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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Docetaxel significantly increases survival for incurable gastric cancers

Wednesday 23 January 2013

Cancer Research UK Press Release

Survival for advanced stomach and oesophagael cancer patients increases by 40 per cent when treated with the chemotherapy drug, Docetaxel* – providing evidence to prescribe it as a second-line treatment, according to the results of a Cancer Research UK trial presented at the American Society of Clinical Oncology (ASCO) Gastrointestinal cancers symposium today (Wednesday)**.

Patients with the advanced disease who do not respond to the initial standard treatment of platinum and fluoropyrimidine chemotherapy have very low survival – around four months. And in all patients with advanced disease and most of those with early disease (70 per cent) their cancer will eventually progress further after chemotherapy.

But these new results show that patients taking Docetaxel lived, on average, more than 40 per cent longer – 5.2 months compared with 3.6 months. The drug improved symptoms, without affecting quality of life.

Docetaxel is a chemotherapy drug usually given to treat breast, prostate and non-small cell lung cancer.

The trial, called COUGAR-02 was coordinated by the Cambridge Cancer Trials Centre at Addenbrooke’s hospital.

It recruited 168 patients from 31 UK hospitals with incurable oesophageal or stomach cancer after initial therapy.

They were then randomly assigned either chemotherapy for up to 18 weeks with Docetaxel, or symptom-control treatment with no chemotherapy.

Chief investigator Dr Hugo Ford, Cancer Research UK-funded clinician at Cambridge University Hospitals, said: “This is important progress for stomach and oesophageal cancer patients. At the moment there aren’t any options for gastric cancer patients whose first round of treatments haven’t worked and there’s an urgent need for new drugs.

“But for the first time we’ve shown that giving further chemotherapy can not only improve survival but also maintain quality of life and reduce pain.

“It’s incredibly hard as a clinician telling a patient with advanced disease that there are no treatments that will work for them. So it’s fantastic that these results will provide new hope and valuable extra time for people and their families who otherwise would have no option other than pain management drugs.”

Each year more than 12,000 people die from oesophagus or stomach cancer in the UK. Stomach cancer is one of the most common cancers worldwide.

Kate Law, Cancer Research UK’s director of clinical research, said: “These exciting results from our trial provide the evidence that Docetaxel is effective when patient’s initial treatment for advanced stomach cancer wasn’t effective.  

“Our scientists were among the first to show that the major cause of stomach cancer is a common infection of the stomach lining by the bacterium Helicobacter pylori (H. pylori). This work has underpinned current research aimed at preventing stomach cancer. And we’re delighted that this latest study will provide new, long overdue treatment options for these patients.

“We hope that Docetaxel can be made available on the NHS as soon as possible to treat the disease.”

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Genetic link to Barrett's oesophagus identified for first time

Monday 10 September 2012

UK scientists have discovered the genetic basis for why some people are more at risk of developing Barrett's oesophagus, a condition that increases the risk of oesophageal cancer.

Regions of genetic variation have been identified on two of the twenty-two chromosomes that make up the human genome, and people who carry particular versions of the genetic code in these regions appear to have a higher risk.

The findings, published in Nature Genetics, may help scientists design screening tests to spot people with acid reflux who are at high risk of developing Barrett's. It could also shed light on how the disease develops.

Barrett's oesophagus is a pre-cancerous condition affecting cells lining the lower end of the oesophagus (food pipe). It is usually caused by acid reflux - when acid from the stomach leaks up into oesophagus - resulting in heartburn.

"This is the first time a genetic link has been shown. Our findings provide a basis for genetically screening 30 per cent of the Western population who get acid reflux to see which 10 to 20 per cent of them - three per cent of the population overall - will go on to develop Barrett's oesophagus. These genetic variations will also form the basis for developing new targets for therapy," said Professor Janusz Jankowski, the London-based study leader.

Dr Rebecca Fitzgerald, Cancer Research UK's Cambridge-based oesophageal cancer expert, said the results were encouraging, but that investigations into the specific genes needs to continue in order to build up a more detailed picture.

"Most people with heartburn symptoms don't develop Barrett's oesophagus, so it's very exciting to begin to get an idea of the inherited genes that seem to make individuals more susceptible," she said.

"But further studies in more people are vital to help to confirm which genes are involved. More importantly, we need to find out exactly how such genes contribute to Barrett's oesophagus, and it's possible that this could give insight into how oesophageal cancer develops too."

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Trial launch of urgently-needed combination treatment for oesophago-gastric cancer

Friday 17 August 2012

Cancer Research UK Press Release

Cancer Research UK’s Drug Development Office (DDO), in collaboration with academia and industry, has announced a new trial to open in Oxford. 

The trial will test an experimental drug from AstraZeneca in patients with advanced oesophago-gastric cancer – a disease for which no well-established standard treatments exist.

The Phase I national trial is the second study to open through the Experimental Cancer Medicine Centre (ECMC) Combinations Alliance initiative, which launched last year to run trials of the newest and most exciting combinations of cancer medicine for UK patients.

Cancer Research UK’s DDO is working in partnership with AstraZeneca and the ECMC network to provide strategic oversight and funding to the trial. AstraZeneca is providing the investigational drug AZD8931 and additional funding. Oxford University is sponsoring and managing the trial with support from the Oxford NIHR Biomedical Research Centre.

The trial will investigate whether combining the experimental drug AZD8931 with existing chemotherapy drugs, called oxalipatin and capecitabine, is more effective than treatment with chemotherapy alone.

Survival rates for patients with these cancers remain low, with less than 20 per cent of patients in England surviving for five years. Around 12,600 people in the UK die from these cancers each year.

Chief Investigator, Dr Anne Thomas, a clinical reader in the Department of Cancer Studies and Molecular Medicine at the University of Leicester and consultant oncologist at Leicester Royal Infirmary, said: “It’s wonderful news that this trial is opening, testing a promising new way to treat oesophago-gastric cancer.

“There still isn’t a standard treatment plan for these diseases and patients are often diagnosed at a late stage when there are fewer options available. So there’s an urgent need to innovate, and develop new and effective treatments.

“The opening of this trial brings fresh hope for the future and we’ll follow the results with great interest.”

Dr Ian Walker, head of alliance management at Cancer Research UK’s DDO, said: “We’re delighted to see the Combinations Alliance with AstraZeneca is now opening a second trial - demonstrating the value and importance of such collaborative partnerships. This trial is particularly important as oesophago-gastric cancers remain difficult to treat. It’s clear that without the Combinations Alliance this trial may never have taken place and this is an excellent example of what can be achieved through such collaborations.

“By combining molecularly-targeted experimental drugs developed and owned by the company with other treatments, we’re able to increase the options for patients and, we hope, save more lives in the future.”

AstraZeneca is the first pharmaceutical industry partner to join the initiative. The Combinations Alliance will be expanded to include more partners and establish cross-company agreements, providing patients with access to a larger number of potential combinations.

AZD8931 works by blocking a family of proteins called erbB which are found on the surface of cancer cells in the oesophagus and stomach. The erbB proteins tell cancer cells to carry on dividing. Turning off this signal will help kill the cancer cells.

Graham Richmond, project leader for AZD8931 at AstraZeneca, said: “It is increasingly evident that strategic partnerships such as this are highly valuable in determining the broader utility of new experimental compounds such as AZD8931 for patients with oesophago-gastric cancer. Through collaborations, we are able to explore the potential of combination therapies for cancer, building on our strong oncology heritage and at the same time tapping into external expertise.”

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Cancer Research UK launches trial of experimental drug combination for advanced stomach and oesophageal cancer

Friday 8 June 2012

Cancer Research UK Press Release

Cancer Research UK’s Drug Development Office (DDO) has joined forces with academia and industry to open a clinical trial that will test an experimental drug from AstraZeneca called AZD4547 in combination with standard chemotherapy to treat a group of patients with advanced stomach or oesophageal cancer.

This is the first study to open through the ECMC Combinations Alliance which launched last year. AstraZeneca is the first pharmaceutical industry partner to join the alliance, which aims to increase patient access to trials of potential new cancer treatments, combining molecularly-targeted experimental drugs developed and owned by the company with standard chemotherapy, radiotherapy and other new experimental drugs.

The Phase Ib/IIa clinical trial will be led from the Glasgow Cancer Research UK and Scottish Health Department’s Experimental Cancer Medicine Centre (ECMC) and the Cancer Research UK Glasgow Clinical Trials Unit at The Beatson West of Scotland Cancer Centre.

The trial is open for patients that have higher than usual amounts of a protein called fibroblast growth factor receptor-2 (FGFR2).

FGFR2 signaling controls cell growth and survival – and is often faulty in cancer cells, causing them to grow and divide beyond control. Studies have shown that patients with higher than normal levels of the FGFR2 gene tend to respond poorly to standard treatment approaches. It is hoped that adding AZD4547 will improve response to treatment by blocking FGFR2.

Chief investigator, Professor Jeff Evans at the University of Glasgow, said: “I’m delighted to see the launch of this trial, which will find out if a new combination of drugs could be used to treat patients with advanced stomach or oesophageal cancer.

“There are very few treatment options for advanced forms of these diseases and there’s an urgent need to develop new therapies.

“We hope this trial will be an important step forward in finding a more effective treatment approach – ultimately improving survival from these diseases – and we’ll be watching the trial results with great interest.”

Patients will receive the experimental treatment AZD4547 alongside the conventional chemotherapy treatment of a drug combination of cisplatin and capecitabine – also called ‘CX’.

In the initial part of the study, to find the correct dose of AZD4547 to give with the chemotherapy drugs, patients with other types of tumour will also be eligible to take part. This may lead on to potential studies in other tumour types in the future.

AstraZeneca is providing the investigational drug AZD4547 
and additional funding. Cancer Research UK’s Drug Development Office is also providing support.

Andrew Foxley, clinical programme director for AZD4547 at AstraZeneca, said: “AstraZeneca is committed to pushing new boundaries in oncology therapy and delivering medicines to broaden the options available to cancer patients and make a meaningful difference to their lives. We are pleased to collaborate with others through efforts such as the ECMC Combinations Alliance to help speed up the delivery of high-quality, targeted medicines to patients.”

Dr Ian Walker, head of alliance management at Cancer Research UK’s DDO, said: “The alliance enables UK patients to take part in important clinical trials of potential new treatment approaches – such as this trial for advanced stomach and oesophageal cancer – and will provide a huge boost to UK research in developing exciting new combination therapies.

“Our aim is to develop cross-company agreements to provide access to a larger number of potential combinations to help us beat cancer.

“We will take the model we’ve established with AstraZeneca forward by actively looking for additional partners who are interested in collaborating with us.”
 

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International consortium releases cancer gene data

Thursday 15 March 2012

The International Cancer Genome Consortium (ICGC) has released genetic data from a series of studies into different types of cancer.

The data can now be used by researchers worldwide, to help drive forward their own research projects.

The data were released on the same day that the ICGC announced a new project in South Korea to pin down the genetic faults that cause breast cancer in East Asian women.

The consortium says it is ahead of schedule in its plan to deliver genomic data on more than 50 types of cancer over a period of 10 years.

The ICGC involves various research organisations around the world, including Cancer Research UK, which is working on prostate and oesophageal cancers.

The Consortium's eighth major data release includes the first findings from the UK's myelodysplastic syndrome study, alongside liver cancer research in France and a childhood brain cancer project in Germany.

Other findings include updates from the UK's breast cancer (triple negative) project, pancreatic research projects in Australia and Canada, and liver cancer research in Japan.

Cancer Research UK's Professor David Scott, welcomed the new data, saying it would drive forward cancer research.

"It's good to see that the International Cancer Genome Consortium is continuing to make progress and is ahead of schedule," he said.

"The release of data announced today should help researchers worldwide - including those funded by Cancer Research UK - gain new insights into how these cancers develop, and open up new avenues in the search for targets for treatments," he added.

For its latest study in South Korea, the ICGC will collaborate with the National Centre for Cancer Genomics in Seoul.

Because there are significant genetic and lifestyle differences between Caucasian and East Asian patients, data from the study will be compared with ICGC breast cancer projects in the UK, France and the US.

The study will be led by Dr Gu Kong from Hanyang University, alongside teams from Seoul National University, the Asian Medical Centre, and Gachon University of Medicine and Science.

Dr Hyung-Lae Kim, director of the national project for personalised genomic medicine at Korea&aposs Ministry of Health, said: "It is our great pleasure to join the ICGC.

"We believe that genomic data from Asian cancer patients will contribute to the current ICGC breast cancer project both scientifically and clinically."

Henry Scowcroft, Cancer Research UK's science information manager, said the research would ultimately improve the way genetic knowledge was applied to people of different ethnicities.

"Most of the research into the gene faults that cause cancer has predominantly looked at Caucasian populations, so it's great to hear South Korea is joining the ICGC.

"It's extremely important to make sure that our knowledge of cancer's inner workings applies to as many people from as broad a range of ethnicities as possible," he said.

ICGC has already received funding commitments from groups in Asia, Australia, Europe and North America for 47 project teams to study the genomes of more than 18,000 tumours. Information on more than 3,493 tumours is available through its website.

Previous data released by ICGC include its Chinese gastric cancer project and the Spanish chronic lymphocytic leukaemia project.

Meanwhile, submissions from the US Cancer Genome Atlas have contributed information on 10 types of cancer affecting the blood, brain, colon, kidney, lung, ovaries, rectum, and uterus.

Cancer Research UK's oesophageal and prostate cancer projects have recently successfully completed pilot phases, with the full projects now starting.

These projects are funded by the Dallaglio Foundation (prostate) and the Catalyst Club (oesophageal).

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Gene offers clue to cause of oesophageal cancer

Thursday 19 January 2012

Scientists have discovered the gene behind a rare skin condition that predisposes to oesophageal cancer, according to a study part-funded by Cancer Research UK.

The finding could be a major step towards new ways to treat and diagnose this type of cancer.

The research, published in the American Journal of Human Genetics, was led by Professor David Kelsell from Queen Mary, University of London, with collaborators from the University of Dundee and the University of Liverpool.

The researchers used the 'next generation' DNA decoding machines to study the genetic make-up of people with an inherited skin condition called tylosis.

This condition affects the skin and mouth, and greatly increases a person's chances of developing oesophageal cancer - more than nine in every 10 people with the condition develop oesophageal cancer by the age of 65.

The team found that a fault in a single gene - RHBDF2, involved in wound healing - caused the condition.

Crucially, initial findings also suggest that this gene could have a role in the more common, non-inherited form of oesophageal cancer - and could reveal a new target for treating this often hard-to-treat disease.

Oesophageal cancer, which is more common in the UK than the European average, affects more than 8,000 people each year in the UK and the number is rising.

Scientists know little about how it develops and very few drugs for targeting the disease are currently available. Survival rates are poor compared with other types of cancer and only eight per cent of patients are alive five years after diagnosis.

"In studying this relatively rare condition, we have made an important discovery about a cancer that is all too common," said Prof Kelsell.

"Finding a genetic cause for this aggressive cancer, and understanding what that gene is doing, is an enormous step forward.

"By analysing the complex biology which causes a particular type of cancer, we begin to understand which treatments might be effective and also which treatments are unlikely to help."

Dr Rebecca Fitzgerald, a Cambridge-based oesophageal cancer expert said: "“This study is an excellent example of how careful genetic analysis of families with rare conditions linked to cancer can lead to broader insights into a disease - in this case squamous cell cancer of the oesophagus. We’ve known generally what part of the chromosome is involved in tylosis for some time, but it’s taken a until now to pin down the exact gene.

“This work has for the first time uncovered the crucial role of the RHBDF2 gene in this disease. It paves the way for further research to better understand the role of this gene, which will hopefully reveal new ways to diagnose and treat oesophageal cancer.”

Dr Laura Bell, senior science information officer at Cancer Research UK, said: "This work shows how next-generation DNA sequencing technologies are revolutionising our understanding of the genetic causes of cancer and gives scientists a promising lead into avenues of research for people with both inherited and non-inherited forms of oesophageal cancer.

"Finding genes like this can help scientists develop new ways to treat and diagnose oesophageal cancer, which are urgently needed for people with this type of the disease."

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Fluorescent dye pinpoints tiniest signs of oesophageal cancer

Sunday 15 January 2012

Cancer Research UK Press Release

A fluorescent dye that can be sprayed onto the oesophagus – the food pipe – could be used to detect oesophageal cancer earlier and spare patients unnecessary treatment, according to research published today (Sunday) in Nature Medicine1.

When sprayed onto the oesophagus the dye attaches to normal, healthy, cells but is unable to stick to cancer cells or those in the early stages of turning cancerous. This gives doctors a clear signpost to where the disease is developing.  

The researchers, funded by the Medical Research Council (MRC) and Cancer Research UK, studied samples of a particular type of oesophageal cancer called adenocarcinoma, cases of which are soaring. Before this disease develops there is a detectable pre-cancerous stage called Barrett’s oesophagus, which can be easily treated successfully.   

The fluorescent dye works by attaching to glycans – molecules on the surface of cells in the oesophagus. When the cells begin to turn cancerous the glycan structures change, meaning that the dye no longer sticks to the surface of these cells. This gives an early warning of where the cancer is developing.

At this point the cancer can be treated with radiofrequency ablation – an electrical current applied to the affected area to kill the cancer cells.

Dr Rebecca Fitzgerald, lead author based at the MRC Cancer Cell Unit in Cambridge, said: “Current methods to screen for oesophageal cancer are controversial – they are costly, uncomfortable for the patient and are not completely accurate. Our technique highlights the exact position of a developing oesophageal cancer, and how advanced it is, giving a more accurate picture. This could spare patients radical surgery to remove the oesophagus that can result in having to eat much smaller more regular meals and worse acid-reflux.”

After pilot studies on large numbers of biopsies the researchers used four patients having removal of early cancer to show how the spray could be used. In two of the cases, pre-cancerous areas were not detected using conventional imaging, but the spray clearly highlighted an area that needed treating.  

In another patient, their entire oesophagus had been removed because a small pre-cancerous area had been identified. Using current techniques it had been impossible to determine how developed the cancer was, but using the fluorescent spray, the researchers found the affected area was small and could have been treated with a less radical procedure.   

Professor Kevin Brindle, one of the researchers based at Cancer Research UK’s Cambridge Research Institute, said: “The benefit of using this dye is that it is specific, relatively cheap and is found in our normal diets so unlikely to cause any unwanted effects at the levels we use. We now need to test our technique in newly diagnosed patients, but it has great potential to be used with current imaging techniques to help improve treatment for oesophageal cancer.”

Oesophageal cancer is the ninth most common cancer in the UK. Each year around 8,000 people are diagnosed with oesophageal cancer and the incidence of the disease in men has risen by more than 50 per cent in a generation.

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: “Oesophageal cancer is one of the most difficult cancers to detect and treat, with only eight per cent of people with the disease surviving at least five years. We urgently need new ways to detect the cancer earlier, and this dye offers a great opportunity to treat the cancer more promptly and more successfully, potentially saving many lives a year.”

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Bowel, oesophageal and pancreatic cancers show biggest improvement in diagnosis time

Tuesday 8 November 2011

Cancer Research UK Press Release

NEW research shows that bowel, oesophageal and pancreatic cancers have seen the greatest improvement in the time it takes from when a patient first visits their GP with symptoms to when they are diagnosed with the disease.

The data – being presented at the National Cancer Research Institute (NCRI) Cancer Conference in Liverpool this week – was collected for breast, bowel, lung, pancreatic, oesophageal and stomach cancers for 2001-2 and for 2007-8.

Information was collected from the General Practice Research Database on more than 14,400 patients aged 40 or over who had been diagnosed with any of the six different cancers and who had previously shown potential cancer symptoms. These symptoms were predetermined by an expert group. An example of symptoms for bowel cancer included things such as constipation, diarrhoea or rectal bleeding.*

In 2001-2 bowel (colon and rectal) cancer was on average diagnosed 96 days after patients first reported a symptom to a GP to when they were diagnosed. This dropped significantly to 75 days in 2007-8.

For oesophageal cancer in 2001-2 the average time to diagnosis after first GP visit was 59 days. This fell to 48 days in 2007-8. For pancreatic cancer in 2001-2 the average time to diagnosis after first GP visit was 63 days. This fell to 52 days in 2007-8.

Breast, stomach and lung cancers did show a drop, though not a significant one.

Breast cancer times to diagnosis fell from 27 days in 2001-2 to 25 days in 2007-8. Stomach cancer diagnosis times reduced from 88 days in 2001-2 to 77 days in 2007-8, and for lung cancer from 106 days in 2001-2 to 102 days in 2007-8.

Midway between these two time periods was the release of the 2005 NICE referral guidance for suspected cancer cases. These guidelines provide GPs with details of symptoms that should prompt them to send a patient for further tests.

Dr Richard Neal, lead researcher based at the North Wales Centre for Primary Care Research, Bangor University, said: “We found that diagnostic intervals can and do change over time. The reduction between 2001-2 and 2007-8 may in part be due to the roll out of the 2005 NICE referral guidance for suspected cancer. This gives clear guidance on which symptoms should prompt a doctor to refer a patient for further investigation. But there is considerable variation between cancers, with diagnostic intervals highest in those cancers which are more difficult to diagnose.

“Diagnostic intervals were longer for patients with harder to diagnose cancers and for those presenting with symptoms that did not qualify for an urgent referral. But diagnostic intervals remain long in most cancers, with considerable potential for further reduction. In particular, the diagnostic intervals for the 10 per cent of patients who are diagnosed most slowly remain very long for most cancers. And we do not fully know the effect of the reduction of diagnostic intervals on improvements in stage at diagnosis and long term survival.”

Sara Hiom, Cancer Research UK’s director of information, said: “It’s very encouraging to see that patients are, on average, being diagnosed more quickly for some cancers, offering a better chance of successful outcome. It’s clearly vital for GPs to have access to good quality information to make the best decisions for their patients. There is still room for considerable improvement though, and reducing the time to diagnose and treat is a critical part of improving outcomes for people with cancer.”

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Study suggests oesophageal cancer 'less common than previously thought' in people with Barrett's oesophagus

Thursday 13 October 2011

In the largest study of its kind, Danish researchers have found that the rates of oesophageal cancer among people with Barrett's oesophagus - a common condition that predisposes to the disease - could be up to four times lower than previous estimates.

The results are in line with another recent study from Northern Ireland, which used a different method. If the new figures are confirmed, it could have implications for the way people with Barrett's oesophagus are monitored in future.

However a UK clinician said that the way the study had been designed could mean its result was an underestimate, and that that the matter was not yet settled.

Barrett's oesophagus is common, affecting around 2 per cent of the UK population. Currently, people with the conditions are offered regular check-ups using an endoscope; however, this is uncomfortable and is not without risk.

Oesophageal cancer affects nearly 8,000 people in the UK each year, and is often diagnosed late. Consequently, the outlook is often poor. The number of people with the disease has been increasing dramatically in recent years.

Although Barrett's oesophagus is one of the strongest risk factors for the disease, only about 5 per cent of patients with oesophageal cancer have previously been diagnosed with Barrett's.

Writing in the New England Journal of Medicine, researchers from the University of Aarhus went back through tissue samples collected at all Danish hospitals between 1992 and 2004.

They identified 11,028 samples from people who were diagnosed with Barrett's oesophagus, and followed up their medical records for an average of 5.2 years, to look for linked cases of oesophageal cancer.

They found 197 cases of oesophageal cancer in total, 131 of which occurred in the first year after the sample was collected, and calculated that the 'absolute annual risk' - the rate at which people with Barrett's oesophagus subsequently developed oesophageal cancer, was 0.12 per cent - far lower than the previous best estimate of 0.5 per cent.

They also calculated that people with Barrett's were 11 times more likely than the general population to develop oesophageal cancer, lower than previous estimates of between 30 and 40 times.

The authors argue that their results, together with other recent analyses of the cost-effectiveness of routine endoscopy and its effect on quality of life, mean that routine screening may not be in patients's best interest, unless abnormal pre-cancerous cells - called dysplasia - are detected.

They wrote, "the results of our study suggest that the risk of [oesophageal cancer] among patients with Barrett's esophagus is so minor that in the absence of dysplasia, routine surveillance of such patients is of doubtful value."

An endoscopy is estimated to cost the NHS around £400.

Dr Rebecca Fitzgerald, a Cambridge-based oesophageal cancer expert said the result, while potentially an underestimate, supported the need for better methods to monitor patients with Barrett's oesophagus.

"This is the largest study of its kind to look at rates of oesophageal cancer among people with Barrett's oesophagus, and its findings are welcome. However, it doesn't give us a final answer. The researchers only used tissue samples to define who did or didn't have Barrett's oesophagus, rather than looking at both tissue samples and endoscopy results. As a result they are likely to have overestimated the proportion of individuals with Barrett's oesophagus and hence it is likely that the cancer risk is an underestimate.

She also pointed out that oesophageal cancer is less of a problem in northern continental Europe than in the UK. Therefore future research will need to establish whether these rates are applicable to other populations.

"Nevertheless, this is a very large, long-term study, and confirms that we urgently need to look for a better method of monitoring people with Barrett's oesophagus rather than endoscopy and biopsy, which is expensive, time-consuming, uncomfortable and not particularly good at predicting which patients are at risk for cancer. Oesophageal cancer is usually detected late when it is difficult to treat. We need to do all we can to spot this disease earlier if we're to make a dent in its survival rates, which have been static for many years."

Dr Fitzgerald is currently trialling a new method of monitoring people with Barrett's oesophagus which, rather than using an endoscope, relies on a 'sponge-on-a-string' that collects cells from the oesophagus. She said the method promises to be cheaper, less invasive and safer.

"It will also involve testing for molecular markers within the cells, rather than relying on looking at them down a microscope, so we hope it will be more accurate at predicting cancer risk too," she added.

Cancer Research UK is funding the trial, which is led from in Cambridge but being carried out at several centres around the UK.

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Gene mutations linked to diseases of the oesophagus

Tuesday 26 July 2011

US scientists have linked mutations in three genes with an increased risk of Barrett's oesophagus and oesophageal cancer, according to preliminary research published in the Journal of the American Medical Association (JAMA).

Barrett's oesophagus happens when abnormal cells start to develop on the inner lining of the foodpipe. It is usually diagnosed in people who have a long history of burning indigestion - a sign of acid reflux. Around 1 to 2 in every 100 people with Barrett's oesophagus will go on to develop oesophageal cancer.

Experts at the Cleveland Clinic used genome-scanning technologies to look for common genetic markers associated with cancer. They found that 13 of 116 people (11 per cent) with a type of oesophageal cancer called an adenocarcinoma or with Barrett's oesophagus had mutations in the genes MSR1, ASCC1 or CTHRC1.

The most frequently mutated gene was MSR1 (in approximately 7 per cent of cases), followed by ASCCl and CTHRC1.

The researchers, lead by Dr Charis Eng, wrote: "Finding predisposition genes may improve premorbid risk assessment, genetic counselling, and management."

They also stated that a larger study will be needed before the genes can be used in risk assessment or diagnosis.

Dr Rebecca Fitzgerald, a Cancer Research UK oesophageal cancer expert, welcomed the new insights into what is the first genome-wide study in oesophageal adenocarcinomas. But she said work is needed to confirm the findings.

"By analysing cases of Barrett's oesophagus and oesophageal cancer together, rather than separately, the researchers have effectively treated them as the same disease. However, this assumes that the same genetic faults drive both diseases and we don't know if this is true. Also, the scientists used an unorthodox study design to make up for the fact that this is a relatively small study which means it is less powerful than larger studies.

"Despite these limitations, the three genes they've pinpointed warrant some serious further investigation. It will be very interesting to see if ongoing larger genome-wide association studies in Europe and the US confirm this early work," she said.

Copyright Press Association 2011

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'Sponge on a string' trial launched to try and prevent deadly oesophageal cancer

Monday 25 July 2011

Cancer Research UK Press Release

Cancer Research UK has launched a large multi-centre trial to test a new device for detecting Barrett’s oesophagus – a condition that puts sufferers at increased risk of developing cancer of the oesophagus, one of the most deadly cancers.

In the last thirty years oesophageal cancer rates have risen dramatically in the UK compared with many other Western countries, particularly for a certain type called adenocarcinoma, which is linked to Barrett’s oesophagus.

The trial will examine whether a promising new test called ‘cytosponge’ could provide an improved method of identifying patients with Barrett’s oesophagus, so they can be offered treatment to reduce their risk of oesophageal cancer.

The test involves patients swallowing a small capsule with a string attached, which dissolves in the stomach and expands to form a 3cm sponge.

The sponge is gently drawn back out using the string, removing a small sample of the cells lining the oesophagus as it passes, which can be tested in the lab for early signs of cancer.

Each test should cost just £25, compared with £400 for a traditional endoscopy, and the procedure is far less invasive.

Chief Investigator Dr Rebecca Fitzgerald, who led the Cambridge-based team that developed the cytosponge test, said: “If this trial is successful it will provide a cheap, safe and highly effective method of identifying people with Barrett’s oesophagus, so they can take steps to reduce their risk of developing cancer.

“This would open the doors for a national screening programme, much like those offered for breast, cervical and bowel cancers, to help prevent oesophageal cancer among the one to two people in every 100 with Barrett’s oesophagus who go on to develop the disease.”

Oesophageal cancer is the sixth most common cause of death from cancer in the UK, with around 7,500 people dying from the disease each year. It is often diagnosed at a late stage, making it difficult to treat, and this largely accounts for the poor survival rates.

Persistent heartburn or indigestion, caused by stomach acid coming back up the gullet, is a major risk factor for cancer of the oesophagus. Over time this can cause the cells lining the lower oesophagus to start to resemble those found in the small and large intestines, a condition known as Barrett’s oesophagus.

But if the condition can be diagnosed before cancer develops, patients can be offered closer monitoring and treatment to help remove abnormal cells.

At present the condition can only be detected by ‘endoscopy’ – a relatively expensive procedure which involves putting a camera down the throat to collect a sample of the cells the lining the oesophagus for analysis under the microscope.

Most patients with heartburn symptoms take medication without ever having an endoscopy, meaning cases of Barrett’s oesophagus often go undiagnosed.

Dudley Hedge, 71, from Cambridge, has been involved with the cytosponge trial. He said: “It is important to get a diagnosis quickly and I was happy to be on the trial. Having the cytosponge was a relatively straightforward procedure and I would definitely encourage others to take part.”

Earlier pilot studies, funded by the Medical Research Council, found that patients significantly preferred cytosponge compared to endoscopy. This latest study will look more closely at the accuracy of the test and identify new biomarkers for diagnosing the different grades of Barrett’s oesophagus more reliably.

Kate Law, director of clinical trials at Cancer Research UK, said: “Oesophageal cancer is one of the most difficult cancers to detect and treat, with only eight per cent of people with the disease surviving over five years. Hopefully this trial will provide a simple means of screening people for Barrett’s oesophagus on a much larger scale, so those at high risk can be offered closer monitoring and measures to help prevent them developing this devastating form of cancer.”

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Projects launched to crack the cancer code

Wednesday 13 July 2011

Cancer Research UK Press Release

CANCER RESEARCH UK today launched two pioneering projects to identify the key genetic faults that are driving oesophageal and prostate cancers, which will transform our understanding of the diseases and pave the way to better and more targeted treatments.

Part of the International Cancer Genome Consortium (ICGC)1, the projects will scan all the genes in 500 oesophageal and 500 prostate cancers, looking for each genetic mistake. Armed with this ‘blueprint for cancer’ the researchers will be able to pick out and target the genes that are causing cancer with new treatments.

The projects will be supported by two new fundraising initiatives. The prostate cancer arm will be supported by the fundraising efforts of the Dallaglio Foundation which is raising £2.5 million for the project, while the oesophageal ICGC project is one of the initiatives being supported by Cancer Research UK’s new Catalyst Club, which is raising £4.5m.

Over 17,000 people die each year from the two diseases in the UK, but very little is known about how they develop and why patients respond differently to treatment.

In the UK, The Institute of Cancer Research (ICR) and The Royal Marsden NHS Foundation Trust will lead the prostate cancer ICGC project, while the University of Cambridge will lead the oesophageal cancer ICGC project.

• Click for a larger version

Dr Rebecca Fitzgerald, who will lead the Cancer Research UK oesophageal cancer ICGC project in Cambridge, said: “The number of people diagnosed with oesophageal cancer is increasing rapidly in the UK, and only eight per cent of patients will survive at least five years. We urgently need to know more about the underlying causes of the disease and what determines whether a patient will respond to a treatment.”

At its core cancer is a disease caused by damaged DNA, and over time these faults make cells grow out of control and cause cancer. But it’s these same faults that researchers can use to learn about its weaknesses to find those that can be exploited with new treatments.

Dr Fitzgerald added: “Armed with the knowledge of which genes are driving the disease we will be able to group patients based on their genetic makeup and determine those who will benefit most from certain treatments, helping to save more lives.”

The DNA from each of the samples will be sequenced – like reading and collecting all the letters in a book. These are then compared to find the mistakes that are commonly found in cancers providing researchers with knowledge of the faults that are ‘driving’ the cancer. These could then be targeted with new personalised medicines tailored to the patient’s genetic makeup.

This ambitious project is now possible thanks to the latest advances in technology made available through an exclusive agreement with Illumina. Today’s genetic sequencing machines are up to a million times faster than those used for the Human Genome Project ten years ago, enabling the scientists involved in ICGC to decode entire cancer genomes quickly and relatively cheaply.

Professor Ros Eeles from the Institute of Cancer Research and The Royal Marsden, who co-leads the prostate cancer ICGC study with Professor Colin Cooper from the ICR and Professors David Neal and Douglas Easton from The University of Cambridge, said: “One of the major challenges in treating prostate cancer is determining who needs aggressive treatment – some are slow growing and will never need treatment whilst others will develop quickly.

“By knowing the genetic differences we may be able to identify which men are at higher risk, so we can target treatment to those patients and potentially save thousands from unnecessary therapy. The second challenge is that the more aggressive prostate cancers can become resistant to our current treatments. Knowing the genetic make-up of such prostate cancers will help us take a targeted approach to developing new treatments for these cancers that would otherwise kill the patient.”

Harpal Kumar, Cancer Research UK’s chief executive, said: “We’re delighted to be playing a leading role in the biggest cancer research collaboration in the world. More than 40,000 people every year in the UK are diagnosed with prostate and oesophageal cancers and the incidence of both is increasing. But this is an incredibly exciting time in understanding the link between different genes and cancer. Armed with knowledge of which mistakes in genes are driving which cancers, doctors and scientists will be able to maximise the chances of cure for each patient by picking the best treatments and by developing new and more targeted treatments for people with oesophageal and prostate cancers in the future.

“Thanks to the generosity and support of our donors we’re able to carry out this life-saving work which we hope will ultimately increase survival from cancer.”

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Current UK system of Barrett's oesophagus monitoring 'not cost effective'

Monday 20 June 2011

The current system to diagnose and monitor Barrett's oesophagus in the UK may not be as effective as it could be. This is because people diagnosed using current criteria could be less likely to go on to develop oesophageal cancer than previously thought, according to a new study at Queens University Belfast.

Barrett's oesophagus occurs when abnormal cells start to develop on the inner lining of the foodpipe. Around 1 to 2 in every 100 people with Barrett's oesophagus will go on to develop oesophageal cancer.

Barrett's oesophagus is usually diagnosed in people who have a long history of burning indigestion - a sign of acid reflux. It is diagnosed by looking for the abnormal cells in the foodpipe, but there currently isn't worldwide agreement as to which changes count as 'risky' Barrett's oesophagus, and which should be excluded because they are unlikely to develop into cancer.

People who are diagnosed with Barrett's oesophagus are usually seen regularly by a doctor and have repeated endoscopies to spot the early signs of cancer. Many countries, including the USA, restrict the definition of Barrett's oesophagus that needs such monitoring to those cases containing abnormalities known as 'specialised intestinal metaplasia' (SIM). In the UK, people can be offered monitoring even if they do not have SIM, but have other abnormalities.

Previous studies have suggested that between 0.58 and 3 per cent of cases of Barrett’s oesophagus per year will progress to cancer (or to precancerous changes).

But the latest study, which followed 8,522 patients with Barrett's oesophagus in Northern Ireland for an average of seven years, found this combined rate to be lower, at 0.22 per cent.

In this new study, cases with and without SIM were included in the analysis, reflecting the UK definition of Barrett's oesophagus. However, when the researchers estimated the cancer risk for people with SIM only, the rate was only slightly lower than prior estimates - 0.38 per year.

This could mean that people without SIM are at relatively low risk of developing oesophageal cancer, and it could be more cost-effective to restrict monitoring to people with SIM only.

Writing in the Journal of the National Cancer Institute, the study authors suggested that the findings may have implications for the routine monitoring of people with Barrett's oesophagus.

They claimed: "Current recommendations for surveillance are based on higher estimates of cancer risk among patients with [Barrett's oesophagus] than were seen in this study and, therefore, they may not be justified."

In an accompanying editorial, Dr Douglas Corley, from Kaiser Permanente's research division in California, said that the study provides one of the first estimates of cancer incidence among a large multicentre population of people with Barrett's oesophagus.

He added that further research is needed to determine whether monitoring or treatment of patients with Barrett's oesophagus actually leads to a decrease in deaths from oesophageal cancer.

Dr Rebecca Fitzgerald, a Cancer Research UK oesophageal cancer expert, commented: "We need to be very cautious when comparing this overall rate of 0.22 per cent per year with previous publications, as the definitions for Barrett's oesophagus vary around the world. These variations can dramatically affect estimates.

"Nevertheless, this is a very informative study. One of the main challenges in the management of Barrett's oesophagus is separating people who will benefit most from surveillance from those who don't need it because they are less likely to develop oesophageal cancer.

"This research suggests that restricting surveillance to those patients with Barrett's oesophagus defined by the presence of so-called specialised intestinal metaplasia would bring the UK more in line with other international guidelines and would improve cost-effectiveness."

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Team at Cambridge MRC Cancer Cell Unit wins innovation prize

Monday 6 June 2011

A team at the Medical Research Council (MRC) Cancer Cell Unit in Cambridge have won one of the Department of Health's first Innovation Challenge Prizes for their work on a new test for Barrett's oesophagus.

Barrett's oesophagus is a condition that sometimes acts as a precursor to oesophageal cancer.

The Cambridge team have developed a new pill on a fine cord which, once swallowed, dissolves into a sponge.

The sponge can then be drawn back up through the throat, collecting cells which can be tested for pre-cancerous changes.

Each test should cost just £25, compared with £400 for a traditional endoscopy, and the procedure is far less invasive.

In addition, by helping to detect cancerous cells at an early stage, the so-called 'Cytosponge' could save millions of pounds by preventing patients from needing chemotherapy.

The award was announced on June 3rd by health minister Lord Howe, who said he was "impressed" by the team's work.

He said: "The Cytosponge is a much simpler treatment for patients and the savings made by this innovation will benefit patients across the region.

"We need to support innovation in the NHS, not suffocate it. In every hospital, GP practice and clinic we need to ensure innovation can flourish by supporting clinicians to develop new ways of thinking and delivering care to benefit patients and the NHS."

Dr Rebecca Fitzgerald, who leads the MRC Cancer Cell Unit, explained that the test could be used in the same way as cervical or bowel cancer screening, to detect cancers at an early stage when endoscopy can be used rather than surgery.

She added: "The prize money will enable us to develop this test further to diagnose the other common type of oesophagus cancer and to collect further data to show how effective the Cytosponge is."

Dr Fiona Reddington, Cancer Research UK's head of population research funding, said: "We're delighted to see Dr Fitzgerald's work recognised in this way.

"Detecting cancer earlier has the potential to save thousands of lives a year, and we're proud to be supporting the future development of this test for oesophageal cancer, which is notoriously difficult to treat when diagnosed late."

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Cancer Research Technology and Affitech A/S sign exclusive antibody development deal

Wednesday 27 April 2011

Cancer Research UK Press Release

Cancer Research Technology, the commercial arm of Cancer Research UK, has signed a license agreement to grant antibody medicines company, Affitech A/S, (NASDAQ OMX: AFFI), exclusive rights to a CRT patent application and relevant know how to develop and use therapeutic antibodies that recognise and block the function of CCR4, a protein found on certain tumours - including early and late stage cervical cancer and oesophageal cancer.

Under the license, Affitech will continue to develop its existing anti-CCR4 antibody program AT008, which is currently in pre-clinical development, and will be able to use any candidate identified in that program in the future for the licensed diagnostic and therapeutic applications.

Cancer Research UK-funded scientist, Professor Frances Balkwill, based at Queen Mary University of London was first to discover that CCR4 is present on cancer cells in various solid tumours, and was a promising target for new drugs to treat a range of cancer types. Cancer Research Technology holds a patent application based on this research and Cancer Research UK has funded further research to prove that CCR4 is a valuable therapeutic target.

Coinciding with the license deal, Cancer Research Technology, Affitech and Queen Mary University of London have also signed a collaborative agreement to provide pre-clinical validation for Affitech’s AT008 programme – with the aim of proving its potential as a new drug programme to treat cancer - using techniques developed in Professor Balkwill’s laboratory. This programme will be fully funded by Affitech.

CCR4 is one of 18 known chemokine receptors - proteins which bind molecules called chemokines to trigger various cellular responses. Chemokine receptors are generally present on the surface of immune cells. But a few – now known to include CCR4 – are also found on the surface of tumour cells, while not present on healthy cells. One of the roles of chemokine receptors in tumor progression is thought to be to evade immune responses, increase the ability of cancer cells to move from the original tumour and to spread to other parts of the body.

Developing antibodies to interfere with CCR4-expressing cells, such as under the AT008 programme, could provide a new highly targeted treatment to block cancer growth and spread for a range of solid tumour types.

Dr Phil L’Huillier, Cancer Research Technology’s director of business development, said: “This important license deal combines Cancer Research UK’s world-class research expertise in the exciting area of chemokine research with the development of Affitech’s existing AT008 antibody programme. This opens new avenues of research and development for potential therapies which could increase survival for patients with a range of cancer types.”

Alexander Duncan, Affitech’s chief scientific officer, said: “We are delighted to have attracted the interest and participation of an outstanding investigator at the forefront of cancer research. Professor Balkwill is at the leading edge of understanding cancer biology and will be a huge asset to our anti-cancer programme.

“She is a world leader in understanding the role of immunology in cancer, particularly the chemokine system. We have embarked on an ambitious programme to understand potential mechanisms of action of the anti-CCR4 antibody, AT008, and its application in solid tumours.

“This agreement and research collaboration will extend our capabilities to advance our lead therapeutic program GPCR targeted AT008/CCR4 significantly.”

Under the license, Cancer Research Technology will receive an initial signature payment, as well as pre-clinical and clinical development milestone payments, and royalties on sales of CCR4 antibodies developed by Affitech.

Cancer Research Technology retains rights to the therapeutic use in solid tumours of antibodies against CCL17 and CCL22 – the chemokine molecules which bind to CCR4 receptor to trigger cellular responses.

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Booze causes at least 13,000 cancers a year in the UK

Friday 8 April 2011

Cancer Research UK Press Release

Alcohol causes at least 13,000 cases of cancer a year in the UK, according to a new report published in the British Medical Journal today (Friday).

Cancer Research UK-funded researchers also show that alcohol has the biggest effect on cancers of the mouth, food-pipe, voice-box and pharynx. More than 6,000 of these cancers were caused by drinking.

Alcohol also causes more than 3,000 colorectal cancers and about 2,500 breast cancers per year.

Study leaders looked at how different levels of drinking affect the risk of cancer, and combined them with figures on how much British people drink.

The research* is part of ongoing work by the European Prospective Investigation of Cancer (EPIC) – a Cancer Research UK co-funded study and one of the largest studies into the links between diet and cancer.

Alcohol is known to increase the risk of several types of the disease including mouth, throat, bowel, liver and breast cancers. When alcohol is broken down by the body it produces a chemical which can damage DNA, increasing the chance of developing cancer.

But the cancer risk increases with every drink, so even moderate amounts of alcohol - such as a small drink each day - increases the risk of these cancers.

Naomi Allen, a Cancer Research UK epidemiologist based at Oxford University, who works on the EPIC study, said: “This research supports existing evidence that alcohol causes cancer and that the risk increases even with drinking moderate amounts.

“The results from this study reflect the impact of people’s drinking habits about ten years ago. People are drinking even more now than then and this could lead to more people developing cancer because of alcohol in the future.”

Government figures from the Office of National Statistics, published last week, showed that an increasing number of women are drinking high amounts of alcohol, well over the recommended limit for a week.

This is of concern as previous evidence shows that drinking one small drink a day regularly can significantly increase the risk of breast cancer, the most common cancer in women in the UK.

Sara Hiom, director of health information at Cancer Research UK, said: “Many people just don’t know that drinking alcohol can increase their cancer risk.

“In the last ten years, mouth cancer has become much more common and one reason for this could be because of higher levels of drinking – as this study reflects.

“Along with being a non-smoker and keeping a healthy bodyweight, cutting back on alcohol is one of the most important ways of lowering your cancer risk.

“Keeping alcohol intake to a maximum of one small drink a day for women and two small drinks per day for men can have a real impact.”

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Daily low-dose aspirin 'reduces death rates for several cancers'

Tuesday 7 December 2010

A new study in the Lancet medical journal adds to a growing body of evidence suggesting that a daily dose of aspirin can reduce the risk of dying from several types of cancer, with even low-dose aspirin appearing to be beneficial.

Scientists from the University of Oxford and the London School of Hygiene and Tropical Medicine have reviewed eight clinical trials involving more than 25,500 patients, all of which were designed to investigate the effect of long-term aspirin on the heart and blood vessels.

When data from these randomised trials were combined, the results showed that taking aspirin was associated with a 21 per cent lower risk of dying from cancer.

Overall, death rates for all cancers fell by 34 per cent after five years of aspirin use, and those for cancers of the digestive system dropped by 54 per cent.

As well as looking at the five-year risk of dying from cancer, the researchers were able to analyse data for 20 years after the trials had ended.

During this period, there were 1,634 deaths from cancer, but the researchers found that patients who had previously taken aspirin had a 20 per cent lower risk of dying from solid cancers than those who had not, and a 35 per cent lower risk of dying from cancers of the digestive system.

The new study is the latest to show that the drug can help to prevent deaths from a range of common cancers. It follows a previous paper in the October issue of the Lancet showing that long-term low-dose aspirin reduced death rates from bowel cancer by more than a third.

The benefits were strongest for bowel, oesophageal and stomach cancers. Aspirin could also help to prevent deaths from pancreatic, lung and brain cancers.

The researchers believe that patients may gain the most benefit by starting to take aspirin in their late 40s or 50s, when the risk of developing many cancers begins to rise.

They also say that such an intervention would be cost-effective, even if patients have to be given other medicines alongside aspirin to reduce the risk of bleeding complications.

Professor Peter Rothwell, from the University of Oxford and the city's John Radcliffe Hospital, said: "These results do not mean that all adults should immediately start taking aspirin, but they do demonstrate major new benefits that have not previously been factored into guideline recommendations.

"Previous guidelines have rightly cautioned that in healthy middle-aged people, the small risk of bleeding on aspirin partly offsets the benefit from prevention of strokes and heart attacks, but the reductions in deaths due to several common cancers will now alter this balance for many people."

Professor Rothwell emphasised that more research is needed, including studies to determine the effects of aspirin on cancer incidence and breast cancer, and longer follow-up studies.

He concluded: "Perhaps the most important finding for the longer term is the proof of principle that cancers can be prevented by simple compounds like aspirin and that 'chemoprevention' is therefore a realistic goal for future research with other compounds."

Ed Yong, head of health information and evidence at Cancer Research UK, said: "These promising results build on a large body of evidence suggesting that aspirin could reduce the risk of developing or dying from many different types of cancer. While earlier studies suggested that you only get benefits from taking high doses of aspirin, this new study tells us that even small doses reduce the risk of dying from cancer, provided it is taken for at least five years.

"In addition to the effect on cancer death, aspirin can affect our health in other ways, such as reducing the risk of stroke but increasing the chances of bleeding from the gut. We await trial results expected next year to learn more about these different effects."

He added: "We encourage anyone interested in taking aspirin on a regular basis to talk to their GP first."

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Less booze not more veg is key to cut cancer risk

Wednesday 1 December 2010

Cancer Research UK Press Release

People should be warned that cancer is linked to obesity and alcohol, rather than urged to eat more fruit and vegetables to protect against the disease.

A review, published today (Wednesday) in the British Journal of Cancer, which looks at decade of evidence on the links between fruit and vegetables and the development of cancer, concludes that the evidence is still not convincing.

The only diet-related factors that definitely affect cancer risk are obesity and alcohol. But tobacco is still the single biggest cause of cancer.

Professor Tim Key, an epidemiologist from Oxford University, says that while there are undoubted benefits in eating fruit and vegetables there is little hard evidence that they protect against cancer. 

But the evidence is indisputable that cancer is strongly linked to being overweight or obese, and drinking more alcohol than the recommended daily limits.

He said: “Fruit and vegetables are an important part of a healthy diet and a good source of nutrients. But so far the data does not prove that eating increased amounts of fruit and vegetables offers much protection against cancer.

“But there’s strong scientific evidence to show that, after smoking, being overweight and alcohol are two of the biggest cancer risks.”

Overweight people produce higher levels of certain hormones than people of a healthy weight and this can contribute to an increased risk of breast cancer.

Being overweight can increase your risk of other common cancers like bowel and also hard-to-treat forms of the disease like pancreatic, oesophageal and kidney cancer.

When alcohol is broken down by the body it produces a chemical which can damage cells increasing the risk of mouth, throat, breast, bowel and liver cancers.

In the UK 15,000 cases of cancer are caused by alcohol. And 19,000 cases of cancer are caused by being overweight or obese.

Sara Hiom, director of health information at Cancer Research UK, said: “Too few people know about the significant cancer risks associated with obesity and drinking too much alcohol. While stopping smoking remains the best way to cut your chances of developing cancer, the importance of keeping a healthy weight and cutting down on alcohol shouldn’t be overlooked.

“Keeping alcohol intake to a maximum of one small drink a day for women and two small drinks per day for men and keeping weight within the healthy limits can have an enormous impact.”

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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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Long-term use of bone-strengthening drugs may increase oesophageal cancer risk

Friday 3 September 2010

People who take bone-strengthening pills called bisphosphonates over a long period of time could be more likely to develop cancer of the oesophagus (gullet), new research suggests.

But Cancer Research UK said that any risk of oesophageal cancer is still small and should be balanced alongside the benefits of the drugs.

Scientists at the University of Oxford's Cancer Epidemiology Unit and the Medicines and Healthcare products Regulatory Agency (MHRA) analysed anonymous data from the UK General Practice Research Database.

They looked at information on 2,954 men and women with oesophageal cancer, 2,018 with stomach cancer and 10,641 with bowel cancer, each of whom was compared with five cancer-free controls.

Typically, oesophageal cancer develops in one per 1,000 people at age 60-79 over five years. Based on their findings, the authors estimate that in people who had received ten or more prescriptions for oral bisphosphonates, or had been taking the drug for about five years, this could increase to two cases per 1,000 people.

The researchers found no link between bisphosphonates and stomach or bowel cancer.

Dr Jane Green, lead author of the study in the British Medical Journal, said that oesophageal cancer is uncommon and that, even if the results are confirmed by further research, "few people taking bisphosphonates are likely to develop oesophageal cancer as a result of taking these drugs".

"Our findings are part of a wider picture," she continued. "Bisphosphonates are being increasingly prescribed to prevent fractures, and what is lacking is reliable information on the benefits and risks of their use in the long term."

Dr Laura Bell, science information officer at Cancer Research UK, commented: "This is an important study that will help doctors understand more about the risks and benefits of oral bisphosphonates but it's important to stress that, even if people take oral bisphosphonates for a long time, the risk of developing oesophageal cancer is still small. Anyone who is taking these drugs and is worried about their risk of cancer should talk to their doctor.

"Earlier this week Cancer Research UK reported that oesophageal cancer rates in men had increased by 50 per cent in the last 25 years, with obesity and increasing age believed to be major risk factors. Each year around 8,000 people are diagnosed with the disease, of whom 5,226 are men. Oesophageal cancer is the ninth most common cancer but affects very few people under 40."

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Oesophageal cancer rates in men up 50 per cent in a generation

Saturday 28 August 2010

Cancer Research UK Press Release

Oesophageal cancer rates in men have risen by 50 per cent over the last 25 years, according to new figures published by Cancer Research UK today.

In 1983 around 2,600 men were diagnosed with oesophageal cancer – cancer of the food pipe – and according to the latest figures around 5,100 men were diagnosed with the disease.
The most dramatic rise was among men in their 50s, as rates increased by 67 per cent over the same period.

Rates in women also rose, but only by eight per cent, from 5.1 to 5.5 per 100,000 people.

Professor Janusz Jankowski, a Cancer Research UK funded clinician at the Barts & The London School of Medicine & Dentistry, said: “We don’t know exactly why we’re seeing this steep rise in oesophageal cancer rates, and why it’s having such a dramatic effect on men.

“But we think the obesity epidemic may be a big reason behind the increase. We know that being overweight significantly increases the risk of adenocarcinoma – the main type of oesophageal cancer that’s on the up. Our changing diets are also likely to be influencing the rise with people eating less fruit and vegetables.

“To investigate why men are more at risk of developing this type of oesophageal cancer, we’re studying the genetic changes that are behind this type of the disease.”

In 1983, 9.6 in every 100,000 men were diagnosed with oesophageal cancer but now 14.4 in every 100,000 men are diagnosed with the disease – an increase of 50 per cent.

Fewer people are infected with a bacterium called H. pylori, which reduces the risk of oesophageal cancer, may also be a factor. But the bacterium is also known to increase the risk of stomach cancer which has been declining steadily over a number of years.

Oesophageal cancer is the ninth most common cancer in the UK. In 2007, around 8,000 people were diagnosed with oesophageal cancer. The risk of developing the disease increases with age and affects very few people under 40.

Oesophageal cancer is one of the most difficult cancers to detect and treat, with only eight per cent of people with the disease surviving at least five years.

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “These new figures are particularly concerning as oesophageal cancer is a very difficult cancer to treat. Oesophageal cancer rates have risen dramatically in the UK compared with many other Western countries so we need to determine the underlying causes. To combat the poor survival rate for oesophageal cancer, Cancer Research UK is funding research to find new ways to identify the disease earlier and improve treatment so that more people beat the disease.”

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Drinking culture blamed for 'appalling' rise in alcohol-related cancers

Tuesday 8 December 2009

There has been a significant increase in cancers which are linked to alcohol over the past ten years, according to figures requested by the Liberal Democrats.

Since 1997, there has been a 43 per cent increase in liver cancer; a 53 per cent rise in mouth cancer; and a 20 per cent increase in cancer of the oesophagus (food pipe), the figures released in response to a Parliamentary Question reveal.

These and a number of other cancers are known to be more common in people who drink alcohol.

Don Foster, the Liberal Democrats' shadow culture, media and sport secretary, described the impact of alcohol as "terrible" and urged ministers not to turn a blind eye to the problem.

"Excessive drinking has been on the rise for years and these shocking figures show how dramatically the health problems of booze Britain are escalating," he claimed.

"The government's failure to cut alcohol consumption now is storing up problems for later, with more people set to develop cancers in the years to come."

The culture spokesman also warned that alcohol-related health problems will continue to become more common unless steps are taken to tackle "reckless" retailers and "irresponsible" drink promotions.

Dr Jodie Moffat, Cancer Research UK's health information manager, said: "We've known for many years that drinking alcohol increases the risk of several different types of cancer, including bowel and breast cancer."

Alcohol is converted into a chemical called acetaldehyde inside the body which may cause cancerous changes to cells, Dr Moffat explained.

"So cutting down on alcohol is an important thing people can do to reduce their cancer risk."

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IARC finds more cancers linked to tobacco and alcohol

Wednesday 4 November 2009

The International Agency for Research on Cancer (IARC) has updated its assessments of several cancer-causing substances and behaviours, which are published in the latest issue of the Lancet Oncology.

A group of 30 leading scientists met at IARC in October 2009 to discuss a number of substances that can cause cancer, including tobacco and alcohol, as well as areca nut and household coal smoke.

This assessment is published as part of the IARC monographs, a series which compiles the available information on all the cancer-causing substances that have been identified so far.

Bowel and ovarian cancers have now been added to the list of cancers caused by tobacco smoking, while recent studies also suggest a small positive association with breast cancer.

Research has also confirmed that parents smoking can cause childhood cancer, with children born to smokers facing a higher risk of a rare form of cancer called hepatoblastoma. There also appears to be an increased risk of leukaemia in children whose fathers smoked before their conception.

Turning to secondhand smoke, the IARC confirms that it can cause lung cancer and notes that there is some evidence for a link between cancers of the larynx and pharynx.

Smokeless tobacco, meanwhile, has now been shown to cause cancers of the oesophagus, as well as mouth and pancreatic cancers.

IARC experts also looked at the cancer-causing potential of betel quid, which is commonly chewed in India and south-east Asia and usually consists of areca nut, betel leaf, catechu, slaked lime, and sometimes tobacco. There is now sufficient evidence that chewing betel quid can cause oesophageal cancer, and limited evidence for an association with liver cancer. It had already been shown that chewing betel quid can cause mouth cancer.

The report finds some evidence that alcohol may cause pancreatic cancer. The existing list of cancers linked to drinking includes cancers of the mouth, pharynx, larynx, oesophagus, bowel, liver and breast. And there's now enough evidence to say that acetaldehyde, a chemical that is produced when alcohol is broken down in the body, can cause cancer. This strengthens the evidence on how alcohol and cancer are linked.

The report also notes that the risk of alcohol-related cancers is particularly high among east Asian populations, many of whom are unable to process it properly because of genetic differences. This leaves them at an increased risk of cancers of the oesophagus, head and neck.

The IARC also looked at the effect of indoor emissions from coal burning on cancer risk. It concluded that in some parts of the world - where coal is regularly used for heating and cooking, often in poorly-ventilated spaces - women and young children who spend more time indoors are particularly at risk.

Jean King, Cancer Research UK's director of tobacco control, said: "Smoking is the single greatest avoidable risk factor for cancer, with the list of cancers caused by tobacco starting at the mouth, moving through and affecting many other parts of the body, including the stomach, pancreas and bladder. This review adds bowel cancer along with a type of ovarian cancer to that list.

"This report also shows just how important it is for parents and expectant parents to quit. Children of parents who smoke may be at greater risk of leukaemia and a type of liver cancer. We hope that more and more parents will ensure that their homes and cars are smokefree.

"Tobacco is a deadly product, and the UK is moving in the right direction of trying to minimise the devastating impact it can have. Ongoing reviews like this highlight the need for other countries to move towards protecting young people and supporting those smokers who are ready to quit."

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Curry compounds kill oesophageal cancer cells in lab

Wednesday 28 October 2009

Cancer Research UK Press Release

MOLECULES found in curry ingredients have been shown to kill oesophageal cancer cells in the laboratory, reveals research published in the British Journal of Cancer today (Wednesday).

Scientists based at the Cork Cancer Research Centre treated oesophageal cancer cells with curcumin – a chemical found in the curry spice tumeric.

They found that curcumin started to kill cancer cells within 24 hours. The cells also began to digest themselves.

The results additionally showed that curcumin kills cells by triggering lethal cell death signals.

Dr Sharon McKenna, lead study author, based at the Cork Cancer Research Centre, University College Cork, said:

“These exciting results suggest scientists could develop curcumin as a potential anti-cancer drug to treat oesophageal cancer.

“Scientists have known for a long time that natural compounds have the potential to treat faulty cells that have become cancerous and we suspected that curcumin might have therapeutic value. Dr Geraldine O’Sullivan-Coyne, a medical researcher in our lab had been looking for new ways of killing resistant oesophageal cancer cells. She tested curcumin on resistant cells and found that they started to die using an unexpected system of cell messages.”

Normally, faulty cells die by committing programmed suicide – or apoptosis – which occurs when proteins called caspases are ‘switched on’ in cells. But these cells showed no evidence of suicide and the addition of a molecule that inhibits caspases and stops this ‘switch being flicked’, made no difference to the number of cells which died. This suggested that curcumin attacked the cancer cells using an alternative cell signalling system.

Each year around 7,800 people are diagnosed with oesophageal cancer in the UK - around 160 of these are in Northern Ireland. Less than 20 per cent of people survive oesophageal cancer beyond five years. It is the sixth most common cause of cancer death and accounts for around five per cent of all UK cancer deaths.

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “This is interesting research which opens up the possibility that natural chemicals found in tumeric could be developed into new treatments for oesophageal cancer.

“Rates of oesophageal cancer rates have gone up by more than a half since the 70s and this is thought to be linked to rising rates of obesity, alcohol intake and reflux disease so finding ways to prevent this disease is important too.”

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New clinical study shows nutrition after cancer surgery improves patient recovery time and could save the NHS millions

Saturday 3 October 2009

Cancer Research UK Press Release

Cancer patients can recover faster from surgery - and potentially save the NHS millions - if they are given liquid food directly into the intestine, say researchers who are presenting at the National Cancer Research Institute Conference on Monday.

Patients with cancers of the oesophagus, stomach and pancreas have been traditionally fasted or are nil by mouth, for up to 10 days after gastrointestinal operations, as surgeons have long thought that nutrition after surgery may be detrimental to patients' recovery.

But a clinical trial funded by a grant from the Health Foundation, and led by Cardiff University and the University Hospital of Wales has found that if patients are give nutrition directly into the intestine - through a feeding tube - they recover around three days faster than if they were fasted and only hydrated with fluids through a drip*.

Patients also developed fewer major complications following their surgery.

The trial of 121 patients looked at whether nutrition straight after surgery had any effect on the speed of recovery compared to eating nothing.

The researchers now believe that if liquid food is given after all major abdominal and thoracic surgery it could save the NHS millions of pounds.

Dr Rachael Barlow, lead investigator on the trial at Cardiff University and the University Hospital of Wales, said: "In our trial we turned the traditional thinking to starve patients after major gastrointestinal surgery on its head and have found huge benefits. The striking find that nutrients straight after surgery meant patients recovered quicker and tended to have fewer complications has major implications for the NHS.

"Importantly patients who were given the nutrition were more likely to be healthier and have a better quality of life in the months after surgery. And may result in a saving of millions of pounds and could mean fewer bed shortages in hospitals.

"A day in an NHS general or surgical ward costs up to £400 and in an intensive care unit it can cost up to £1200 or more. In this economic climate of financial deficits, finding new ways of improving care is important for NHS managers.

"The next step is to find out if we can adopt the same practice in other types of surgery and we are hoping to run more clinical trials in this area."

Professor Sir Kenneth Calman, chair of the NCRI, said: "This result shows that a small change in follow up care after operations for oesophagus, stomach and pancreas cancer could benefit patients and have huge cost saving implications for the NHS. We look forward to seeing the results of further clinical trials to see if the same technique of food after surgery can be applied to patients who have had operations for other types of cancers."

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Number of Britons diagnosed with alcohol-related cancers exceeds Wimbledon's Centre Court

Wednesday 1 July 2009

Over 20,000 people are diagnosed with an alcohol-related cancer each year in the UK - more than enough to fill Wimbledon's Centre Court.

Professor Martin Wiseman, medical and scientific adviser at World Cancer Research Fund (WCRF), highlighted the high number of people who would probably not have developed cancer if they had not consumed alcohol.

He revealed that around 10,000 cases of breast cancer diagnoses each year can be attributed to alcohol consumption, along with many cancers of the bowel, liver, oesophagus (gullet), mouth, pharynx and larynx.

There is convincing scientific evidence that drinking alcohol increases a person's risk of cancer, particularly if they smoke as well.

However, a recent YouGov survey found that only 45 per cent of Britons are aware of the link.

Professor Wiseman said that the number of cases of alcohol-related cancer is of "real concern" and that people should drink "moderately, if at all".

"When we talk about numbers of cancer cases, it can be difficult to comprehend what this means. But by comparing it to what Centre Court looks like when it is full for a big match we hope to highlight how the stakes are," he said.

"It is also important to emphasise that this is not a question of all or nothing. If people find our recommendation on alcohol too hard to follow, they can still make a positive difference to their cancer risk by reducing the amount they drink."

Yinka Ebo, health information officer at Cancer Research UK, commented: "The link between alcohol and seven types of cancer has been firmly established for many years now and is based on a large number of scientific studies.

"Cutting down on alcohol is just one thing people can do to help protect themselves against cancer along with being a non-smoker, keeping a healthy body weight and being active."

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Alcohol flush gene could reveal oesophageal cancer risk

Wednesday 15 April 2009

People who lack an enzyme that causes their skin to flush when they drink alcohol may be more likely to develop oesophageal (gullet) cancer, even if they only drink moderately, a team of US and Japanese scientists have warned.

The deficiency, which affects the aldehyde dehydrogenase 2 (ALDH2) enzyme, is most frequent among people of east Asian descent.

ALDH2 plays an important role in the breakdown of alcohol, which the body initially converts into a chemical called acetaldehyde.

Acetaldehyde chemical is capable of damaging DNA and is usually broken down rapidly into a non-toxic chemical called acetate by the ALDH2 enzyme.

A small number of people inherit two copies of a 'faulty' variant of the ALDH2 gene - which makes the aldehyde dehydrogenase enzyme. They are unable to break down acetaldehyde effectively as the enzyme does not work properly. They have such severe symptoms after drinking alcohol - including facial flushing, nausea, and rapid heartbeat - that they are only able to consume very small amounts.

Other people, who inherit a single copy of the faulty gene variant, are often able to tolerate the unpleasant effects of acetaldehyde - but because they still break the chemical down more slowly than normal people, the chemical accumulates in their bodies.

Writing in the journal PLoS Medicine, scientists at the US National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Kurihama Alcohol Centre in Japan reviewed the evidence that suggested whether people with one copy of the faulty gene - who account for around eight per cent of the world's population - may be particularly at risk of oesophageal cancer because of the DNA-damaging effects of acetaldehyde.

They point to a series of epidemiological studies showing that people with one copy of the faulty gene are between six and ten times more likely to go on to have oesophageal cancer than those with 'normal' copies of the gene who drink a similar amount of alcohol.

Among people with one copy of the faulty gene, those who typically drank 33 alcoholic beverages per week were found to be 89 times more likely to develop oesophageal cancer than those who do not consume alcohol.

"It is very important for clinicians who treat patients of east Asian descent to be aware of the risk of oesophageal cancer from alcohol consumption in their patients who exhibit the alcohol flushing response, so they can counsel them about limiting their drinking," said Dr Kenneth Warren, acting director of the NIAAA, whose findings are published.

First author Dr Philip Brooks, from the NIAAA's Laboratory of Neurogenetics, noted that oesophageal cancer has a relatively poor survival rate compared with other cancers.

"We estimate that at least 540 million people have this alcohol-related increased risk for oesophageal cancer," he revealed.

"We hope that, by raising awareness of this important public health problem, affected individuals who drink will reduce their cancer risk by limiting their alcohol consumption."

Oliver Childs, senior science information officer at Cancer Research UK, said: "We know that drinking alcohol increases the risk of several different cancers, and that the more you cut down on your drinking, the more you reduce your cancer risk. This research helps us better understand how our environment and genes work in tandem to influence our risk of cancer."

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Iranian scientists find evidence of link between oesophageal cancer and 'extremely hot tea'

Wednesday 1 April 2009

Iranian researchers appear to have found a link between drinking extremely hot tea and a person's risk of cancer of the oesophagus (foodpipe).

However Cancer Research UK said the study only looked at a small number of people and didn't prove a cause-and-effect relationship.

The Iranian study, which is published on bmj.com, found that oesophageal cancer appeared to be more common amongst people who drank black tea at a temperature of 70 degrees Celsius or more.

The team of scientists studied the tea drinking habits of 300 people in northern Iran who had been diagnosed with oesophageal squamous cell carcinoma (OSCC), the most common form of the disease.

These participants were compared with a further 571 healthy volunteers from the same area.

Tea drinking is particularly widespread in the northern Iranian province of Golestan, while rates of smoking and alcohol consumption - both of which are well-known risk factors for OSCC - are low.

Golestan Province has one of the highest rates of OSCC in the world and the researchers theorised that this may be linked to the practice of regularly drinking tea at high temperatures.

All of the people involved in the study claimed to drink black tea on a regular basis, with a typical person consuming over one litre of tea per day.

Researchers found that people who consumed very hot tea (70 degrees Celsius or more) were eight times more likely to develop oesophageal cancer than those who consumed warm or lukewarm tea (65 degrees Celsius or less).

Meanwhile, those who consumed hot tea (65 to 69 degrees Celsius) faced a twofold risk of the disease compared with those who drank warm or lukewarm tea.

Drinking tea less than two minutes after pouring - ie when it is at its hottest - was found to be associated with a fivefold increased risk compared with drinking tea four or more minutes after pouring.

The researchers found no evidence of a link between the actual amount of tea consumed by a person and their risk of cancer.

However, writing in an accompanying editorial, David Whiteman from the Queensland Institute of Medical Research in Australia insists that tea-drinkers should not be alarmed, although he agreed that any hot foods or drinks should be allowed to cool a little before swallowing.

The average person in the UK has previously been shown to prefer their tea in the 56 to 60 degrees Celsius temperature range, which the Iranian study suggests poses little risk.

Dr Whiteman said that consumers should not be deterred from drinking tea and merely recommended avoiding scalding hot food and drink.

He wrote: "We should follow the advice of Mrs Beeton, who prescribes a five to ten-minute interval between making and pouring tea, by which time the tea will be sufficiently flavoursome and unlikely to cause thermal injury."

Oliver Childs, Cancer Research UK's senior science information officer, said: "Tea drinking is part of many cultures, and these results certainly don't point to tea itself being the problem. Although this study is small, it does provide some evidence that a regular habit of eating and drinking very hot foods and drinks could increase your risk of developing cancer of the oesophagus (food pipe). People in this region of northern Iran often drink very hot tea as part of their daily routine. We're a nation of tea lovers in the UK, but we don't tend to drink tea at such high temperatures and we usually add milk, which cools it down. "The most important risk factors for oesophageal cancer are smoking and drinking alcohol. So to reduce your risk give up smoking, limit alcohol and eat plenty of fruit and vegetables to help keep a healthy bodyweight."

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Stomach bacteria may prevent some oesophageal cancers

Tuesday 7 October 2008

US and Iranian scientists have found more evidence that some stomach bacteria may help to protect against the development of a form of oesophageal (gullet) cancer called adenocarcinoma.

The team carried out a review of 19 published studies investigating the link between the bacterium Helicobacter pylori, which lives in the human stomach, and two forms of gullet cancer - adenocarcinoma and squamous cell carcinoma.

They found that people who had H. pylori strains carrying a gene called CagA were almost half as likely to get oesophageal adenocarcinoma.

Study co-author Dr Farin Kamangar, a research fellow at the US National Cancer Institute, commented: "CagA-positive strains of H. pylori may decrease the risk of adenocarcinoma by reducing acid production in the stomach and, therefore, reducing acid reflux to the oesophagus.

"It may also work by decreasing the production of the hormone ghrelin, which is secreted from the stomach to stimulate appetite. A reduction in the level of ghrelin may lead to lower rates of obesity, an important risk factor for adenocarcinoma."

The finding that H. pylori may reduce the chances of gullet cancer is interesting as infection with the bacterium increases the likelihood of stomach cancer developing.

As the world's sanitation and antibiotics have improved, the incidence of stomach cancer has fallen.

Meanwhile, the incidence of oesophageal adenocarcinoma has increased and the latest findings, which appear in the journal Cancer Prevention Research, may help to partially explain the trend, although rising obesity rates are also thought to be an important factor.

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Chance of surviving gut cancers up 40 per cent in two decades

Tuesday 7 October 2008

Cancer Research UK Press Release

Cancer patients in England are 40 per cent more likely to survive for at least a year after diagnosis of stomach and oesophageal cancer than they were in the eighties, according to latest figures revealed at the National Cancer Research Institute (NCRI) Cancer Conference in Birmingham today (Tuesday).

Experts say that one important factor in this significant increase in survival is improved early diagnosis of these cancers, which is important for treatment to be successful. Stomach and oesophageal cancers have been hard to diagnose as the symptoms of the diseases are often a sign of conditions other than cancer.

Improvements in treatment have also played a part, including the shift to surgery by experts in specialist centres and the introduction of chemotherapy for advanced disease.

The figures also show that early detection of breast cancer has led to 95 per cent of patients surviving for more than one year following diagnosis.

The report, published by the National Cancer Intelligence Network (NCIN), looked at one-year survival for all cancers* in over 3.5 million cancer patients recorded by English cancer registries between 1985 and 2004.

Despite more people being diagnosed with cancer in England since the 1980s - due to the ageing population - there has been a fall in the number of deaths. In the five years in the late 1980s, around 840,000** people were diagnosed with cancer and 56 per cent survived beyond a year after diagnosis. In the five years from 2000, over a million people were diagnosed in a five year period with the disease, but 67 per cent survived beyond a year.

Professor David Forman, information lead at the NCIN based at the University of Leeds, said: "Increases in one-year survival rates are a useful signpost - for many types of cancer, they suggest that the disease is being diagnosed at an earlier stage, which is vitally important in treating the disease successfully.

"It's really positive that survival rates for stomach and oesophageal cancer have significantly increased, because they're cancers that are usually diagnosed very late - too late to cure."

One year survival for stomach cancer went from 27 per cent in the 80s to 38 per cent in the 00s - an increase of 11 per cent. And one year survival for oesophageal cancer went from 25 to 36 per cent in the same period.

In addition, one-year survival for all of the most common cancers increased significantly in twenty years. Although survival did not decrease for any cancer***, rates for cervix, Hodgkin disease and a group including eye, brain and CNS cancers stayed relatively constant.

Marked increases in survival were also seen for breast, ovary and bowel cancer.

Professor Forman continued: "One-year survival has significantly increased for around 75 per cent of cancers. Most of the rest have shown small improvements but clearly there is more work needed to improve the detection of some cancers."

One-year breast cancer survival has increased by six per cent in the last two decades, meaning 95 per cent of women will survive at least a year after diagnosis. This is a clear indication of greater awareness of the disease in patients and GPs, leading to faster referrals of cancer patients to specialist doctors. And the breast cancer screening programme has helped pick up the disease earlier - survival rates jumped in the early 90s following the introduction of the screening programme in 1988.

Sara Hiom, director of health information at Cancer Research UK, said: "Early detection of cancer is vital in ensuring the disease is successfully treated. It's important that people are aware of the signs and symptoms of cancer and they go for screening when invited. Cancer Research UK is investing in research to improve early detection of the disease and is working with GPs to provide relevant information to help this."

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NCRI sees record investment in cancer research

Sunday 5 October 2008

Cancer Research UK Press Release

The National Cancer Research Institute (NCRI) partners funded £393m worth of research into cancer in 2006, an increase of £135m compared to 2002. But it will warn of slower progress in spend for some cancers, it is announced at the NCRI Cancer Conference in Birmingham today (Sunday).

An analysis of cancer research spend by the NCRI - a collaboration of government and charity partners - reveals that between 2002 and 2006, its 20 member organisations spent a total of £1.6 billion on cancer research in the UK.

During this period, the NCRI witnessed an increase in spend from its members on most types of cancer, and a doubling of investment in cancer prevention work. But its analysis also revealed that some cancers faired better than others. Of particular concern were lung, pancreatic and oesophageal cancers, which remain difficult to treat and research. This is largely due to the fact that symptoms often present late - resulting in the cancer being at a more advanced stage at diagnosis and the difficulties associated with where the tumour is located in the body.

Dr Jane Cope, director of NCRI explains: "These figures show the extent to which investment in research is mirrored by increasing survival rates - which is great news. But it’s of concern that we're not seeing the same improvements for some of the harder to treat cancers.

"There is a 'snowball effect' at work here - the more a cancer is researched, the more avenues are opened for further work. Well understood cancers like breast and leukaemia have a "critical mass" of research behind them that has been built over many years and which leads to more research and promising findings.

"The NCRI is committed to developing ways to drive forward research activity in the more challenging areas and has already found some solutions but clearly there is still more to do."

Although nearly four per cent of research funding targeted to a specific tumour site was directed towards lung cancer in 2006, the disease accounts for 22 per cent of cancer deaths. NCRI established a group to examine the reasons why lung has received less attention than other cancers, relative to incidence and mortality. A number of priority areas for action were identified and are being pursued, including £2.25m allocated to supportive and palliative care research in lung cancer.

Since its inception in 2002, the NCRI has collected information on all the cancer research funded by its member organisations. This enables them to analyse and understand the overall investment in cancer research at a national level, with the aim of reducing gaps in the portfolio and responding to opportunities.

One of the biggest increases in investment has been in prevention research, which leapt from £6m to £14m in the five years since the NCRI's inception. Prevention research now makes up almost four per cent of the NCRI's total funding portfolio - up from two per cent in 2002. This investment has in part been administered through the National Prevention Research Initiative (NPRI), established in 2004 by the NCRI in to drive forward work in this area. In 2008, an additional £12m was awarded for a third call for proposals to advance research in this field and this will ensure that the increased trend in investment will continue.

Professor Sir Ken Calman, chair of the NCRI, said: "This important analysis allows us to see where we've done well and address those areas where investment is still lacking. The increase in overall spend is encouraging but we must not be complacent - the variations in relative spend on the different disease sites are clearly concerning and we will work towards ensuring that all cancers receive the focus and attention that they deserve, so that more people can survive the disease."

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Cancer risks for overweight women

Wednesday 7 November 2007

Cancer Research UK Press Release

Half of all cases of womb cancer and a type of oesophageal cancer in women are caused by being overweight or obese, according to a new report published online in the British Medical Journal today (Wednesday).

This study provides the first reliable evidence on the relevance of being overweight or obese for a wide range of cancers in women in the UK today.

Its findings suggest that among middle aged and older women in the UK, around five percent of all cancers, that is 6000 cancers each year, are caused by being overweight or obese.

As well as pinpointing womb cancer and one type of oesophageal cancer as examples where being overweight or obese is a major risk factor, the study also finds that excess weight increases the risk of kidney cancer, leukaemia, multiple myeloma, pancreatic cancer, non-Hodgkin's lymphoma, ovarian cancer and, in some age-groups, breast and bowel cancer.

The Million Women Study, funded by Cancer Research UK, is the biggest study ever undertaken to look at women and cancer risk. Over one million UK women were studied during seven years. More than 45,000 cases of cancer and 17,000 cancer deaths occurred during that time.

Lead researcher Dr Gillian Reeves, Cancer Research UK epidemiologist based at Oxford University, said: “Based on our findings, we estimate that being overweight or obese accounts for around 6,000 out of a total 120,000 new cases of cancer each year among middle-aged and older women in the UK.

“Our research also shows that being overweight has a much bigger impact on the risk of some cancers than others. Two thirds of the additional 6000 cancers each year due to overweight or obesity would be cancers of the womb or breast.”

But the research found that the relationship between body mass index (BMI)* and cancer also depended on a woman’s stage of life. For example, being overweight increases the risk of breast cancer only after the menopause and the risk of bowel cancer only before the menopause.

Sara Hiom, director of Cancer Research UK's health information, said: “This research adds to the evidence regarding the impact of being overweight or obese on developing cancer and dying from the disease.

“While most people readily associate carrying extra weight with being a general health risk, many do not make a specific link with cancer. These findings need to be taken into consideration alongside the established strong relationships between body fatness and other common illnesses such as diabetes and heart attacks.”

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Local researchers trial aspirin to help prevent cancer of the foodpipe

Monday 5 February 2007

Cancer Research UK Press Release

Doctors from around the UK are investigating whether the humble aspirin can be used to prevent cancer of the foodpipe - known as oesophageal cancer.

The drug is being used with an anti-ulcer drug to try to prevent a condition called Barrett’s oesophagus from developing into oesophageal cancer.

Barrett's oesophagus affects up to two per cent of the UK population and is responsible for around half of all oesophageal cancers. Patients with the condition have stomach acid that rises from the stomach into the oesophagus usually causing frequent heartburn. The acid damages the cells in the lining of the oesophagus and in some cases they turn cancerous.

The Cancer Research UK funded trial* aims to see if aspirin and the anti-ulcer drug can prevent this condition of the oesophagus worsening and its progression to cancer. The number of cases of oesophageal cancer has climbed quickly in recent years - increasing more than 10 per cent over the last decade. There are over 7,000 cases in the UK every year. Deaths from oesophageal cancer are increasing as the number of new cases rises.

The trial is one of the largest cancer prevention trials in the world, now with 5000 men and women who have Barrett’s oesophagus being recruited for the trial from over 50 UK centres. Previously the trial was only open to men.

Professor Janusz Jankowski, lead researcher based in the department of clinical pharmacology at Oxford’s Radcliffe Infirmary, said: "Only a small proportion of those with Barrett's oesophagus will develop oesophageal cancer but an increasing number of people in the UK are developing this cancer. Cases of oesophageal cancer are high in the UK compared to the rest of the western world, at three to four times the level seen in Europe or the US.

"This research should provide us with valuable knowledge on how to prevent oesophageal cancer. Anyone who has Barrett’s oesophagus and would like more information should call 02070618355."

The researchers will use combinations of aspirin and a drug called esomeprazole to treat Barrett’s oesophagus. Aspirin is an anti-inflammatory drug and it is thought this property may reduce the chances of the Barrett’s cells to turn cancerous. Esomeprazole works as an anti-ulcer drug by reducing the amount of acid produced by the stomach. A high dose of esomeprazole may also minimise damage to the lining of the oesophagus and promote healing - helping to prevent cells becoming cancerous.

One of aspirin's side effects is an increased risk of stomach ulcers and it is hoped that esomeprazole will minimise this risk. People with Barrett's oesophagus are also more likely to suffer from heart problems - another area where aspirin has been shown to be of benefit.

Those who take part in the trial will receive one of four different combinations of the drugs for up to eight years: aspirin and a high dose of esomeprazole; a high dose of esomeprazole but no aspirin; aspirin and a lower dose of esomeprazole; or a lower dose of esomeprazole but no aspirin. Each drug is taken as a daily tablet.

Professor Janusz Jankowski added: "The UK is at the epicentre of researching new ways to tackle this cancer. We hope these drugs will offer a simple method of preventing this particularly aggressive form of the disease.

"We are at the crucial stage of recruiting men and now women with Barrett's oesophagus to this important trial. These people will not only get the best possible care, they will also help uncover key clues in the fight against cancer."

Professor John Toy, medical director at Cancer Research UK, said: "Preventing cancer is a major focus for Cancer Research UK. This large trial may be the first step towards a way to prevent many cases of a cancer that kills over 7000 people a year in the UK. It’s an opportunity to reverse the trend and close the stable door before the horse has bolted."

For more information about the trial and how to join please contact Cancer Research UK’s cancer information nurses on 02070618355.

ENDS

For media enquiries please contact Paul Thorne in the Cancer Research UK press office on 02070618352 or the out of hours on 07050264059.

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Heart drug may cut cancer risks finds study

Wednesday 24 May 2006

People using a class of heart drug known as ACE-inhibitors to lower their blood pressure have "significantly" reduced risks of pancreatic, bowel and oesophageal cancers, researchers have said.

The research was carried out by the Overton Brooks Veterans Administration Medical Centre in the US and was presented at the conference Digestive Disease Week 2006.

Medical histories of almost 500,000 US armed forces veterans were used in the study, which compared cancer rates against age, race, tobacco use and other health indicators.

ACE-inhibitors seemed to have the most significant effect on oesophageal cancer, reducing risks by 55 per cent compared to non-users.

The study also suggested that the drugs reduced the incidence of pancreatic cancers by 48 per cent and colon cancer by 47 per cent.

Researchers believe the potential benefit of ACE inhibitors against cancer may be because they can stop new blood vessel growth.

The team thinks the drugs might work by acting on a protein called VEGF, which is believed to play a significant role in the growth and reproduction of tumours.

"This is a large and exciting study that could point to new ways to prevent cancer in the future. It shows a substantial reduction in risk for certain types of cancers in patients taking these blood pressure drugs," said Dr Kat Arney of Cancer Research UK.

"The drugs may work by blocking the growth of blood vessels that feed tumours, which is an active area of cancer research at the moment.

"But ACE inhibitors are prescription medicines, and can have side effects in some people. We don't know enough about their safety and effectiveness in cancer prevention at the moment, so more laboratory and clinical studies are needed," she added.

While follow-up work is needed to reveal the mechanisms involved, scientists said they believe that ACE-inhibitors block production of a protein important to tumour growth.

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Alcohol cancer risks "underestimated" say researchers

Thursday 2 February 2006

Researchers have warned that many drinkers significantly underestimate the cancer risks associated with alcohol. 

Scientists at the French International Agency for Research on Cancer (IARC) examined previous studies into alcohol and cancer, concluding that the more alcohol consumed, the greater the cancer risks associated with it. 

Excessive drinking raises the risk of cancer of the mouth, larynx, oesophagus, liver, prostate and breast, they added. 

"Alcohol is underestimated as a cause of cancer in many parts of the world," Dr Paolo Boffetta of the IARC told Reuters. 

"A sizeable proportion of cancer today is due to alcohol intake and this is increasing in many regions, particularly in east Asia and eastern Europe. Alcohol is probably the main factor responsible for increased risk of head and neck cancer recorded in various countries." 

Cancer Research UK believe alcohol is contributing to the 25 per cent increase in mouth cancer cases in the UK since 1992.

In November last year, the charity launched a three year campaign to raise awareness of the early signs and risk factors of the disease. 

Dr Kat Arney, science information officer at Cancer Research UK, added, "You may have heard that drinking small amounts of alcohol can reduce your risk of heart disease.

"But this is only really true for men over 40 and women who have been through the menopause. Heavy drinking can actually contribute to heart disorders."

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New test gives hope for early diagnosis of oesophageal cancer

Tuesday 3 August 2004

Cancer Research UK Press Release

A new screening test for oesophageal (food pipe) cancer could dramatically improve survival from the disease, according to research published in the British Journal of Cancer this week.

Cancer Research UK funded scientists at University College London's Wolfson Institute for Biomedical Research used a protein in fluid taken from a person's oesophagus to diagnose cancer with unprecedented accuracy.

Oesophageal cancer is often difficult to diagnose in its early stages, partly because of its lack of distinct symptoms. The potential new test would be simple and inexpensive and holds promise for improving detection of the cancer. The team now plans to investigate the test's clinical viability through a large-scale trial.

There are over 7,000 cases of oesophageal cancer in the UK each year, making it the ninth most common cancer. Incidence of the disease has risen by 27 per cent in the last 15 years.

The new test works by detecting levels of a protein called Mcm5 in fluid samples taken from the oesophagus using a narrow tube.

Mcm5 is one of a family of proteins called minichromosome maintenance (MCM) proteins, which are already known to be good markers of the uncontrolled cell growth that is the hallmark of cancer.

The team analysed samples from 40 patients at Addenbrooke's Hospital in Cambridge to assess whether the Mcm5 test could accurately detect cancer.

Approximately half of the patients in the study had oesophageal cancer and half did not. The test was able to identify cases of disease, distinguishing between patients with and without oesophageal cancer with 85 per cent accuracy.

Dr Kai Stoeber, lead researcher on the project, says: "Our team has been studying MCM proteins for a number of years to find out how they might prove useful in diagnosing cancer.

Cancer Research UK Senior Clinical Research Fellow Professor Gareth Williams, who heads the research group, adds: "As oesophageal cancer is particularly difficult to diagnose early, doctors and patients would benefit greatly from a simple test to detect the condition.

"Research shows that early diagnosis is the single most important factor for improving survival prospects for patients with oesophageal cancer."

Five-year survival from oesophageal cancer in the UK is currently around eight per cent. But where the disease is diagnosed early, surgery and chemotherapy can yield survival rates in excess of 80 per cent.

Dr Stephen Middleton, who led the clinical trial at Addenbrooke's Hospital, says: "Our pilot study has shown that the Mcm5 test has many advantages over the methods doctors currently use to detect oesophageal cancer.

"Current tests rely on a pathologist or technician analysing cell changes through a microscope. But as the new test is chemical in nature it could be readily automated, making it suitable for screening large numbers of people for precancerous or cancerous changes in oesophageal cells."

"The test would be much less invasive than the endoscopic tests currently used to regularly check the oesophageal lining of patients who have a high risk of developing cancer. This would make it safer and more convenient for patients.

"If large-scale trials prove the test's effectiveness, it could enter use within five years."

Mcm5 plays a key role in cell division. In normal cells its levels are tightly regulated so that cells only divide when they are required to do so. Cancer develops when these controls break down, leading to very high levels of Mcm5 and uncontrolled cell division.

Professor Williams adds: "Testing for high levels of Mcm5 could enable doctors to pick up cancer at an early stage, as it reflects a faulty cellular process that begins long before the tumour reaches an easily detectable size."

Cancer Research UK holds the patent on the Mcm5 test, and the research team are currently seeking commercial partners to develop it further.

Cancer Research UK's Director of Policy and Communications Professor Robert Souhami says: "Low survival rates for oesophageal cancer are to a great extent a result of late diagnosis. Until we have a reliable, accurate and practical test to diagnose the disease at an early stage it will be difficult to improve survival prospects.

"Professor Williams and his team are making a great contribution towards this goal using the Mcm5 protein. A large-scale trial will tell us if using the test is feasible and can save lives."

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