to operate on a patient such as other illnesses, age, general health and patients’ own choice. But where possible all cancer patients who are generally fit enough, should be able to have surgery. We need specialist thoracic surgeons for patients whose fitness is borderline or who may need more complex surgical procedures.

“And we would certainly encourage all cancer patients and their families to speak to their consultant to find out if surgery is an option.”

Mr Richard Page, consultant thoracic surgeon at Liverpool Heart and Chest Hospital and member of the NCIN’s lung clinical reference group, said: "For the first time a definite link has been demonstrated between pushing the boundaries for lung cancer surgery and an improvement in long-term survival. The obvious message to commissioners of health care is that in order to cure more patients suffering from this devastating disease there is a clear need to invest in services which lead to an increase in access to thoracic surgery. This is an important paper for all those professionals looking after lung cancer patients, and especially for thoracic surgeons."

Professor David Taggart, President of the Society of Cardiothoracic Surgery (SCTS), said: “This excellent study vindicates the decision by the SCTS, Specialty Advisory Committee and Royal College of Surgeons to promote specialist training in lung surgery around a decade ago. We are now seeing the results with consultants coming through and as more surgeons are trained - providing NHS Trusts create the posts - the access to surgery will go up.

“Decisions in treatment for cancer are now made by teams of clinicians with different specialties and skills (multi-disciplinary teams or MDTs) which has changed the feeling in the past that the risks of surgery were too great for patients. This study shows that increasing the proportion of patients who receive surgical treatment has the potential to save 35 lives from lung cancer-related death for every one extra person who may die from surgery. Given we are talking about the most common life-threatening cancer, it is clear that the balance must be in favour of many more people having the chance of survival. The surgeons are increasingly there to undertake these procedures so we now need the positive decisions by MDTs to operate.”

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'Epigenetic' therapy shows promise for hard-to-treat lung cancer

Thursday 10 November 2011

A new 'epigenetic' therapy appears to be able to prolong the life of patients with late-stage non-small cell lung cancer (NSCLC), according to the results of a small clinical trial published in the journal Cancer Discovery.

Forty-five patients with late-stage NSCLC who received a combination two-drug therapy survived around two months longer than would normally be expected.

Rather than killing dividing cells, like conventional chemotherapy, epigenetic therapies are devised to switch certain genes back on.

In healthy cells, some genes act to prevent cancer by stopping cells form dividing when they shouldn't. But tumour cells devise ways to silence these genes by binding and gagging them so that the cell is no longer able to use them - so-called 'epigenetic silencing'. So researchers have been developing epigenetic drugs that can reverse this, removing these molecular shackles to reinstate the anti-cancer activity of these genes.

The researchers from the Johns Hopkins Kimmel Cancer Center tested a combination epigenetic therapy of azacitidine and entinostat on patients with recurrent metastatic NSCLC. All the patients had already been treated with standard therapies, but their disease has subsequently progressed.

The trial had an 'open label' design, in which all patients received the treatment and there was no control group receiving placebo.

Patients survived on average for 6.4 months with treatment, compared with a typical survival rate of around four months for this patient population.

Following the epigenetic therapy, four of the 19 patients also had unexpectedly strong responses to further treatment with standard chemotherapies.

According to study author Dr Stephen Baylin, "This raises the possibility that the epigenetic treatment is having a delayed effect, or is even sensitizing patients' tumours in a way that makes them more vulnerable to subsequent therapies."

"This study appears to show the first durable successes in solid tumours with epigenetic therapy."

The preliminary findings were described as encouraging by Professor Tony Kouzarides, deputy director of the Wellcome Trust/Cancer Research UK Gurdon Institute at the University of Cambridge.

He said: "This is an encouraging step forward, even though it is an early-stage trial in a small number of people. More work is needed before such a treatment could be made more widely available, but this is a very good news for epigenetic therapy, which is still in its infancy.

"The research shows the potential for epigenetic drugs in the treatment of solid tumours, and provides a rationale for testing more such treatments in combination therapy. It's an exciting area of research, and one which my own group is actively working on for the treatment of leukaemia."

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Chest X-rays for lung cancer 'do not save lives'

Thursday 27 October 2011

People who have annual chest radiography screening do not have a significantly lower rate of death from lung cancer compared with people who aren't screened, a US study has suggested.

Dr Martin Oken, of the University of Minnesota, and colleagues examined data from the large Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Published in the journal JAMA, the study looked at people who were either given annual chest x-rays - known as chest radiography - or standard medical care without screening.

In the randomised controlled trial of 154,901 participants aged 55-74, around half (77,445) were offered an annual chest radiograph over a four-year period, while the remaining 77,456 received standard care.

There were 1,696 lung cancers detected in the annual chest radiograph group and 1,620 lung cancers in the control group during the entire 13-year study period.

1,213 lung cancer deaths were observed in the former group over the 13-year follow-up period, compared with 1,230 in the latter.

In conclusion, the authors wrote: "These findings provide good evidence that there is not a substantial lung cancer mortality benefit from lung cancer screening with four annual chest radiographs."

In an accompanying editorial, Professor Harold C Sox of Dartmouth Medical School wrote that the study "provides convincing evidence that lung cancer screening with chest radiography is not effective".

Professor Sox described the PLCO trial as "another important step, confirming expectations rather than setting new ones".

Hazel Nunn, head of evidence and health information at Cancer Research UK, agreed: "This study is important because it strongly suggests chest x-rays are not effective at screening healthy people for the early signs of lung cancer.

"Earlier this year, a different study called the National Lung Screening Trial showed that early detection of lung cancer with a screening method called spiral CT can reduce the risk of dying from the disease. But it compared spiral CT against chest x-rays, not against people who hadn't been screened.

"The next step is to see if spiral CT lowers deaths from lung cancer when compared to no screening. There are considerable risks associated with the investigations that follow a positive screening result, so it will also be vital to continue research to help better understand these harms."

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Tobacco control policies 'bring healthcare savings'

Thursday 29 September 2011

Tobacco control policies implemented by national governments not only improve the health of a nation, but are also good for the economy, according to a new report in the Lancet medical journal.

The report's authors, based at the University of California, San Francisco, also exploded the myth that the advantages of cutting tobacco use take decades to be felt, arguing instead that important benefits of reducing smoking accrue quickly.

The authors of the report say after quitting smoking for just one year, the risk of heart attack is reduced by half. Someone who has not had a cigarette in five years can see their risk of heart attack almost return to that of someone who has never smoked, they added.

The economic benefits of reduced smoking figures also far outweigh the loss of revenue generated from the tobacco industry, the research found.

It showed that California's tobacco control scheme cost US$1.4 billion (£895 million) during its first 15 years, saving US$86 billion (£55 billion) in direct healthcare costs in the process - this is a 61 times return on investment.

Meanwhile, the amount of income lost as a result of people giving up or not smoking was a mere US$3.1 billion (£1.9 billion), which pales into insignificance when compared with the healthcare savings.

And the authors added: "In middle-income countries, tobacco use lowers the household standard of living and human capital levels because money to purchase tobacco comes at the expense of other crucial necessities."

Jean King, Cancer Research UK's director of tobacco control, said: "Here is yet more evidence of the effectiveness and cost-effectiveness of tobacco control policies. As smoking rates fall, so do rates of diseases like heart attacks and cancers, with major savings to health services.

"We know that plain packaging will help to bring down smoking rates in the medium term and so we urge the government to introduce it together with other key measures like tax hikes and maintaining high-quality stop smoking services."

"And we urge governments around the world to implement the global treaty on tobacco control as quickly as possible, both to save lives and to save money on health care."

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Women 'underestimate the risks of lung cancer'

Monday 22 August 2011

The majority of women are unaware of the risks of lung cancer, according to a new survey by the Roy Castle Lung Cancer Foundation (RCLCF).

Around four in five women surveyed did not realise that lung cancer kills more women than any other cancer in the UK.

Many respondents mistakenly believed that breast and cervical cancer caused more deaths, despite lung cancer claiming more lives each year than both these diseases combined.

Some 15,000 women in the UK die from lung cancer every year, while breast and cervical cancer together claim a total of 13,000 lives.

Common symptoms of lung cancer include a constant cough, fatigue and weight loss.

Despite most women being able to identify the warning signs, almost a fifth of those surveyed said they would not visit their doctor if they spotted these symptoms.

And one in 10 smokers - who are most at risk from the disease - said they would not visit their doctor if they developed signs of lung cancer.

But many said they would be more likely to book an appointment if they knew they could be tested for a quick diagnosis, and that effective treatment is available.

Dr Marianne Nicolson, a consultant medical oncologist at Aberdeen NHS Grampian, said: "Early diagnosis saves lives and the earlier lung cancer is diagnosed, the better the chance of cure. This is especially relevant for women, who typically respond better to active treatment than men.

"It is important that women appreciate the risk of lung cancer, reduce their risk by stopping smoking where that is an issue and, through recognition of the danger signs, seek medical advice immediately if they believe they have the relevant symptoms."

More than 2,000 women took part in the survey, which marks the launch of the RCLCF's Women Against Lung Cancer campaign.

The findings revealed that many women do not appreciate the poor prognosis faced by lung cancer sufferers.

Just 9 per cent of women with lung cancer will be alive five years after diagnosis - but more than four in five women believed the five-year survival rate was between 20-40 per cent.

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: "Spotting the early signs of cancer can make all the difference to the chance of surviving the disease so it's very worrying that so few women would go to their doctor if they noticed potential lung cancer symptoms.

"Every year over 40,000 men and women are diagnosed with the disease so it's vital that if people have a cough that's lasted longer than a couple of weeks, a change to an existing cough, unusual breathlessness, weight loss, chest or shoulder pain or if they are coughing up blood they should get checked out by their doctor immediately.

"If anyone has concerns they can speak to a Cancer Research UK nurse on 0808 800 4040 or visit www.cancerhelp.org.uk."

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Chemotherapy strategy for elderly lung cancer patients questioned

Tuesday 9 August 2011

French scientists have suggested that elderly patients with non-small-cell lung cancer (NSCLC) may benefit from a two-drug chemotherapy combination usually reserved for younger patients.

But Cancer Research UK cautioned that the result should be confirmed in larger studies before this type of treatment can be widely adopted for older patients.

In research published in The Lancet, a team from the Hopitaux Universitaires de Strasbourg and Universite de Strasbourg concluded that patients over 70, who were treated with a two-drug platinum-based chemotherapy survived longer compared with those given a single drug therapy.

The team saw more side effects in the group of 225 elderly NSCLC patients treated with both carboplatin and paclitaxel than in the control group of 226 similarly aged participants given either vinorelbine or gemcitabine.

But despite this, those given the combination chemotherapy survived around four months longer on average than patients given just one drug (10.3 months versus 6.2 months). Forty-five per cent of patients given two drugs survived for one year, compared with 25 per cent of those given a single drug.

Patients aged over 70 with advanced NSCLC are usually given single-drug therapy, whereas younger patients - who are considered fitter - tend to be given two drugs. The authors point to concerns from clinicians, the patients and their families about side effects and the relevance of the treatment as reasons for this difference.

The team, led by Professor Elisabeth Quoix from the Department of Chest Diseases, writes: "Clinical trials with no upper limit of age suggested that fit elderly patients might gain similar benefits to their younger counterparts from platinum-based doublet chemotherapy.

"We believe that treatment current paradigm for elderly patients with advanced non-small-cell lung cancer should be reconsidered."

The most common side effects were a reduced white blood cell count (48 per cent of the two-drug therapy group versus 12 per cent of the one-drug therapy) and feelings of weakness (10 per cent versus six per cent).

Commenting on the research, also in The Lancet, Dr Karen L Reckamp, City of Hope Comprehensive Cancer Center in the USA, writes: "Older patients dominate the lung cancer population, but continue to be under-represented in clinical trials.

"Additional studies are needed that enrol adequate numbers of older adults, and include a comprehensive geriatric assessment to provide the knowledge required to properly assess the risk-benefit ratio in treatment decisions, so that a personalised approach can be taken."

Liz Woolf, head of Cancer Research UK's patient information website CancerHelp UK, said: "This study confirms that treatment for cancer needs to be tailored to the needs of the individual. In the 21st century, age is not necessarily a good indicator of fitness, and older people should not be denied appropriate treatment simply because of their age.

"When confirmed in larger studies, the results of this trial should help to dispel any prejudice that remains towards treatment choices for older people with cancer."

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Erlotinib improves progression-free survival in non-small cell lung cancer

Friday 22 July 2011

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Scientists uncover role gene plays in small cell lung cancer

Thursday 21 July 2011

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Cancer rates rise in middle-aged

Monday 18 July 2011

Cancer Research UK Press Release

CANCER rates in middle-aged men and women in Great Britain have gone up by nearly 20 per cent in a generation – an increase of 17,000 cases a year – according to new figures released today (Monday) by Cancer Research UK.

And among women in their forties and fifties cancer rates have risen by more than 25 per cent.

In 1979 44,000 people, aged 40-59, were diagnosed with cancer in Britain but the latest figures for 2008 show almost 61,000 people in the same age group have been struck by the disease. And the cancer incidence rates in this age group have increased from 329 per 100,000 to 388 per 100,000.

Cases of cancer in men have risen from almost 20,000 in 1979 to almost 24,000 in 2008 while in women cases have increased from more than 24,000 to more than 36,500.*

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But despite such an alarming increase in people getting cancer, the number surviving the disease is better than ever before as figures show survival has doubled since the 70s. But there is still much more to do to combat the rising number of cancer sufferers in middle age as well as later in life.

As Cancer Research UK launches its new national TV advertising campaign today the charity’s message is clear: valuable publicly funded research has enabled more people to beat cancer. But as tens of thousands continue to develop the disease more money is needed to identify effective ways of prevention and better treatments for patients.

The increasing number of people being diagnosed with cancer is, in part, due to the NHS breast screening programme and the PSA test for prostate cancer. Screening will detect more cancers at an earlier stage and this means treatment is more likely to be successful.

Among 40-59 year olds, prostate cancer rates** have risen sixfold in 30 years and breast cancer rates*** have increased by 50 per cent. But cases of lung cancer in men of this age have dropped from 6,300 to around 2,700.****

Nisha Sidhu, a mother of three from Ascot, Berkshire, appears in the TV advertisement which is launched today. Nisha was just 41 years old when she noticed a lump in her breast while taking a shower three years ago.

“I didn’t tell any of the family but after a couple of weeks I went to the doctor. Even when I was sent for a mammogram I was in denial about what it could be. I felt very well, had no other symptoms and there was no breast cancer in my family.”

Nisha had a mammogram and biopsy before being given the news she had breast cancer. “I just hadn’t thought it could be cancer and had gone for the tests with my four year old son. It was a real shock but I knew I just had to get on with the treatment.”

After a lumpectomy and chemotherapy Nisha is now on a course of tamoxifen and she runs a support group where she has met other middle aged breast cancer survivors. “I hadn’t realised how many women in their forties and fifties are being diagnosed. I am doing Relay for Life to raise money for Cancer Research UK and I want to help raise awareness among women that they should go to the doctor at the first sign of any change in their breast.”

Harpal Kumar, Cancer Research UK’s chief executive, said: “There has been undeniable progress in the treatment of cancer over the last 40 years and many more people are surviving the disease. But we must redouble our efforts to ensure that our research continues to discover new techniques to improve and refine diagnosis and treatment so that cancer survival becomes the norm for patients, irrespective of the cancer they have or their age at diagnosis.

“It is entirely due to the amazing generosity of the public that we are able to support the work of the 4,000 dedicated doctors, nurses and scientists who continue to unlock the secrets of a disease that affects us all. As cancer incidence rises and the economy tightens, we need their support now more than ever.”

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'Detox protein' is collaborator in pancreatic and lung cancer development

Wednesday 6 July 2011

Cancer Research UK Press Release

CANCER RESEARCH UK scientists have revealed that a ‘detox’ protein which mops up harmful ‘reactive oxygen’ in cells could also trigger pancreatic and lung cancer development, according to a study published in Nature, today.

The team at Cancer Research UK’s Cambridge Research Institute investigated how pancreatic and lung cancer cells detoxify damaging Reactive Oxygen Species (ROS) in mice. ROS are chemically-reactive molecules containing oxygen which can generate cancer-causing mistakes in DNA.

In healthy cells, the ‘detox’ protein Nrf2 steers a signalling pathway which disposes of this harmful reactive oxygen.

But the team discovered that in pancreatic and lung cancer cells, a faulty version of a gene called K-Ras sparked an unexpected upsurge in production of the antioxidant Nrf2. The findings unveil a new and surprising role for the Nrf2 protein as a ‘companion protein’ recruited by K-Ras to trigger cancer development.

And to confirm these results, the team discovered that blocking the Nrf2 signalling pathway, decreased the development of both pancreatic and lung tumours.

These results suggest Nrf2 may be an important target for new drugs to prevent the development of cancer.

Lead author, Dr Gina DeNicola, at Cancer Research UK’s Cambridge Research Institute, said: “It seems counterintuitive that a key protein in the cell’s detox program which mops up harmful oxygen, seems to also be a trigger for pancreatic and lung cancer development.

“But cancer is a complicated disease and this important knowledge will help us get to grips with the role of the double agent in question – a protein called Nrf2. By understanding exactly how it operates, we’ll learn how we can block its role in causing cancer.”

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “The more that we understand about fundamental cancer biology, such as the findings from this important research, the better equipped we are to beat the disease.

“Research like this has already created the foundations for the development of many current cancer drugs - helping to save many thousands of lives.

“And by discovering that a cell’s detox system appears to be a double agent – also triggering cancer development in cells carrying a particular gene fault – we’re one step closer to identifying new targets for potential drugs.”

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Small US study suggests celecoxib may reduce risk of lung cancer in former smokers

Wednesday 6 July 2011

US scientists have found preliminary evidence that a drug called celecoxib could help to prevent lung cancer in patients who used to smoke and therefore face an increased risk of the disease, according to research published in the journal Cancer Prevention Research.

Researchers at the University of New Mexico carried out a small phase II clinical trial involving celecoxib, which belongs to a group of drugs known as COX-2 inhibitors.

A total of 137 patients took part in the trial, all of whom were at least 45 years of age and had given up smoking for at least one year.

Half of the participants took 400mg of celecoxib twice a day, while the other half received a placebo (dummy drug).

The researchers performed bronchoscopies - where a flexible tube is inserted and used to visualise the inside of the airways and to take cell samples from inside the lungs - at the start of the study, and again six months later in order to determine the patients' lung health.

They did this by measuring the level of a protein called Ki-67, which is raised in growing and dividing cells and can therefore be used as a marker of cell growth. Increased Ki-67 levels have also been used as a marker of early lung cancer development in previous studies.

Analysis revealed that patients who were treated with celecoxib showed a 34 per cent decrease in levels of Ki-67, whereas those who took the placebo typically showed a 3.8 per cent increase.

Patients who had decreases in the Ki-67 index also tended to develop fewer lung nodules, which are sometimes a precursor to cancer.

The findings echo the results of an earlier study published in the same journal in February 2010. However, the researchers emphasised that large phase III trials will be needed to confirm the findings.

Dr Jack Lee, professor of biostatistics at the University of Texas MD Anderson Cancer Centre and statistical editor of Cancer Prevention Research journal, noted that five-year survival for lung cancer is just 15 per cent unless the disease is caught early.

He observed: "The best way [to treat the disease] is to intercept at the earliest stages and try to reverse the processes that can lead to cancer. These studies suggest celecoxib may be a tool to do that."

Professor Jack Cuzick, a Cancer Research UK expert on cancer preventive therapy, said: "Smoking causes one in four cancer deaths in the UK, so it's encouraging to see work which takes us a step closer to effective drugs that could prevent lung cancer in former smokers.

"But we're not there yet - this is a small study that only looked at indirect measurements of lung cancer development, such as increased levels of a protein called Ki-67. So there's a long way to go before recommending that former smokers take celecoxib. Scientists need to run much larger prevention trials that directly measure how the cancer develops if the drug is to reduce the number of people developing lung cancer.

"Nevertheless this is very interesting work which makes a strong case for doing these larger trials. In particular, this result shows that it might be possible to identify a group of patients for whom it is safe to take celecoxib. This is important because the drug is known to increase the risk of cardiac disease, so we'd only want to offer it when the benefits outweigh the risks," he added.

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Large US trial finds screening of heavy smokers reduces lung cancer deaths

Friday 1 July 2011

Current or former heavy smokers who are screened with low-dose spiral computed tomography (CT) scanning could be up to 20 per cent less likely to die from lung cancer than those screened by single view chest x-rays, show results from a decade-long clinical trial by the US National Cancer Institute (NCI).

Early results from the National Lung Screening Trial (NLST), of more than 53,000 people, were published in November 2010.

Now, scientists have published a full analysis in the New England Journal of Medicine, which provides further evidence of fewer deaths from spiral CT, which uses x-rays to obtain a multiple-image scan of the entire chest.

Dr Denise Aberle, national principal investigator for 23 of the 33 sites involved in the study and a researcher at the University of California, Los Angeles' Comprehensive Cancer Centre, said: "These findings confirm that low-dose CT screening can decrease deaths from lung cancer.

"This study also will provide us with a road map for public policy development in terms of lung cancer screening in the years to come."

The trial involved 53,454 men and women, aged 55 to 74, current or former heavy smokers with no history of lung cancer.

Participants were recruited in August 2002 and were screened each year for three years, either by low-dose spiral CT or standard chest x-rays.

They were followed for up to five years. According to the full analysis, there were 20 per cent fewer lung cancer deaths among patients who were screened with low-dose spiral CT than with chest x-rays.

In addition, the overall death rate from all causes was 6.7 per cent lower in the CT scan group.

Dr Aberle noted: "The NLST cannot answer all of the important questions about screening that will be important for implementation. However, the NLST data can be used to develop mathematical models to determine how long screening should be performed and how often.

"In addition, the data can be used to determine whether other groups at risk of lung cancer, such as light smokers, those with family histories of lung cancer or individuals with lung diseases like emphysema, would benefit from screening with spiral CT scanning."

Professor Stephen Duffy, Cancer Research UK's screening expert, said: "An intervention like this that can reduce deaths from lung cancer is exciting news. However, CT screening for lung cancer does have its financial and human costs. In particular, this study suggests that lots of people who have a suspicious scan may turn out not to have cancer. Research going on across Europe will help by pinpointing the type of people for whom the benefits of screening outweigh the costs and risks.

"We should also continue to reduce the health burden of tobacco - after all, smoking causes nine out of ten cases of lung cancer, and increases the risk of dozens of other cancers. But this doesn't detract from the importance of these results, which take us closer to a new and effective tool in the fight against lung cancer."

Writing in an accompanying editorial, Dr Harold Sox, from Dartmouth Medical School in the US, said that policymakers should wait for further research on cost-effectiveness and the amount of over-diagnosis - when a cancer is detected that is so slow-growing that it is likely to be harmless - before introducing national lung cancer screening programmes.

But, he said this latest study provides doctors and patients with "much better information than before on which to base their discussions about lung cancer screening".

He added: "The findings of the NLST regarding lung cancer mortality signal the beginning of the end of one era of research on lung cancer screening and the start of another. The focus will shift to informing the difficult patient-centred and policy decisions that are yet to come."

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Study shows benefits of motivational text messages for smoking cessation

Wednesday 29 June 2011

Smokers who receive motivational text messages are twice as likely to quit successfully as those who do not, UK scientists have found.

Researchers at the London School of Hygiene and Tropical Medicine carried out a trial of 5,800 smokers, all of whom had expressed a desire to quit.

Participants were divided into two groups, with 2,915 people assigned to the 'txt2stop' motivational text messaging strategy and the remaining 2,885 receiving non-motivational text messages.

The motivational strategy involved messages of encouragement up to the quit day, advice on preventing weight gain while quitting, and help with cravings.

One text read: "Cravings last less than 5 minutes on average. To help distract yourself, try sipping a drink slowly until the craving is over."

The non-motivational texts thanked people for participating in the study or asked for confirmation of contact details, but gave no encouragement or guidance on quitting.

After six months, participants provided saliva samples which were tested to determine whether or not they had successfully quit.

The results, which are published in the Lancet medical journal, show that smokers who received motivational text messages were more than twice as likely to have successfully quit after six months as those in the control group.

Biochemical testing confirmed that 10.7 per cent of people in the txt2stop group successfully abstained from smoking, compared with just 4.9 per cent of those in the control group.

The study authors noted that the text messages were effective both on their own and when used in conjunction with other techniques to aid quitting, and that a nationwide service would probably be "highly cost-effective".

They concluded: "To scale up the txt2stop intervention for delivery at a national or international level would be technically easy.

"On the basis of these results the txt2stop intervention should be considered as an addition to existing smoking cessation services."

Lead researcher Dr Caroline Free, from the London School of Hygiene and Tropical Medicine's Clinical Trials Research Unit, added: "Text messages are a very convenient way for smokers to receive support to quit.

"People described txt2stop as like having a 'friend' encouraging them or an 'angel on their shoulder'. It helped people resist the temptation to smoke."

Cancer Research UK funded the original pilot study of txt2stop. Professor Robert West, the charity's expert in giving up smoking, commented: "The results of this trial are very exciting and extend the range of things we know that smokers can do to help themselves to break free from their addiction to cigarettes.

"We hope the Department of Health will feel able to turn this finding into a highly effective, low-cost national service to smokers who feel they're unable to attend the NHS stop-smoking services."

Writing in an accompanying comment, Drs Derrick Bennett and Jonathan Emberson, from the University of Oxford, noted that the method could also be effective in developing countries, where mobile phones are rapidly becoming more commonplace.

They observed: "The lessons learned from the txt2stop trial could therefore not only provide a new approach to smoking cessation in high-income and middle-income countries, but could also provide a useful starting point for implementing behavioural change in resource-poor settings."

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Trigger for 'undruggable' lung cancer gene offers new treatment hope

Thursday 12 May 2011

Cancer Research UK Press Release

Cancer Research UK scientists have discovered that an enzyme called C-Raf controls a hugely important gene responsible for the development of lung cancer, according to research published in Cancer Discovery* yesterday (Wednesday).

The important gene – K-Ras – is one of the most commonly mutated genes in cancer. But it has been difficult to develop inhibitors of mutated K-Ras because of the structure of the molecule.

But now, a team based at Cancer Research UK’s Cambridge Research Institute have shown that C-Raf is needed for mutated K-Ras to encourage the growth of lung cancer.

This opens up a completely new avenue of research looking at ways to block the growth of lung cancer, bypassing the K-Ras gene.

Professor David Tuveson, lead author of the study, said: “The K-Ras gene has presented us with a difficult problem for lung cancer and other cancers where K-Ras is mutated, like pancreatic and bowel cancer. It’s known as an ‘undruggable’ gene – drugs developed to target and block the protein produced by the mutated gene have, to date, failed to do so.

“Our discovery may provide us with a solution to this problem. We now know that K-Ras can’t promote lung cancer development without the enzyme C-Raf.

“It’s an exciting result and we’ll be taking this research further to see if blocking C-Raf can be a feasible way to stop the cancer-causing effects of K-Ras.”

Dr Florian Karreth, first author of the study, said: “Under normal conditions, B-Raf seems to be the major player. So we were surprised to find that instead K-Ras depends on C-Raf to initiate lung cancer.”

The researchers used genetic techniques to get rid of two enzymes – C-Raf and B-Raf – in mice and in lung cells in the laboratory. They found that when B-Raf was knocked out, it had no effect on whether K-Ras was able to turn normal cells into cancer cells. But when C-Raf was removed, cancer development was prevented.

Mutations in Ras genes are seen in around 30 per cent of all tumours and K-Ras is the most common type of Ras mutation.

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “As we’re learning more about the genetics of cancer, we’re starting to uncover just how complex it is.

“The discovery of K-Ras was an important milestone but it turned out to be more difficult to target than we initially thought. This study offers us a way to target the gene through the ‘back door’.”

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Cancer Research UK leads global lung cancer drug trial

Tuesday 29 March 2011

Cancer Research UK Press Release

Cancer Research UK scientists in Oxford are trialling an experimental drug to treat lung cancer patients who have stopped responding to initial chemotherapy treatment. The trial will take place at the Oxford Radcliffe Hospitals NHS Trust.

The international early Phase II trial led by a team based at the Oxford Cancer Research Centre will trial the experimental drug called LY2181308 with advanced non-small cell lung cancer patients who no longer respond to platinum chemotherapy - the standard initial treatment for this group.

LY2181308 blocks the ability of cancer cells to make a protein called survivin which instructs cells to grow - and crucially prevents cell death. This combination of ‘immortal’ cells with uncontrolled growth leads to cancer.

Raised levels of survivin are frequently found in tumours, and preventing its production kills cancer cells. It is rarely found in healthy tissue so the drug only targets cancerous cells – this is key in reducing side effects.

The trial consists of two elements. One group of patients will receive docetaxel on its own – the normal standard of care after platinum treatment. The other group will receive LY2181308 alongside docetaxel.

This is one of the first trials taking place at the new Oxford Cancer Research Centre, bringing together Oxford Radcliffe Hospitals, the University of Oxford and Cancer Research UK to develop new treatments for cancer patients and to bring them to patients as soon as possible.

Trial chief investigator, Dr Denis Talbot, consultant medical oncologist at Oxford Radcliffe Hospitals and the Cancer Research UK clinician at The University of Oxford, said: “It’s greatly encouraging that we’re able to take this new experimental drug to treat lung cancer into further development. We hope that it may increase survival rates for lung cancer patients.

“Survival from this disease still remains low. One reason is that the majority - 65-75 per cent - of lung cancer patients are diagnosed when the cancer has already become aggressive, which makes it more difficult to treat successfully. There’s an urgent need to develop new medicines which may provide additional options for these patients.

“We’ll look forward to the results of this trial with great interest.”

Survival rates for all types of lung cancer are still low. Fewer than 10 per cent of lung cancer patients survive the disease beyond five years after diagnosis.

Non-small cell lung cancer accounts for around 85 per cent of all lung cancer cases. Around 30,000 people are diagnosed with this form of the disease each year in the UK.
Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: “We’ve made progress in recent years to discover new ways to tackle lung cancer and this important trial brings further opportunities for this hard to treat disease.
“We were involved in the development and testing of several drugs commonly used to treat the disease including cisplatin and carboplatin. And it’s exciting to be leading on the research to test a new potential drug which we hope will one day help increase the survival rate for lung cancer patients.”

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Counting lung cancer cells opens window on disease

Monday 21 March 2011

Cancer Research UK Press Release

CANCER RESEARCH UK scientists have found that counting the number of lung cancer cells circulating in the blood could determine how aggressive the cancer is and predict the best treatment to use.

The research, published today in the Journal of Clinical Oncology1, looked at the number of circulating tumour cells (CTCs) in blood samples of 101 non small cell lung cancer patients before and after one cycle of chemotherapy. They found lung cancer patients with five or more CTCs had a significantly worse survival2.

Chemotherapy and radiotherapy can slow the growth of lung cancer but in most patients the cancer returns and is more resistant to treatment, but there are no tests available that provide early warning about resistance.

Counting CTCs could be a simple way to monitor how well a patient is responding to treatment within a few weeks of starting it. Being able to detect when CTC numbers are rising could give doctors the option to move patients onto new treatments earlier.

Dr Fiona Blackhall, joint author and lung cancer clinician The Christie in Manchester, said: “Our research shows a new way to monitor how a patient’s lung cancer is responding to treatment and determine how aggressive it is. We now need to test our findings in more patients but, if our results are confirmed, there is now the potential to tailor treatments to individual patients and find new ways to treat the disease.”

Around 50 per cent of patients do not respond to existing treatment but may be exposed to the side effects that accompany some of these treatments.

New drugs are in the pipeline to treat lung cancer, particularly more tailored treatments that are designed to target the genetic faults in lung cancer. But when new drugs are tested in clinical trials it is rarely possible to assess how the treatment is affecting the cancer cells at a molecular level.

Counting CTCs potentially provides a less invasive way to look at the cancer cells before and after a new treatment to see if the drug is working.

Professor Caroline Dive, lead author based at Cancer Research UK’s Paterson Institute in Manchester, said: “In the near future we hope to be able to use gene sequencing tools to learn more about CTCs. If we can do this before a patient has chemotherapy and then again later if the cancer returns we may be able to learn more about the processes that lead to drug resistance and ultimately develop new drugs.”

Until now, the diagnosis of lung cancer has been made through an invasive procedure called a bronchoscopy where a camera is passed into the airways and a needle passed through to the camera to take a piece of tissue for diagnosis. But, this invasive procedure is normally only done once and it is not possible to look at changes in the cancer over time.

Lung cancer is the second most common cancer in the UK - in 2008 around 41,000 people were diagnosed with the disease. It has one of the lowest survival outcomes of any cancer because over two-thirds of patients are diagnosed at a late stage when curative treatment is not possible. Each year around 35,000 people die from the disease.

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “Lung cancer is the leading cause of death from cancer in the UK and we desperately need new treatments for the disease. To be able to detect and count these rare tumour cells circulating through the blood, and the link this has to the progress of the disease, opens an incredibly exciting new area of research. We could now look at the genetic faults that are behind the disease and start to develop drugs that target these.”

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Scottish National Party pledge £30 million to improve cancer detection

Thursday 17 March 2011

Scotland's health secretary Nicola Sturgeon has revealed details of a new cancer detection strategy at the Scottish National Party's (SNP) spring conference.

Should the party be re-elected to power in the country's May elections, the new government would spend £30 million on improving cancer detection as part of an effort to boost Scotland's cancer survival rate.

Speaking to delegates, Ms Sturgeon noted that the cancer survival rate in Scotland, while in line with the rest of the UK, is inferior to that seen in many of the countries on the continent.

She put this down to late detection, with many people only diagnosed with cancer when the disease is in its advanced stages.

In a bid to put this right, the SNP has pledged to use £30 million to set up the 'Detect Cancer Early' initiative, which will focus on lung cancer, breast cancer and colorectal cancer.

"By raising cancer awareness and significantly increasing diagnostic capacity in the NHS, we plan to increase by 25 per cent the number of Scots diagnosed in the first stage of cancer," Ms Sturgeon explained.

"If successful, this initiative can save more than 300 lives every year."

Money will come out of a £1 billion investment pot already allocated for health spending over the next four years.

Ms Sturgeon also highlighted the SNP's achievement of reducing waiting times for cancer patients during its time in office.

She noted that the previous administration had not once managed to hit a self-imposed target for cancer patients to start their treatment within 62 days of being referred by their GP.

But, the SNP achieved the goal within 18 months of coming to power, and went on to set an even more stringent marker.

This new 31-day target was then met a year ahead of schedule.

Jon Spiers, head of public affairs and campaigning at Cancer Research UK, said: "Research shows that one of the major reasons that cancer survival in Scotland lags behind the best performing countries in the world is late diagnosis. When cancer is detected early, treatment is more likely to be effective."

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Lung cancer rates double in women over 60

Monday 7 March 2011

Cancer Research UK Press Release

Lung cancer rates have doubled for women over 60 since the mid 1970s according to new Cancer Research UK figures released today (Monday) ahead of No Smoking Day this Wednesday*.

Rates for British women aged 60 and over rose from 88 per 100,000 in 1975 to 190 per 100,000 in the latest figures from 2008.

Almost 5,700 women over 60 were diagnosed with lung cancer in 1975. This jumped to more than 15,100 in 2008.

And women over 80 had the greatest increase of all, with lung cancer rates more than tripling from 84 per 100,000 in 1975 to 273 cases diagnosed for every 100,000 women in 2008. These rates have consistently risen by an alarming amount. The number of cases rose from around 800 in 1975 to more than 4,700 in 2008.

Since the late 1980s there was some improvement for women aged 60-69, with lung cancer rates levelling out and then falling. But, worryingly, since 2002 these rates have steadily gone back up.

But there is some good news, after large increases since the mid 1970’s, lung cancer rates in women aged 70-79 have now levelled off over the last decade. And lung cancer rates in 40-49 year old women have fallen by a fifth, from 14 per 100,000 in 1975 to 11 per 100,000 in 2008.

Overall the number of women diagnosed with lung cancer has risen from around 7,800 cases in 1975 to more than 17,500 in 2008.

Figures for men show the opposite with around 23,400 over 60s diagnosed with lung cancer in 1975, falling to around 19,400 men in 2008, with rates showing a similar large drop.

Lung cancer is unique in that the reduction in cases is directly linked to a reduction in smoking which causes around 90 per cent of lung cancers. The difference in lung cancer trends for men and women is mirrored by the smoking patterns in previous years for each sex.

Men had the highest smoking rates in the 1940s and 50s and falling from then. Women had rising rates in the 60s and 70s.

Successful anti-smoking measures - such as the tobacco advertising ban and the legislation making public places smokefree - have meant the number of smokers has continued to drop.

Jean King, Cancer Research UK’s director of tobacco control, said: “These figures highlight how important tobacco control measures are in helping people to stop smoking. With the lung cancer rate rising among women we would like the government to introduce a comprehensive and well funded tobacco control strategy that targets at risk groups and stops young people from beginning an addiction that kills half of all long term smokers.

“Around nine in ten cases of lung cancer are caused by smoking and one in five people still smoke, so it’s vital that work continues to support smokers to quit and protect young people from being recruited into an addiction that kills half of all long term smokers. In particular we want displays in shops covered up so that young people are no longer being exposed to this form of tobacco marketing.”

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AstraZeneca and Pfizer join Cancer Research UK's Stratified Medicine Programme

Tuesday 1 February 2011

Cancer Research UK Press Release

CANCER RESEARCH UK will be supported by AstraZeneca and Pfizer in a multimillion pound initiative to examine how genetic tests to improve cancer diagnosis can be best rolled out across the NHS.

Cancer Research UK’s pioneering Stratified Medicine Programme will also promote research into new targeted treatments by building a database of genetic information about tumours, treatments and survival rates that will enable researchers to design more effective cancer treatments in future.

Cancer Research UK will now select six hospitals and three labs to collect tumour samples from 9,000 cancer patients around the UK, and test them for a set of gene faults specifically linked to cancer – an approach called ‘molecular diagnosis’.

Molecular diagnosis of tumours is not yet available for all patients on the NHS and currently only possible using a single test for each mutation.

But the programme aims to develop a multi-gene panel that can test for genetic markers for drugs already used in the clinic - such as EGFR for gefitinib - as well as those for promising new drugs in late-stage trials.

So as and when new targeted cancer treatments become available, doctors will have access to the tests needed to help them match the right drug to the right patient.

The programme will deliver a clear set of standards and processes for molecular diagnosis of NHS patients’ tumours, which can be scaled up to provide a national service.

This will help ensure that the hospitals and labs can deliver high quality, efficient molecular diagnosis of tumours, so all cancer patients across the NHS can get access to the tests that they need.

The £5.5m programme will be led by Cancer Research UK, with funding from AstraZeneca and Pfizer.

It is closely aligned with the Technology Strategy Board’s £5.6 million investment in tumour profiling and data capture to improve cancer care and the new cancer strategy recently launched by the coalition government.

Rob Day, Head of Pfizer Oncology, UK, said: “Pfizer is delighted to partner with Cancer Research UK on the Stratified Medicine programme to advance the role of genetic testing in cancer diagnosis and treatment selection. Personalised medicines are likely to transform the way cancer is treated in the future. As a company dedicated to advancing oncology research, Pfizer Oncology is focused on discovering gene-specific targeted medicines to improve outcomes for patients with cancer.”

Dr Susan Galbraith, Vice President and Head of Oncology, Innovative Medicines, at AstraZeneca, said: “We are delighted to be involved in this collaboration. AstraZeneca has spent over fifty years at the forefront of cancer research and it is our view that better understanding of which patients will benefit from treatment with currently available and new therapies is the way forward in fighting this disease.’

“This collaboration is particularly exciting as by building a database of tumour genetic information, treatments and outcomes, we can better understand which targets for new drugs occur in which patients. The information currently available on this is often incomplete. This kind of testing will mean better selection of patients for clinical trials with drugs which are more likely to make an impact on their disease. Ultimately this will help us develop drugs which improve the survival of patients with cancer.”

Paul Mason, Head of Development at the Technology Strategy Board, said: “We are delighted to be working with Cancer Research UK in this exciting area. The alignment of our activities to build a national programme, and their contribution to the Stratified Medicines Innovation Platform, will go a long way to help generate the critical mass the UK needs.”

James Peach, director of Cancer Research UK’s stratified medicine programme, said: “Cancer Research UK recognises the huge potential of personalised medicine to save lives from cancer. Such an ambitious vision could not be realised without partnership and we know that the support of AstraZeneca and Pfizer will be invaluable in facing the many challenges that lie ahead.”

“It’s important that NHS cancer patient have access to these kinds of tests to make sure they get the right treatment at the right time. And by acting now we can ensure patients benefit from personalised cancer medicines as soon as they become available.

“Cancer Research UK is proud to be leading this coordinated national effort – including the Government, NHS and pharmaceutical and diagnostic companies – that will bring us a step closer to tailored treatments becoming a routine part of NHS cancer care.”

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UK survival for major cancers improves, but still lags behind other countries

Wednesday 22 December 2010

Despite gaining ground, survival figures for newly diagnosed breast, ovarian, bowel and lung cancers were still lower in the UK than in Australia, Canada and Sweden between 1995 and 2007, a new study in the Lancet medical journal shows.

The research looked at one, five-year and five-year 'conditional' survival for these four major cancers between 1995 and 2007 in Australia, Canada, Sweden, the UK (excluding Scotland), Denmark and Norway.

Among other things, one-year survival figures can give information about how late cancers are being diagnosed, as the later cancer is diagnosed the lower the proportion of patients who survive one year.

Five-year 'conditional' survival looks at five-year survival rates among people who survive at least one year, and is thought to be an indication of the quality of care and treatment received.

Survival figures over this period were found to be better for patients in Australia, Canada or Sweden than for those in the UK or Denmark, while Norway's survival rates were intermediate.

For example, five-year bowel cancer survival for 2005-07 was 54 per cent in the UK compared to 66 per cent in Australia, while one-year survival for lung cancer was around 30 per cent in the UK, compared to 43 per cent in Australia and 44 per cent in Sweden.

Experts say that late diagnosis or differences in treatment are likely to be behind the lower survival rates in Denmark and the UK.

But the study also shows that, while the UK's survival rates are not as high as those in other countries, relative survival did improve for all four cancers between 1995 and 2007.

One-year and five-year breast cancer survival rates improved more in the UK and Denmark than in the other countries between 1995 and 2007, indicating that the UK's cancer plans, which were introduced in England in 2000, Northern Ireland in 1996 and Wales in 2004, may have made a difference.

The study authors wrote: "Differences in individual, health-system and clinical factors - such as public awareness of cancer, diagnostic delay, stage [of cancer at diagnosis], comorbidity [other serious illnesses at time of cancer diagnosis] and access to optimum treatment - are all potential explanations for the overall differences in relative survival.

"The patterns are consistent with late diagnosis or differences in treatment, particularly in Denmark and the UK, and in patients aged 65 years and older."

The research was carried out as part of the International Cancer Benchmarking Partnership, a collaboration aimed at understanding the reasons for differences in cancer outcomes between countries. The new paper is the first to emerge from 'module one' of the partnership's work, which aims to generate quality data to base future analyses on.

Other modules will attempt to unpick the reasons for these discrepancies.

Sara Hiom, director of health information at Cancer Research UK, which helped to fund the study, said: "It's encouraging to see that survival for breast, bowel, lung and ovarian cancers has improved across the board and this study shows how far survival has improved for some of the most common cancers in the UK. But we still have work to do. Now we know how we currently compare to other countries, we must look at exactly why these differences in survival exist.

"When the government refreshes its cancer strategy, it's vital to retain a focus on early diagnosis and on improving equitable access to treatment. We also urge the government to continue to collect good quality information. Reliable data - which are consistent across the country - are crucial to understanding the extent of the problem and identifying the causes of the survival gap within the UK and compared to other countries."

Sir Mike Richards, England's national director for cancer, said: "These data will be crucial in helping all the partners involved improve their cancer outcomes.

"In England we have already started work on improving early diagnosis, including a new campaign starting next month to alert people to the early signs and symptoms of bowel, lung and breast cancer, and plans to give GPs more direct access to key diagnostic tests. Full details of our future plans will follow when the coalition government launches its new cancer strategy in the new year."

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Deprived cancer patients face fatal health problems

Wednesday 24 November 2010

Cancer Research UK Press Release

CANCER patients from deprived backgrounds are more likely to develop life-threatening health problems, research published today (Wednesday) in the British Journal of Cancer* shows.

The study** found that less affluent patients are 50 per cent more likely to develop at least one serious illness like heart disease, tuberculosis, dementia or diabetes, which could reduce their chance of recovering from cancer.

The research looked at over 72,000 patients with 14 different types of cancer*** between 1997 and 2006. The results showed that the likelihood of one-year survival for poorer patients was significantly worse than those who were well-off.

Scientists claimed this was the first large study to show how a cancer patient's background affected their chances of developing other illnesses and could impact their survival.

Dr Marieke WJ Louwman, one of the study authors based at the Eindhoven Cancer Registry in The Netherlands, said: "Remarkably, we found that additional health disorders were common in patients from a lower socioeconomic background for every cancer type."

The study outlined possible explanations for increased health problems among poorer cancer patients. Previous research has shown that smoking is a likely cause for the higher risk of heart disease.

This was confirmed by the high number of cases of the disease among patients with smoking-related cancers like lung, stomach, bladder and kidney.

Cancers like pancreatic, breast, womb and bowel have been linked to diabetes which can be triggered by obesity. Previous evidence has shown that obesity is more common among those from a low socioeconomic background.

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: "It's worrying to see that survival is considerably worse for deprived patients - this research stresses the need to close the gap between rich and poor in health.

"The results of this study suggest that the causes of the types of cancer and the health problems common among poorer cancer patients are likely to be down to lifestyle.

"More work needs to be done to raise awareness in economically-deprived areas about the risks of smoking and obesity and the benefits of a healthy diet and exercise."

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Recession saw fewer smokers quitting

Tuesday 9 November 2010

Cancer Research UK Press Release

Since the recession began the number of smokers quitting has fallen according to new research being presented at the NCRI Cancer Conference in Liverpool today (Tuesday).

In 2007 around 32 per cent of smokers said they had tried to quit within the previous three months. This was before the recession hit the UK economy in the second half of 2008. But this had fallen to 23 per cent by 2008, 22 per cent by 2009 and by 2010 only 17 per cent according to the report.

Professor Robert West, director of tobacco studies at the Cancer Research UK Health Behaviour Research Centre, has been tracking the number of smokers and their quitting patterns* in England since November 2006 before the smoking ban came into force in July 2007.

His figures reveal the rate of quitting slowed down when recession hit the UK economy.

Professor West also highlighted that very few smokers use the most effective methods to help quit. Fewer than five per cent of smokers use the NHS quit smoking services even though it is four times more effective than other methods.

From the 1970s the number of UK smokers has fallen from 55 per cent of the population to around a fifth (22 per cent) of the population in 2008. Professor West urged the government not to lose focus on reducing the impact of tobacco.

Maintaining support for smokers who have given up and trying to stop young people from starting are key.

Nine out of ten lung cancers are caused by smoking and half of all long term smokers will die from the addiction.

Professor Robert West said: "As the country tightens its financial belt we've seen the number of smokers trying to quit slow down. While no one can be sure about the cause and effect with data of this kind this could be another very damaging impact of the financial crisis.”

Sara Hiom, Cancer Research UK’s director of health information, said: "Later this year the Department of Health will issue a white paper on public health. This is an opportunity to give a serious shot in the arm to tobacco control. We need to pay close attention to the evidence on what helps smokers to quit if we are to give hope and encouragement to the 70 per cent of smokers who want to stop."

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Spiral CT screening of heavy smokers could decrease lung cancer death rates

Monday 8 November 2010

Heavy smokers who have lung cancer screening with low-dose 'spiral' chest CT scans appear to be less likely to die from the disease than those who are screened using single view chest x-rays, initial study results from the US National Cancer Institute (NCI) suggest.

Spiral CT uses x-rays to obtain a multiple-image scan of the entire chest, whereas standard chest x-rays produce a single image.

The institute has published early results from a large-scale trial of screening methods in older people with a high risk of smoking-related lung cancer, but a full analysis is yet to be performed.

Researchers collected data on more than 53,000 current and former heavy smokers, aged 55 to 74, in order to compare the effect of low-dose spiral chest CT and standard chest x-rays on the risk of dying from lung cancer.

Participants underwent screening each year for three years and were then followed for up to five years to see whether they died from lung cancer.

The National Lung Screening Trial (NLST) found there were 20.3 per cent fewer lung cancer deaths among high-risk patients screened with low-dose spiral CT than with chest x-rays.

The overall death rate from all causes was also seven per cent lower in people who had CT scans, although the researchers said they were unsure why this might be the case, and that a full analysis would follow.

NCI director Dr Harold Varmus said: "This large and well-designed study used rigorous scientific methods to test ways to prevent death from lung cancer by screening patients at especially high risk.

"Lung cancer is the leading cause of cancer mortality in the US and throughout the world, so a validated approach that can reduce lung cancer mortality by even 20 per cent has the potential to spare very significant numbers of people from the ravages of this disease.

"But these findings should in no way distract us from continued efforts to curtail the use of tobacco, which will remain the major causative factor for lung cancer and several other diseases."

Dr Denise Aberle, NLST national principal investigator for the American College of Radiology Imaging Network, which conducted the research, said: "The results of this trial provide objective evidence of the benefits of low-dose helical CT screening in an older, high-risk population and suggest that if low-dose helical CT screening is implemented responsibly, and individuals with abnormalities are judiciously followed, we have the potential to save thousands of lives."

However, Dr Aberle noted: "Given the high association between lung cancer and cigarette smoking, the trial investigators re-emphasise that the single best way to prevent lung cancer deaths is to never start smoking, and if already smoking, to quit permanently."

Professor Stephen Duffy, Cancer Research UK's screening expert, said he thought the results were 'very encouraging' but that a full analysis was needed to confirm the risks as well as the benefits.

"For many years, we've been looking for a method to substantially reduce deaths from lung cancer. We look forward to seeing the full details published, telling us the disadvantages as well as the benefits of the screening," he said.

"The work to reduce smoking exposure is still vitally important though - as nine out of ten lung cancers are caused by smoking. In the meantime, however, these initial results may be the most positive in lung cancer control for a long time."

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Data suggests too few lung cancer patients getting surgery

Monday 8 November 2010

Cancer Research UK Press Release

Only half as many lung cancer patients in England are getting potentially lifesaving surgery compared to the best countries in the world, according to a new report by the National Cancer Intelligence Network (NCIN).

The report, launched today at the National Cancer Research Institute (NCRI) Cancer Conference in Liverpool, looked at all newly diagnosed lung cancer patients in England between 2004-2006 and followed them up for six months after diagnosis using routine NHS data* to see whether they had surgery to treat the disease in an NHS Trust in England.

The findings showed that overall nine per cent of lung cancer patients had surgery** whereas experts suggest in many parts of the world around 20 per cent are being operated on. This could, at least in part, explain why England’s five year lung cancer survival lags behind the rest of the world.

These data also show that 14 per cent of men and women aged 50-59 have surgery to treat the disease compared to 9 per cent of those aged 70-79. And for the over 80s, the numbers having surgery dropped to just two per cent.

Dr Mick Peake, Consultant Chest Physician at Glenfield Hospital, Leicester and Clinical Lead for the NCIN, said: “These figures show a worryingly low number of people are having surgery for lung cancer in England. We should be matching the best in the world with around 20 per cent of lung cancer patients undergoing surgery.

“Not all lung cancer patients will be eligible for surgery as this depends on the stage of their cancer or whether they have any other diseases. However these data still show that only half compared to the best in the world are having this potentially lifesaving treatment. And this may be a major reason why the long term survival figures for patients with lung cancer in England are not as good as they could be.

“We need to understand why this is happening. Do we need more lung cancer surgeons or are patients simply being diagnosed too late for surgery?”

Professor Sir Mike Richards, National Cancer Director, said: "This study highlights the importance of collecting information on the treatments received by cancer patients across the country. Where there is variation among patients receiving surgery we must look carefully to understand the reasons for this.

"The low rate of lung cancer surgery is likely to be due in part to late diagnosis. We know that earlier diagnosis can save lives, that is why we are launching a new campaign from January to alert people to the early signs and symptoms of lung, bowel and breast cancer. We will publish an updated cancer strategy in the winter setting the future direction for cancer care."
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Relatives of young breast cancer patients could face increased risks of other cancers

Wednesday 29 September 2010

Cancer Research UK Press Release

Both male and female relatives of women diagnosed with breast cancer before the age of 35 are at an increased risk of other cancers even if they do not carry faulty BRCA1 and BRCA2 genes, scientists have discovered.

The study*, published in the British Journal of Cancer** today (Wednesday) looked at the risks of breast and other cancers for the relatives of young women diagnosed with the disease.

Scientists studied the 2200 parents and siblings of 500 women with breast cancer diagnosed before the age of 35 who had been tested for BRCA1 and BRCA2 gene mutations***.

After excluding families with mutations in BRCA1 and BRCA2, scientists found that the relatives not only faced an increased risk of breast cancer, but also of prostate, lung, brain and urinary cancers.

This could potentially reflect the presence and effects of other undiscovered gene disorders causing disease in these young women and perhaps other cancers in their families.****

In the 1990s Cancer Research UK scientists led the world in tracking down the BRCA1 and BRCA2 genes.

Since then they have discovered many other genes involved in breast cancer and their ongoing research will help to identify and advise those women at greatest risk.

Professor John Hopper, who led the study from the Centre for Molecular, Environmental, Genetic and Analytic Epidemiology at the University of Melbourne, said: “These results are surprising and novel, and could be pointing to a new cancer genetic syndrome.

“Just as the link between male and female breast cancers in some families led UK researchers to find the breast cancer susceptibility gene BRCA2, the results of this study could help scientists discover new cancer susceptibility genes.”

Previous studies have suggested increased risks of other cancers for relatives of women diagnosed with breast cancer but the links have been weak and inconsistent.

This study is one of the few to look at the cancer risks for relatives of very early onset breast cancer cases and it is possible that there could be more substantial effects at this age.

It is already known that relatives of very early onset breast cancer patients - without mutations in the BRCA1 and BRCA2 genes – carry a four-fold increased risk of the disease than those with no family link.

But this study suggests that close relatives also face similarly high increased risks of prostate, lung, brain and urinary cancers.

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “These early results are interesting in pointing to some increased risks of other cancers in the relatives of very young breast cancer cases.

“This study is important in suggesting a strategy to help identify other genes which significantly increase a woman’s breast cancer risk. And more studies with larger numbers will help confirm these risks.”

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