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

Monday 11 February 2013

Cancer Research UK Press Release

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

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

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

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

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

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

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

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

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

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

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

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

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

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Genetically engineered virus extends the lives of terminally-ill liver cancer patients

Monday 11 February 2013

A genetically-engineered virus has prolonged the lives of terminally ill liver cancer patients in a small clinical trial.

The results will need confirming in larger studies, but Cancer Research UK welcomed the advance as "an exciting step forward".

The partially disabled cowpox virus, known as Pexa-Vec or JX-594, was given to 30 patients with advanced liver cancer during the study.

Sixteen patients given a high dose of the vaccine survived for an average of 14.1 months, compared with 6.7 months for the 14 who received the low dose, according to the findings published in Nature Medicine.

Study co-author Dr David Kirn, a researcher at Jennerex Biotherapeutics in San Francisco, said: "For the first time in medical history we have shown that a genetically engineered virus can improve survival of cancer patients."

Professor Alan Melcher, a Cancer Research UK expert at the University of Leeds who is also working on modified viruses to treat cancer, was upbeat about the research but cautioned that the work was still a several years from the clinic.

He said: "It helps demonstrate the cancer-fighting potential of viruses, which have relatively few side effects in comparison to traditional cancer treatments such as chemotherapy or radiotherapy. If this treatment proves effective in further, larger trials, then it could be available to patients within five years."

JX-594 has been genetically engineered from the vaccinia virus, which has been used as a vaccine for decades, helping to eradicate smallpox.

It is designed to multiply in and subsequently destroy cancer cells, while at the same time mobilising a patient's own immune defence against the cancer.

Patients with a type of advanced liver cancer called hepatocellular carcinoma had both a reduction in the size of their tumour and a decreased tumour blood flow when treated with either a low or high dose.

For most patients, side effects were relatively mild at both at high and low doses, with all participants suffering from a day or two of flu-like symptoms, while one patient had severe nausea and vomiting.

A larger trial is needed to confirm the results, and a follow-up with approximately 120 patients is already under way in the US.

The virus is also being tested in other cancer types.

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Early results show two drugs may be better than one to treat most deadly skin cancer

Monday 11 February 2013

Cancer Research UK Press Release

Adding lung cancer drugs to targeted melanoma treatment could increase survival for certain patients, according to research published in Cancer Discovery today.

Scientists at Cancer Research UK’s Paterson Institute at The University of Manchester showed that lung cancer drugs such as gefitinib (Iressa) can override resistance to new targeted therapies for melanoma, called BRAF inhibitors.

The first BRAF inhibitor, vemurafenib (Zelboraf), was approved for patients on the NHS in 2012, and others are currently in development. They work by targeting a faulty version of the BRAF protein, found in more than half of all melanomas as well as some other types of cancer.

But patients often become resistant to BRAF inhibitors after a short time and their disease returns, leaving them without further treatment options.

Now scientists have found that treating BRAF inhibitor-resistant cancer cells or tumours with the drugs gefitinib or dasatinib, which block a different biological pathway, can halt their growth.

Lead author, Professor Richard Marais, director of Cancer Research UK’s Paterson Institute, said: “This exciting research shows that two drugs can be better than one in beating this deadly disease.

“If these findings are confirmed in larger studies, combining two drug types could provide an effective new treatment for skin cancer patients for whom the only existing targeted treatment available – vermurafenib – no longer works.  

“This is a vital step to understand how to treat the disease more effectively but there is still a lot to do. We hope that this work accelerates progress that will ultimately increase survival from skin cancer.”

Around 12,800 people in the UK are diagnosed with malignant melanoma each year and there are around 2,200 deaths from the disease.

Dr Julie Sharp, Cancer Research UK’s senior science information manager, said: “These new results builds on our work on the BRAF gene, which has led to the development of important new drugs for melanoma.  

“This fundamental research into the biology of cancer is leading directly to new treatments and we hope that this latest study will bring forward more effective approaches for treating melanoma, which we urgently need. This is the kind of work that the new Manchester Cancer Research Centre excels at - bringing together a wide range of expertise to revolutionise cancer treatment.”

Professor Marais’ team is part of the Manchester Cancer Research Centre (MCRC), which is a partnership between Cancer Research UK, The Christie and The University of Manchester. A new campaign, “More Tomorrows”, is fundraising to build a centre for MCRC scientists to work together on treatments for cancer.

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'DNA editing' enzyme could fuel breast cancer

Friday 8 February 2013

Genetic errors driving the majority of breast cancers may be caused by a hyperactive enzyme called APOBEC3B, according to US researchers.

The finding could lead to new ways to diagnose and treat breast cancer, exploiting the root cause of genetic damage - 'DNA editing' by the enzyme - rather than the damage itself.

Under normal circumstances, APOBEC enzymes help repair damaged DNA and protect against viruses like HIV.

But the University of Minnesota researchers showed in a research paper published in Nature that one particular form of APOBEC was found in high levels in breast cancer cells.

Lead researcher Dr Reuben Harris and his team measured the activity of seven related enzymes known collectively as the APOBEC3 family, in breast cancer cells grown in the lab and breast tumour samples.

They found that only one, known as APOBEC3B, was present in high levels inside cancer cells.

But APOBEC3B appears to be a biological "double-edged sword", as it protects some cells from viruses such as HIV, yet can produce changes giving rise to cancer in others.

In 2009, researchers funded by Cancer Research UK found evidence that a related enzyme, called AID, could similarly edit breast cancer DNA when activated by oestrogen.

And adding to the picture, last year researchers at the Wellcome Trust Sanger Institute in Cambridge published a detailed analysis of the DNA damage in breast cancer, and spotted signs that looked like the activity of APOBEC enzymes.

"Our next steps will focus on the connections between high levels of APOBEC3B, age and other genetic risk factors that are known breast cancer markers," said Dr Harris, who stressed the need for additional research.

"Ultimately, we hope our discovery leads to better therapeutic outcomes for patients."

In 2010, about 50,000 women and 400 men in the UK were diagnosed with breast cancer, and there were nearly 12,000 deaths from the disease.

If future studies confirm that high APOBEC3B levels indicate the early presence of breast cancer, a simple blood test could be a strategy for early detection.

Cancer Research UK's Professor Charlie Swanton, who studies the genetic complexity inside tumours, said it was a "fascinating and important study" which showed how researchers are beginning to understand the precise mechanisms that drive the genetic chaos found in cancer cells.

"Pinpointing these mechanisms give us new avenues to try to limit this chaos, or maybe even exploit it to tip cancers over the edge.

"There's a long way to go before we get a handle on the cancer's true genetic complexity, let alone turn this into treatments to help patients," he added.

"But studies like this show that important and tangible progress is being made in understanding this disease."

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Friends and family say doctors should give lifestyle advice to cancer patients

Friday 8 February 2013

Cancer Research UK Press Release

Over 80 per cent of cancer patients’ close friends and family think that doctors should give their cancer patients lifestyle advice on eating habits, weight-loss and exercise, according to a new study* published today (Friday) in the British Journal of Cancer.
 
Cancer Research UK scientists at University College London (UCL) asked over 1200 people** who knew someone close with cancer a number of questions to assess their attitudes towards giving cancer patients lifestyle advice.

There has been concern that such information could be seen as insensitive or implying ‘blame’, particularly at a time when the patient is trying to cope with the stress of diagnosis or treatment.

They found that around 90 per cent of those closest to cancer patients (their friends and relatives) saw lifestyle advice as ‘beneficial’ and over 80 per cent believed that doctors had a ‘duty’ to provide it. They also found that less than 20 per cent felt such advice was ‘unnecessary’, ‘interfering’, ‘insensitive’, or implied ‘blame’.

Kate Williams lead author from UCL, said: “Our new research suggests that the friends and family of cancer survivors are much more likely see advice on exercise and healthy eating as beneficial, rather than insensitive.

“The concern has always been that talking to someone diagnosed with cancer about changing their eating or exercise habits could be seen as upsetting and inappropriate by cancer patients or their friends and family members. But we’ve found that not only are they receptive to the information but most believe it is their doctor’s duty to advise them on ways to lead a healthier lifestyle.”

The study also examined the attitudes of a smaller number of cancer survivors (222) to being given lifestyle advice. It found that patients were similarly positive to receiving lifestyle advice with more than 80 per cent believing it would be ‘beneficial’, ‘helpful’, ‘encouraging’ and ‘the doctors duty’.

Research shows that cancer patients are at greater risk of developing conditions such as cardiovascular disease, osteoporosis and second primary cancers, but this risk can be reduced by leading an active and healthy lifestyle.

Hayley Hardy, 33, from Poole said: “I think it’s very important for doctors to give cancer patients advice on leading a healthier lifestyle.

“My husband James was diagnosed with testicular cancer in 2006, which was such a shock. It was a wake-up call to both of us to look after ourselves better generally – we realised we had to be here for the kids who will be turning 10 and 13 this year.

“Since then we’ve both thrown ourselves into a more outgoing lifestyle – we go to the gym regularly and are both training for a London to Brighton cycle challenge in July. I run a Weightwatchers class too, and took part in Race for Life to raise vital research money to help beat this disease.”

Sara Hiom, director of patient engagement at Cancer Research UK, said: “This study is encouraging as it suggests that not only patients, but also their friends and relatives, are open to receiving advice from the doctors about how to lead a healthier lifestyle.

“We know that along with being a non-smoker, keeping a healthy body weight, eating a balanced diet and keeping active are important factors to help us all reduce our risk of developing cancer. For cancer patients, clearly doctors are an important part of setting up a supportive environment where lifestyle changes can be made.”

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GPs refer eighty per cent of suspected cancers after two visits

Friday 8 February 2013

Cancer Research UK Press Release

More than 80 per cent of patients suspected of having cancer are being referred by their GP in the first two consultations, with more than half being sent to see a specialist at the first appointment, according to new research published in the British Journal of Cancer.

A group of researchers from the universities of Cambridge, Durham and Bangor looked at data from over 13,000 patients in order to measure the promptness of cancer diagnosis in primary care. They found that 82 per cent of people were referred after two visits, with over half of patients (58 per cent) referred to a specialist after the first visit.

The study has also revealed that some cancers are proving harder to spot in the first few consultations, such as lung cancer and myeloma. This may be because they often produce symptoms that are common and not unique to cancer, so can be mistaken for less serious conditions.

The findings show that, the more consultations a patient needs, the greater number of weeks between first presentation and referral. With most of the patients who have these harder-to-spot cancers, it takes longer before there is a suspicion of cancer and they are seen by hospital specialists.

Dr Georgios Lyratzopoulos, study author and National Institute for Health Research post-doctoral research fellow working at the Cambridge Centre for Health Services Research, said: “These results show the progress we’re making in spotting cancer at the earliest opportunity. We now understand the typical symptoms of some cancers, like breast and melanoma, very well and that helps doctors to spot them quickly.

“Other cancers have less typical symptoms, making them more difficult to recognise straight away. Not suspecting cancer early enough can be stressful for patients and their relatives so understanding the symptoms of these cancers better is where we need to be making greater research efforts to help spot the disease earlier.”

Last year, the Royal College of General Practitioners (RCGP), in partnership with Cancer Research UK, launched a five-year programme to improve early diagnosis of cancer in general practice.

Professor Greg Rubin, the RCGP and Cancer Research UK clinical lead for cancer* and co-author of the research, said: “We’ve found that most patients who go to their GP with cancer symptoms are being promptly referred to a specialist. NICE referral guidelines have helped people with classic symptoms to be seen more quickly but, for patients with less typical symptoms, the decision to refer isn’t always as simple.

“Reducing the number of pre-referral consultations can result in a more timely diagnosis of cancer. We need to consider ways of making the process of primary care assessment even smarter, for instance by wider use of clinical decision support tools or more efficient investigation pathways.”

Sara Hiom, early diagnosis director at Cancer Research UK, said: “These findings are encouraging but there is still room for improvement. Progress is clearly being made but one in five people have to make more than two visits to their GP, although it’s not surprising that this is usually for those cancers that are harder to spot. And we know for some people, difficulty making an appointment can be a barrier to going to the GP in the first place.

“Cancer can be treated more effectively when diagnosed early, so we need to make every effort to support GPs in getting the disease consistently diagnosed more quickly and accurately. But it’s also important that we all act on any persistent health changes that concern us and have the confidence to go back to our GPs if problems don’t clear up after an initial visit.”

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More evidence that beta blockers help stop cancers from spreading

Wednesday 30 January 2013

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Desire for a tan is making teenage girls ignore sunbed dangers

Wednesday 30 January 2013

Cancer Research UK Press Release

Teenage girls desperate for a tan are determined to find ways of getting round the law banning under-18s from using sunbeds, according to a new study from Cancer Research UK published in the Journal of Public Health.

During focus groups,* 15-18 year old girls who regularly used sunbeds were asked questions that explored their motivation to use them, their attitudes towards supervision and their knowledge of the health risks. The study found that their desire to get a tan overcame any misgivings about the potential health risks.

Participants said that having a tan made them feel more confident, look healthier and was an important consideration for special events. And when it came to the health risks, most teenagers knew about the potential dangers but were happy to accept or ignore them.

Dr Jeffrey Lake, public health consultant and lead author of the study, said: “The research shows us that the desire for tanned skin in young people is blinding them to the potential long-term health risks associated with regularly using sunbeds.

“We’re finding that their worries are cosmetic when they should really be thinking about the unseen damage they’re inflicting on themselves.”

In 2010, a Cancer Research UK study revealed that a quarter of a million children in England between the ages of 11 and 17 were regularly using sunbeds.** In 2011, legislation in England and Wales made it illegal for under 18s to use sunbeds.

But the law in England risks falling short because it is difficult to ensure that tanning salons are supervised by trained staff who can stop teenagers from using potentially harmful equipment and warn customers about health risks.

Catherine Thomson, head of statistical information at Cancer Research UK and co-author of the study, said: “It’s worrying to see that, in some areas of the UK, half of all 15-17 year old girls are using sunbeds on a regular basis.

“Introducing the legislation banning sunbed use by under 18s was vital to protect younger people from the harmful effects of UV. But proper supervision in salons is essential to combat the determination of teenagers to get round laws that are there for their own protection.”

The findings are published just over a week before Cancer Research UK launches its R UV UGLY? campaign for a second time in England.  As part of the campaign, people will be offered free cosmetic skin scans at sk:n clinics across the country.  Specialist skin-scanning technology will be used to highlight the hidden cosmetic damage lurking beneath the skin’s surface, such as pigmentation and premature wrinkles, caused by overexposure to UV both from sunbeds and the sun.

Yinka Ebo, senior health information officer at Cancer Research UK, said: “This study shows that we need to persuade teenagers that damaging their health really isn’t justified by the promise of a tan.

“Sunbeds aren’t harmless and research has showed that using them for the first time before the age of 35 increases the risk of developing melanoma, the most serious form of skin cancer, by 59 per cent.”

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Cancer death rates over a third higher in men than women

Tuesday 29 January 2013

Cancer Research UK Press Release

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

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

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

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

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

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

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

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

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

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

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

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

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

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Women smokers' death risk soars

Thursday 24 January 2013

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

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

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

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

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

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

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

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

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

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

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

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

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

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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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Prostate cancer lifetime risk trebles in 25 years

Wednesday 23 January 2013

Cancer Research UK Press Release

Boys born in 2015 will have almost three times the risk of being diagnosed with prostate cancer at some point during their lives than those born in 1990.

Latest figures* from Cancer Research UK show that the lifetime risk of prostate cancer will rise from five per cent (1 in 20) for boys born in 1990 to just over 14 per cent (1 in 7) for boys born in 2015.

This is largely due to increased use of the Prostate Specific Antigen Test (PSA). This test detects a wide variety of prostate cancers, including those which will never be life-threatening, as well as aggressive forms of the disease, but unfortunately, it does not distinguish between the two.

PSA testing has rapidly boosted the number of men being diagnosed with the disease. Today, around 41,000 men per year are diagnosed with prostate cancer in the UK – up from around 15,000 men per year 25 years ago.

But the rise in prostate cancer diagnoses isn’t just because of increased testing. Higher numbers of prostate cancer cases are also due to more men living to an older age, when the disease is most likely to develop.  

The good news is that death rates from prostate cancer in the UK are 18 per cent lower than they were 20 years ago**. This is likely to be because of improved treatments and PSA tests which can help diagnose cancers earlier, when the chances of survival are greater. Today, around 10,700 men die each year from prostate cancer in the UK.

Research has lead to more widespread and earlier use of hormone treatments prescribed since the early 1990s. More recently, a range of new hormone treatments have been developed to prolong life – such as abiraterone which was approved by NICE in May 2012 to treat patients with advanced disease, and which is a drug which Cancer Research UK scientists helped to develop.

Professor Malcolm Mason, Cancer Research UK’s prostate cancer expert, said: “We’re detecting more cases of prostate cancer than ever before. And we’re carrying out an intensive amount of research to find better methods than PSA to distinguish between the minority of cases that are life threatening and do need treatment – the vipers – from the majority of cases that don’t – the grass snakes. But there is much more to be done.

“Targeting the tests at men who have a higher risk of developing prostate cancer might be a better approach than screening all men. Research has already saved lives from prostate cancer. But there is uncertainty over the best approach to treating some forms of the disease. Surgery and radiotherapy - with their potential side effects – is one option, to be balanced against the option of careful monitoring with regular checkups."

Cancer Research UK’s scientists have carried out research that suggests a protein called MSMB (Beta-microseminoprotein) may be better at identifying men at higher risk of developing the disease. But more work is needed to prove if this test could be useful.

Dr Harpal Kumar, Cancer Research UK’s chief executive, said: “Thanks to people’s generosity, our world-class scientists are leading the way to understand why some cancers are aggressive and others aren’t. We need to build on the great progress already made and develop more targeted treatments for those men whose disease is life-threatening. We also need to develop better tests that will help us to know when to leave harmless forms of the disease alone.”

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Late ovarian cancer diagnoses 'are costing lives'

Wednesday 23 January 2013

Delays in diagnosis are cutting short the lives of women with ovarian cancer, according to a UK charity.

Women putting off visiting their GP and subsequent delays in getting the correct diagnosis are highlighted as "areas of concern" by Target Ovarian Cancer.

The charity's latest Pathfinder Study, launched today at the House of Commons, also says that delays in diagnosis could be down to GPs requests for tests for their patients being refused.

Dr Claire Knight, health information manager at Cancer Research UK, said the report was a "timely reminder" that urgent attention must be given to ovarian cancer, and added that treatment - not just early diagnosis - needs to be improved.

Women diagnosed with ovarian cancer at the earliest stage have a five-year survival rate of 92 per cent.

But the overall survival rate in the UK is just 43 per cent - among the worst in Europe.

Previous studies have suggested that late diagnosis could be one reason why the UK lags behind other countries, but recent research  suggests that the UK may be worse at treating late-stage ovarian cancer.

The latest study found that, over the last five years, one in four women diagnosed with ovarian cancer took more than three months to visit their GP after they started having symptoms. Around half took more than a month.

Three per cent of these women said they "knew a lot" about the disease prior to their diagnosis. And more than half said they had "heard of the disease but knew nothing about it".

Once at the GPs, the report found that women still faced problems getting a correct diagnosis. A third of women were diagnosed more than six months after they first went to see their doctor.

The report also showed that 30 per cent of women were misdiagnosed as having irritable bowel syndrome, 15 per cent as having ovarian cysts and 13 per cent as having a urinary infection.

On top of this, one in ten GPs reported having diagnostic tests for their patients, such as abdominal scans, refused in the past year.

Cancer Research UKs Dr Knight said: "Nearly a third of women with the disease are diagnosed as an emergency and survival rates in the UK are worse compared to other countries. We urgently need to do more to improve both the way the disease is diagnosed and treated.

"Symptoms of ovarian cancer include pelvic or tummy pain, bloating, difficulty eating or feeling full.

"If you experience any of these, they are new for you and happen on most days, see your GP. And if your symptoms persist, keep going back to your doctor."

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Israeli researchers developing BRCA 'radiation' test

Tuesday 22 January 2013

A new blood test that measures cells’ response to radiation could detect inherited faults in a person’s BRCA genes, according to Israeli researchers.

Rather than directly analysing an individual’s DNA, the scientists propose the new test could identify at-risk people with mutations that current methods find hard to spot.

But others cautioned that the method, while promising, would need significant development and testing before it could replace existing methods, which rely on DNA sequencing.

Discovered in the 1980s, the BRCA1 and BRCA2 genes are found in all human cells, and normally make proteins that are involved in cell division and DNA repair - two processes that go wrong in cancer.

As a result, people who inherit faulty copies of either gene have a significantly increased risk of breast, ovarian and prostate cancers, and these cancers often run in their families. About five in every hundred breast cancers are thought to be caused by an inherited BRCA gene.

At the moment, DNA samples from members of affected families can be tested, and carriers offered extra monitoring or treatment.

But the test relies on being able to predict whether a fault is likely to be harmful, by comparing the DNA analysis against previously known mutations.

This has disadvantages, says study author Dr Asher Salmon, from the the Hadassah Hebrew University Medical Center in Jerusalem.

"The current tool for mutation detection is gene sequencing, which is expensive, time-consuming and, in many cases, lacking clear and decisive clinical decision making information," he said.

"In many cases, [it] identifies a mutation, but we do not know if the mutation is neutral or harmful."

Since they are unable to repair damaged DNA, cells that contain faulty BRCA genes are more sensitive to radiation. So Salmon's team tested whether this response could be used as a marker for faulty BRCA genes.

Initially analysing blood samples from nine healthy women with a mutated BRCA1 gene and eight healthy women with a mutated BRCA2 gene, they developed a 'signature' of the cells' response to radiation, made up of a number of genes that were switched on or off in response to radiation.

They then confirmed this signature's presence in radiation-treated blood samples from an independent group of 40 women who were carriers of mutated BRCA1 and/or BRCA2, but absent from 17 non-carrier women.

The test correctly identified 95 percent of BRCA carriers, and 88 percent of non-carriers.

According to Salmon, the test can show whether an individual carries a cancer-linked fault, regardless of the specific mutation they carry. In addition, it could be extremely useful across the developing world, where expensive gene-sequencing equipment may not be accessible.

However, Cancer Research UK’s Dr Julie Sharp urged caution.

"This is a very preliminary finding. The current test - DNA sequencing - is easy to standardise across different labs, whereas this new method would require substantial expertise and training to make sure its results were as consistent between labs.

"And we don't currently know whether there are indeed significant numbers of families out there who are unidentified carriers of BRCA mutations, who would not be picked up by existing methods."  

"That said, if further development goes as planned, this could be a useful technique to spot BRCA mutation carriers under certain circumstances."

The research is published in the journal Cancer Prevention Research

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Sunbed skin cancer risk double that of mediterranean midday summer sun

Thursday 17 January 2013

Cancer Research UK Press Release

The average skin cancer risk from sunbeds is more than double that of spending the same length of time in the Mediterranean midday summer sun – according to new research1 from the University of Dundee and published today in the British Journal of Dermatology.

The study tested levels of ultraviolet (UV) radiation from 400 sunbeds in England and found that nine in ten of the sunbeds tested emitted UV radiation at levels above British and EU standards. The average strength of radiation was approaching twice the recommended limit.

The Cancer Research UK study also compared the skin cancer risk from using these sunbeds with the risk from the Mediterranean midday summer sun. The average skin cancer risk from the sunbeds tested was more than twice that of spending the same length of time in the Mediterranean midday summer sun, with one of the sunbeds producing a skin cancer risk six times higher than the sun.

Professor Harry Moseley, consultant medical physicist at University of Dundee and lead author, said: “The development of high-power sunlamps, along with clear failures of the sunbed industry to regulate themselves effectively, is putting young people at an even greater risk of skin cancer than we previously thought.

“We hope that these findings will make people think twice before using sunbeds as you can’t be sure how much radiation you’re exposing yourself to when you try to top-up a tan. People need to be encouraged to take better care of their skin, otherwise the cases of malignant melanoma, the most dangerous form of skin cancer, will continue to increase in England.”

Yinka Ebo, senior health information officer at Cancer Research UK, said: “It’s worrying to see that so many sunbeds in England are not meeting the safety standards. This strengthens our advice that using a sunbed just isn’t worth it.

“Research has already shown that using sunbeds for the first time before the age of 35 increases the risk of malignant melanoma by 87 per cent. They’re not going to do you any good – the best case scenario is that they’ll age and damage your skin; the worst case scenario is a cancer diagnosis and potentially death.”

The strength of UV from sunbeds was found to be no different in those areas where the licensing of sunbeds is required compared to unlicensed areas.

The British and European standard2 was introduced in 2003 and sets out a maximum level of UV radiation to be emitted by sunbeds used for cosmetic purposes. The findings suggest that there is much more work for local authorities to do to ensure that standards are being met by tanning businesses.

Nina Goad of the British Association of Dermatologists explained: “Product safety standards are there to protect the public and the government needs to step up its regulation of the industry.

“England is sadly trailing behind the rest of the UK in this matter. We need proper regulation, covering issues like safety of equipment and health warnings for clients and enforceable through inspections of premises.”

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US researchers warn against apps to diagnose skin cancer

Wednesday 16 January 2013

Smartphone apps that claim to detect skin cancer could delay proper medical diagnosis and potentially life-saving treatment, US expert have warned.

Apps that analyse photographs of the skin to detect possible melanoma skin cancer often give inaccurate results, according to scientists from the University of Pittsburgh School of Medicine.

Researchers used four apps to analyse 188 images of skin lesions. Three of the apps incorrectly classified 30 per cent or more melanomas as 'unconcerning'.

"These tools may help patients be more mindful about their health care and improve communication between themselves and their physicians," said Dr Laura Ferris, one of the researchers.

"But it's important that users don't allow their 'apps' to take the place of medical advice and physician diagnosis."

Every year around 12,800 people in the UK are diagnosed with melanoma, the most serious form of skin cancer. And around 2,200 die from the disease.

The study concentrated on apps that are available on the two most popular smartphone operating systems.

Each of the apps is designed to analyse digital images taken with the phone to advise the user whether their moles are potential melanomas or if they are likely to be benign.

The apps work in different ways. Some returned results based on automated algorithms, whereas one sent images to a skin specialist.

All of the apps featured disclaimers stating they were for educational purposes only, but researchers said there was a risk that patients might rely too heavily on the verdict generated by the phone.

"If they see a concerning lesion but the smartphone app incorrectly judges it to be benign, they may not follow up with a physician," said Dr Ferris.

"Technologies that decrease the mortality rate by improving self- and early-detection of melanomas would be a welcome addition to dermatology. But we have to make sure patients aren't being harmed by tools that deliver inaccurate results."

Dr Claire Knight, health information manager at Cancer Research UK said the finding was worrying.

"Using a mobile phone app may seem like a convenient alternative to visiting the doctor about any changes to your skin, but if the app gets it wrong a potentially deadly skin cancer could be missed," she said.

"If you notice any changes in the size, shape or colour of a mole or any other change to a mole or normal patch of skin, consult your doctor, not your phone."

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Cervical smear tests 'could also detect ovarian and womb cancer'

Thursday 10 January 2013

DNA from cervical screening samples could also be used to detect ovarian and womb (endometrial) cancers, according to preliminary US research.

Cervical screening uses a test called cytology, which most people know as the 'smear test'. Cytology involves taking a sample of cells from the cervix with a small brush.

Scientists from John Hopkins Medical Institutes extended the DNA testing already used as part of the screening programme to look for changes relating specifically to womb and ovarian cancer from cells that had trickled down to the cervix.

The test identified all of 24 women who had subsequently developed womb cancer, and nine out of 22 women who had gone on to develop ovarian cancer.

Despite the lower detection rate, the researchers propose that such a test could be most useful for women with ovarian cancer, since the disease is difficult to diagnose early and so is often harder to treat.

And womb cancer already tends to be detected earlier than ovarian cancer as a result of more obvious symptoms such as vaginal bleeding.

Importantly, no healthy samples were wrongly identified as having cancer- so called 'false-positive' results.

Dr Jacqui Shaw, a Cancer Research UK grant holder from the University of Leicester, said: "This is an exciting early study. It suggests that the national cervical screening programme could one day be expanded to test for ovarian and womb cancers too.

"The idea of testing women's cervical screening samples for DNA from ovarian and womb cancers is clever, and this small study shows this may be possible in the future.

But she cautioned further research is needed: "The next step is to carry out larger studies that can better measure how accurately such DNA tests could detect these cancers".

"It will also be interesting to see whether expanding the number of genes analysed could make the test more accurate, especially for detecting ovarian cancer, which is notoriously difficult to diagnose early, " she added.

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'Drug holidays' improve response to key skin cancer drug in mice

Wednesday 9 January 2013

Melanoma skin cancers that develop resistance to the drug vemurafenib also become "addicted" to it, fuelling their resistance.

In lab tests, scientists in California and Switzerland showed that removing the drug for a short period of time - rather than giving a continuous dose - caused such vemurafenib-dependent tumours to shrink.

The finding could help improve survival for patients with late-stage melanoma, the most deadly skin cancer, according to research published in Nature.

Professor Mark Middleton, director of Cancer Research UK's Experimental Cancer Medicine Centre at Oxford, said: "We still need to test the idea in the clinic, but these results suggest a way in which this important new treatment might be able to increase the benefit to patients and their families.

"It also offers the possibility of more cost-effective treatment, with fewer side effects, because patients would spend some of the time off vemurafenib."

Vemurafenib, also known as Zelboraf, is one of the first new drugs to be made available to patients with melanoma for over a decade. It works by targeting a faulty protein called BRAF, which is found in around half of all melanomas.

The researchers from the University of California, San Francisco (UCSF) and Novartis Institutes for Biomedical Research found that tumours that become resistant to vemurafenib treatment do so by making more BRAF - the very thing the drug is intended to targeted

They then deduced that drug-resistant tumours might stop growing when they stopped giving vemurafenib.

As predicted, in mice with drug-resistant melanomas no longer treated with vemurafenib the tumours shrank.

Study leader Dr Martin McMahon, from UCSF, said: "Remarkably, intermittent dosing with vemurafenib prolonged the lives of mice with drug-resistant melanoma tumors," said.

The research raises the possibility that so-called "drug holidays" could extend vemurafenib's effectiveness in humans, although clinical trials have yet to be conducted.

Professor Richard Marais, Director of Cancer Research UK's Paterson Institute at the University of Manchester, was part of a Cancer Research UK-funded team that discovered the BRAF faults in melanoma. He described vemurafenib as "an exciting drug and one of the success stories of cancer research".

"It's not a cure for melanoma but can give people valuable extra months," he added.

More than 12,800 people in the UK are diagnosed with melanoma skin cancer every year and around 2,200 die from the disease.

Professor Marais added: "This new study is exciting because it suggests a way to combat the evolution of drug resistance in melanoma patients using the drugs we already have, rather than having to develop new ones. It will be interesting to see if these lab results are mirrored in clinical trials."

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Cancer Research UK Reveals 2012’S Greatest Legacies

Thursday 27 December 2012

Cancer Research UK Press Release

The Olympic and Paralympic Games combined are expected to leave the most significant legacy of 2012, according to a survey by Cancer Research UK.*

Almost three-fifths of people (58 per cent) put The Games at the top of their list (46 per cent chose The Olympic Games, and 12 per cent chose The Paralympic Games), whilst the national cheer of the Queen’s Diamond Jubilee celebrations seems to have been overshadowed with just nine per cent thinking this would be most likely to leave a long-term effect on society.

People’s choices also weren’t entirely positive with one in six (16 per cent) saying that the Euro-zone crisis would leave the most significant legacy from 2012.

• 58 per cent of UK adults feel that the London 2012 Olympic and Paralympic Games combined will leave the most significant legacy of 2012 for the UK
• 60 per cent of UK adults think, overall, the significant UK events from 2012 will leave a positive legacy
• 41 per cent of UK adults feel optimistic about what their life will be like in 2013
• 66 per cent of people want to be remembered for their honesty and kindness, compared with only 8 per cent for being rich or successful and 5 per cent for being good looking

The online survey of 2,098 UK adults was carried out by YouGov for Cancer Research UK’s campaign to raise awareness about the importance of legacies or gifts in Wills, which fund over a third of the charity’s life-saving work.

Caroline Kent, director of Legacies at Cancer Research UK, said: “2012 has been a fantastic year with so many exciting events taking place, all of which have sparked a great debate about which will leave the most lasting legacy. We wanted to make the most of this opportunity while legacies are at the forefront of people’s minds to raise awareness of the huge impact leaving your own legacy to charity can make.

“Legacies left to us at Cancer Research UK have been crucial to achieving the progress we’ve made, with survival rates doubling over the last 40 years. We rely on people’s generosity, with gifts in Wills making a significant contribution to our work into the prevention, diagnosis and treatment of cancer to help bring forward the day when all types of cancer are cured.”

When people were asked what they would most like to have done and be remembered for, winning gold at the Olympics came out on top with a quarter (26 per cent) of the vote. What’s more, the importance of scientific research resonated with the public with 16 per cent saying they would have liked to have been responsible for catching a first glimpse of the Higgs Boson particle – possibly one of the greatest scientific breakthroughs of all time. However, very few wanted to be named in the history books for their daredevil antics. Only two per cent said they would have liked to make their name breaking the sound barrier without machine assistance as Felix Baumgartner did when he leapt from space in October.

The study also asked respondents how positive they felt about the events of 2012. Despite the banking crisis, phone hacking scandal and flooding devastating the homes of many across the UK, this survey suggests that the national pride inspired by the Olympic legacy has helped positivity prevail across the nation as the year draws to a close. Three in five (60 per cent) say they think that overall 2012 will leave a positive legacy and around four in 10 (41 per cent) feel optimistic about what their lives will be like in 2013.

When asked to choose from a list of traits to be remembered for, nearly two thirds of people (66 per cent) chose honesty and kindness, compared with just eight per cent for being successful or rich. Faithfulness and loyalty (45 per cent), and being a good parent (44 per cent) were also popular choices while people were less likely to want to be remembered for being clever (16 per cent) or good looking (five per cent).

There was a startling difference between how the older and younger generations would like to be remembered. Of those aged 18-24, more than four in 10 (43 per cent) wanted to be remembered for being clever compared to less than one in 10 (8 per cent) of the 55s and over. What’s more, 14 per cent of those aged 18-24 wanted to be remembered for being good looking whereas amongst the 55s and over this had dropped to only one per cent. Interestingly, the 55s and over were also much less likely to want to be remembered for making a difference to society (17 per cent) compared to those aged 18-24 (41 per cent).

Kent added: “It’s clear from the results of this survey that besides the differences shown between generations in how they would wish to be remembered, most people want to be remembered for being honest and kind.  We would like to encourage everyone to think about what their own legacy could be. A gift in your Will to help us beat cancer is one way of creating a lasting legacy today which will benefit millions in years to come. By remembering Cancer Research UK in your Will you can be part of the collective force leading pioneering research to save more lives by preventing, controlling and curing cancer."

Find out more information about leaving a legacy to Cancer Research UK at www.cruk.org/legacies.

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Bowel cancer gene discovery cracks mystery of families with a strong history of the disease

Sunday 23 December 2012

Cancer Research UK Press Release

Cancer Research UK-funded scientists have discovered that two gene faults increase the risk of bowel cancer in families with a strong history of developing the disease, who, until now, had no explanation as to why their risk was greater. The research is published in Nature Genetics1.

To find the faults, the researchers from the University of Oxford and The Institute of Cancer Research, London, scanned the genes of 20 people2 from families with a strong history of bowel cancer. They found everyone who had a faulty POLE or POLD1 gene developed bowel cancer or had a precancerous growth in the bowel.

The two genes are so-called ‘dominant’ genes, where only one faulty copy needs to be inherited for someone to be at a high risk of developing bowel cancer.

To confirm their findings they then looked for the faults in almost 4,000 people with bowel cancer and 6,700 without the disease. Neither of the faults were found in people without bowel cancer, while 12 people with the POLE gene were found in the bowel cancer group and one person had a POLD1 gene fault.  

The POLD1 fault was also found to increase the risk of getting womb cancer and possibly brain tumours with seven people in the study being diagnosed with womb cancer and one developing two brain tumours.

Cancer Research UK’s Professor Ian Tomlinson, lead researcher based at the University of Oxford, said: “There are some families where large numbers of relatives develop bowel cancer but who don’t have any of the known gene faults that raise the risk of developing the disease.

“These two faults are rare, but if you inherit them your chance of bowel cancer is high. By testing people with a strong family history of the disease for these faults, we can identify those who are at high risk and try to prevent the disease by using colonoscopy and other methods.”

POLE and POLD1 are involved in scanning and repairing damage to DNA, removing incorrect sequences from the DNA chain. Without these genes, affected individuals build up damage in their DNA which can cause bowel cancer.

Study co-leader Professor Richard Houlston from The Institute of Cancer Research said: “Uncovering gene faults like these two is extremely important, as inherited susceptibility plays a role in the development of about a third of all cases of colorectal cancer.

“This is one of the most important discoveries in bowel cancer genetics in years. It should allow us to manage families affected by inherited bowel cancer much more effectively, and it offers new clues for the prevention or treatment of all forms of the disease.”

Joe Wiegand, a financial advisor from Hampshire, was diagnosed with bowel cancer seven and a half years ago at just 28 years old. Joe had most of his large bowel removed and six months of chemotherapy. His treatment was successful and he is now followed up once a year with a sigmoidoscopy. As many of Joe’s relatives had also had bowel cancer, during his treatment he was invited to take part in this study to investigate genetic faults that may be behind his cancer.

Joe said: “There’s a very strong history of bowel cancer in my family – my dad’s mother and sister both had it, my dad was diagnosed with it at 43 and a few cousins have had bowel cancers and brain tumours. It’s clear that something’s going on in our family. I hope that taking part in this study will spare my two children the uncertainty of not knowing if they have this gene fault by having a simple yes or no blood test.”

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: “This research provides another piece of the puzzle for families who have a much greater risk of developing bowel cancer.

“Cancer Research UK scientists have played an important role in finding the gene faults that increase cancer risk. Their work means doctors can help families with a strong family history by preventing cancer from developing or diagnosing it earlier to help more people survive.”

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World-first tissue study could re-shape future of advanced prostate cancer treatment

Thursday 20 December 2012

Cancer Research UK Press Release

The first-ever comprehensive study of prostate cancer tissue has revealed a completely new gene network driving the disease in patients who have stopped responding to standard hormone treatment, according to Cancer Research UK research published today in Cancer Cell.

Surgeons at the Cancer Research UK Cambridge Research Institute, at the University of Cambridge studied tissue samples from men with prostate cancer. They discovered that a protein called the androgen receptor fuels advanced prostate cancer by switching on genes previously not linked with the disease. These findings reveal potential new drug targets and markers that could be used to monitor progression of the cancer.

Prostate cancer is mainly driven by androgens – the male sex hormones – which send messages through the androgen receptor into the cells and tissues. When these messages are faulty they can trigger cancer cell division.

Standard treatment for prostate cancer includes blocking these androgens. But some men become resistant to the drugs – developing what is known as castrate-resistant prostate cancer.

Previous cell studies have shown that the androgen receptor attaches to and ‘switches on’ specific genes to drive cancer.

But this tissue study reveals, for the first time, that when androgen is absent from the bloodstream, the androgen receptor continues to fuel the disease by switching on a completely different gene set. This includes genes associated with the production of glucose and fat.

Study author, Naomi Sharma, Urology Academic Registrar at Addenbrooke’s Hospital based at the Cancer Research UK Cambridge Research Institute, said: “This is the first comprehensive tissue study of its kind and shines a new light on the biology of prostate cancer.

“Our understanding so far comes from studies in cells grown in the laboratory. In this sophisticated study using samples directly from patients, we’ve uncovered a much more complex network of cell messages. These messages switch on a completely different set of genes that continue to drive the disease in men for whom standard hormone treatments have stopped working.

“These important findings provide fresh targets for the development of new drugs to treat advanced stages of prostate cancer, and new ‘flags’ to help doctors track the progression of the disease in patients.”

Up to 41,000 men in the UK are diagnosed with prostate cancer each year – the most common cancer in UK men – and around 10,700 men die from the disease each year.  

Professor Malcolm Mason, Cancer Research UK’s prostate cancer expert, said: “This fascinating research reframes our understanding of how the androgen receptor works – painting a very different picture of how it drives cancer.

“I run clinical trials aiming to help men with prostate cancer so I’m keenly aware of the need to find new ways for us to deal with the disease.

“We helped to develop abiraterone – an important new drug for treating men with advanced disease. And it’s thanks to the generosity of our supporters, that we’re able to fund cutting-edge research like this, which is helping us work towards a day when cancer is cured.”

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Blocking SMURFs may increase effectiveness of experimental melanoma drug

Thursday 20 December 2012

Lowering the levels of a protein called SMURF2 inside melanoma cells can boost the effectiveness of experimental drugs called MEK inhibitors, according to researchers in Manchester.

The discovery could ultimately lead to new trials aimed at overcoming resistance to these drugs, which can develop rapidly in melanoma patients on existing trials.

Dr Claudia Wellbrock and her team at the Wellcome Trust Centre for Cell-Matrix Research at Manchester University compared human melanoma cells that responded to the drugs against cells that did not.

The cells that did not respond to the drug contained higher levels of the protein SMURF2, according to the research published in the Journal of the National Cancer Institute.

But if the level of SMURF2 in the resistant melanoma cancer cells was artificially reduced, then the tumour cells became 100 times more sensitive to the drug.

Further analysis showed that removing SMURF2 lowers the level of a second protein, called MITF, in tumour cells. The research indicates that MITF is responsible for resistance to MEK inhibitors, at least in some cases.

"We're very excited about the potential for this new approach that has proved to be so effective in our experiments," Dr Wellbrock said.

Melanoma is one of the most deadly forms of cancer and is the fifth most common cancer in the UK.

"By the time many people are diagnosed with melanoma the cancer has already started to spread and advanced tumours can be highly resistant to conventional cancer treatments," Dr Wellbrock said.

"The development of resistance to new drugs has also been a major drawback."

"If we can identify more potent and less toxic drug combinations to tackle melanoma then we could save thousands of lives."

Cancer Research UK co-funded the research. Dr Julie Sharp from the charity said such efforts will form a key part of plans for the new Manchester Cancer Research Centre.

The centre is intended to bring together all the latest research developments and expertise to help revolutionise the way cancer is treated.

"Recently there have been some really exciting developments in treating melanoma - but new approaches that tackle the problem of resistance are still needed," she added.

Dr Wellbrock's team at Manchester University next task is to find a drug that can reduce the activity of SMURF2 in cancer cells.

Researchers are currently searching through existing drug collections for one that may already be approved for treating a different condition.

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One in five bowel cancer patients diagnosed in an emergency

Tuesday 18 December 2012

Many bowel cancer patients are first diagnosed in an emergency setting, when they have severe and potentially life-threatening conditions, figures show.

There are 29,000 bowel cancer patients diagnosed each year in England and Wales. One in five of these is admitted as an emergency, according to the National Bowel Cancer Audit.

Nearly a third of those diagnosed through the emergency route were not offered surgery because their cancer was already too advanced to be operated on.

The proportion of bowel cancer patients who die following major surgery has fallen for the fourth consecutive year.

But more patients operated on in an emergency died within 90 days of having surgery (11.9 per cent) compared with the number of all bowel cancer patients who died within 90 days of surgery (5.1 per cent).

More needs to be done to raise awareness about the disease to ensure more people are diagnosed earlier, say experts.

Nigel Scott, the consultant colorectal surgeon at the Royal Preston Hospital who led the audit, said: "Bowel cancer emergency admissions are a persistent and very significant health problem.

"Symptom awareness campaigns are useful to break down the taboos of bottoms and bowels that lock these symptoms behind the bathroom door. But emergency surgery continues to be the Cinderella of surgical practice in the UK."

He also said that a recent survey of surgeons highlighted that "NHS pressures currently work against emergency cases, with 55 per cent of surgeons describing inadequate emergency theatre access."

Sarah Woolnough, Cancer Research UK's director of policy, said: "This report confirms that too many people are being diagnosed with bowel cancer through an emergency hospital admission, and at a stage when treatment is less likely to be successful. This underlines the importance of knowing the potential symptoms of bowel cancer, such as loose stools or blood in your stools, as there's a better chance of surviving the disease if it's diagnosed earlier.

"Raising awareness about bowel cancer symptoms could also encourage people to take up their invitation for bowel screening and improve early detection of the disease."

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Blood cell gene fault linked to breast and ovarian cancer

Monday 17 December 2012

Scientists have linked a rare genetic fault in the immune system to an increased risk of breast and ovarian cancers.

The research from a team at The Institute of Cancer Research suggests an entirely new way tumours develop.

The lead researcher on the study, Professor Nazneen Rahman, said it was one of her lab's "most interesting and exciting discoveries".

According to the study, published in the journal Nature, women with faults in a gene called PPM1D in their blood cells were 20 per cent more likely to develop breast or ovarian cancer.

That is twice the average breast cancer risk and more than 10 times the ovarian cancer risk of women in the general population.

The discovery could have implications for future genetic testing and targeted prevention, especially in the case of ovarian cancer.

Dr Emma Smith, Cancer Research UK's senior science information officer said: "This exciting discovery could help doctors identify women at higher risk of developing breast and ovarian cancer in the future.

"This may have a particular impact on ovarian cancer, which is often diagnosed at a late stage.

"Understanding the genetic mistakes that drive these cancers may also lead to new ways to treat these diseases."

The researchers speculate that they have uncovered a new cancer-causing process, since the PPM1D gene appears to operate differently to other genes known to increase the risk of breast and ovarian cancer, such as BRCA1 and BRCA2.

The team found that changes in PPM1D were not inherited and rather than being present in every cell - as in most inherited cancer-causing genes - they were only present in immune cells known as lymphocytes.

Even more surprisingly, the PPM1D gene was not altered in women's cancer cells, nor in their normal breast or ovarian cells, the study discovered.

The changes make the PPM1D gene overactive, reducing the action of a gene called TP53, one of the most frequently altered genes in cancer cells.

The ICR's Professor Nazneen Rahman, who led the study, said: "This is one of our most interesting and exciting discoveries. At every stage the results were different from the accepted theories.

"We don't yet know exactly how PPM1D mutations are linked to breast and ovarian cancer, but this finding is stimulating radical new thoughts about the way genes and cancer can be related."

Professor Rahman said the findings could also help inform women's decisions about future medical treatments.

A woman might, for example, consider keyhole surgery to remove her ovaries after completing her family if she knew she had PPM1D changes and had a one in five chance of developing ovarian cancer.

The study was funded by Cancer Research UK, the ICR, the Wellcome Trust and Breakthrough Breast Cancer.

Researchers analysed 507 genes involved in DNA repair in 1,150 women with breast or ovarian cancer, identifying PPM1D gene changes in five women.

They then sequenced the PPM1D gene in 7,781 women with breast or ovarian cancer and 5,861 people from the general population.

25 of the women with cancer had faults in PPM1D, compared with only one in the general population, a highly statistically significant difference, the researchers said.

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Thyroid cancer cases double in 20 years

Friday 14 December 2012

Cancer Research UK Press Release

The number of people diagnosed with thyroid cancer in England has doubled since the early 1990s, according to a new report published by the National Cancer Intelligence Network (NCIN) today (Friday).

Between 1990 and 1994 around 900 people (1.7 per 100,000 people) were diagnosed with thyroid cancer every year in England. By 2006-10 this figure increased to 1,950 (3.4 per 100,000 people). But, thanks to effective treatments, survival rate have remained high, at around 90 per cent.

Researchers from the Oxford Cancer Intelligence Unit found that most of this increase has been seen in a particular type of thyroid cancer called papillary cancer. This form of the disease has the best prognosis.

The rise has been linked to increased diagnosis of the disease through better techniques such as ultrasound and fine needle biopsies that can pick up much smaller cancers and possibly a ‘real’ rise in the number of people developing thyroid cancer.

Mr David Chadwick, consultant endocrine surgeon at Chesterfield Royal Hospital and Chair of the NCIN Thyroid Working Group, said: “The exact reason behind this steep rise in thyroid cancer cases remains unclear. We now have more sensitive diagnostic techniques so it could be that more cancers are being picked up when patients are being tested for other conditions. And, this could mean that we’re detecting and treating some cancers that would otherwise not have shown up during a person’s life.

“We may also be seeing a ‘real’ increase in the incidence of thyroid cancer, some of which may be due to improved long-term survival of other cancers previously treated with radiotherapy to the neck or chest. Sadly, older forms of radiotherapy had a side-effect that increased the risk of other cancers later in life.”

The report also showed that thyroid cancer is three times more common in women than in men1. For men and women one year survival rates had increased, by nine per cent for men to 88.3 per cent and by 15 per cent for women to 94.3 per cent.

Unlike most cancers, thyroid cancer is most often picked up in people aged between 20 and 59, particularly for the papillary form of the disease, with those aged 30 and 54 having the highest rates.

Treatment for thyroid cancer most commonly includes surgery to remove the thyroid and is often followed up with radioactive iodine. This acts as a ‘targeted treatment’ as the iodine is only taken up by thyroid cancer cells, ultimately killing them.

While this treatment approach has meant that most people with thyroid cancer are successfully treated, there are some forms of the disease that have a very poor prognosis.

Currently, it is difficult for doctors to predict the behaviour of thyroid cancer in an individual patient, which means that most patients will require thyroid surgery.

Chris Carrigan, head of the National Cancer Intelligence Network (NCIN), said: “This increase in the number of people being diagnosed with thyroid cancer reflects a trend that we’re seeing in other countries. While thyroid cancer is generally a very treatable disease, there is a lot we don’t understand about it. We need to better understand the different forms of the disease so that doctors can predict which patients need more aggressive treatment and which don’t.”

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Inherited gene fault influences breast cancer survival

Tuesday 11 December 2012

Cancer Research UK Press Release

Researchers have shown that an inherited gene fault influences the chances of some women surviving breast cancer. It also increases the risk of women developing a second breast cancer. The research is published in this week’s Journal of Clinical Oncology1.

The scientists, funded by Cancer Research UK, found that women with the fault, and who had the oestrogen-receptor-positive form of breast cancer, were more likely to die from the disease - 62 out of 100 women who carry the fault will be alive ten years after being diagnosed compared with 73 of 100 who do not carry the fault.

The research also found that women with the fault were more likely to develop a second cancer. In the study, 24 per cent of women with the fault developed a second breast cancer compared to seven per cent without the fault2.

The gene fault, called CHEK2*1100delC, creates a faulty protein that interrupts a cell’s ability to repair damaged DNA, so increasing the number of DNA mistakes that can lead to cancer.

The fault is carried by about one per cent of all women and it is already known that women with it are more likely to develop breast cancer.

Dr Paul Pharoah, lead researcher based at the University of Cambridge, said: “This is the first time we’ve shown how CHEK2 faults influence the long-term prognosis of breast cancer. We need further studies to see if we can find other similar faults that affect how the disease develops so that one day we can test and predict how each individual woman’s breast cancer will behave.”

The researchers also predict that women with this genetic mistake are more susceptible to other forms of cancer, contributing to the increased risk of early death after a breast cancer diagnosis.

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: “We’ve made huge progress improving the diagnosis and treatment of breast cancer - in the 1970s around five out of 10 women with breast cancer survived beyond five years but now it's more than eight out of 10. But, we still need better ways to predict how the cancer will behave to help doctors treat the disease more effectively.

“These results suggest that more widespread testing for the CHEK2 fault could help identify women with oestrogen-positive breast cancers who are at a greater risk of developing a second breast cancer. Further research needs to be done to see if these women would benefit from long-term treatment with anti-oestrogen drugs, such as tamoxifen, to try and reduce this risk.”

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High-risk women may need more frequent ovarian cancer screening

Friday 7 December 2012

Cancer Research UK Press Release

Screening women at high risk of ovarian cancer once a year may not be effective enough to spot the disease in its earlier stages, and more frequent screening may be needed for this group of women, according to new research published in the Journal of Clinical Oncology.

The UK Familial Ovarian Cancer Screening Study (UKFOCSS) looked at the results of annual screening in over 3,500 women aged 35+ between 2002 and 2008. During this period, 26 women developed ovarian or fallopian tube cancers.

The research, funded by Cancer Research UK and The Eve Appeal, aimed to see how good a yearly screening programme (involving ultrasound and blood tests) would be at picking up ovarian and fallopian tube cancers in women who were thought to be at high risk of the disease*.

The study found that annual ovarian screening did pick up the majority of cancers, but by the time cancers had been diagnosed, most of them had already started to spread. Women who had been screened within the previous year were less likely to be diagnosed with the most advanced stages of ovarian cancer, compared to women who had not been screened for over a year.  But screening did not increase the proportion of women diagnosed with stage I cancers, leaving the question of whether even more frequent screening would be necessary to increase the number of cancers detected earlier.

The authors from UCL’s Institute for Women’s Health suggest that screening high-risk women more frequently, coupled with swift surgery where necessary, might improve the chances of finding these cancers at an earlier stage. They are now assessing the results of the second phase of the study, which will show the impact of screening high-risk women every four months, and the findings are to be presented next year.

Dr Adam Rosenthal, senior lecturer and consultant gynaecological oncologist at Barts Cancer Institute and lead author of the study, said: “These results support a possible role for screening women at high risk of ovarian cancer, but only if they have decided not to have surgery to remove their ovaries and fallopian tubes.

“The study shows that screening is picking up most cases of ovarian cancer before they reach the most advanced stages. But, by the time they are detected, the majority have still spread and the outlook for these patients is likely to be poorer than for women whose cancers have not spread. At this time, annual screening cannot be considered to be such a safe bet as risk-reducing surgery and it’s important that high-risk women know the options and outlooks available to them.”

Professor Ian Jacobs, principal investigator of UKFOCSS said “I am delighted that the results of this first phase are now published and that the findings are encouraging. We await further information from this trial and from the large study of screening in women without a family history, the UK Collaborative trial of Ovarian Cancer Screening, UKCTOCS, to establish whether or not screening with a blood test or ultrasound saves lives.”

Jessica Harris, health information manager at Cancer Research UK, said: “Until we have the results from two other key studies into ovarian cancer screening, it’s too soon to know whether any type of screening could be effective for high-risk women. So women with a strong family history of ovarian or other cancers should talk to their doctors about the options and whether they could be referred for genetic testing.

“Cancer Research UK has been at the heart of research that has helped make women diagnosed with ovarian cancer now twice as likely to survive compared to back in the 1970s. When ovarian cancer is diagnosed at an early stage, treatment is more likely to be successful and many more women survive. So if you experience tummy pain, bloating or a lasting sense of feeling full that won’t go away, then you should visit your doctor.”

Robert Marsh, CEO of The Eve Appeal, said: “It’s encouraging to receive meaningful and helpful information for high-risk women from the first phase of this trial. While we await the results of phase II of this, and the larger UKCTOCS trial for women without a history of ovarian cancer, our message to all women is to be aware of the signs and symptoms of ovarian cancer and to visit your GP if you have any concerns at all.”

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Study confirms fewer, bigger doses of radiotherapy benefit breast cancer patients

Thursday 6 December 2012

Cancer Research UK Press Release

A lower total dose of radiotherapy, delivered in fewer, larger treatments, is as safe and effective at treating early breast cancer as the international standard dose, according to the 10-year follow-up results of a major Cancer Research UK trial presented at the 2012 CTRC-AACR San Antonio Breast Cancer Symposium today (Thursday).

Nearly 4,500 women across the UK have taken part in the START trials, which were co-ordinated by the Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, and funded by Cancer Research UK, the Medical Research Council and the Department of Health.

The initial five-year results showed it was just as effective and safe to give women a lower total dose of radiotherapy in fewer, larger treatments than the 25-dose international standard. The new treatment routine also offered important benefits for women, including fewer trips to hospital, as well as cost savings for the health service.

As a result, the shorter treatment course of 15 treatments was adopted in the UK in 2008, but the longer course is still used in many other countries.

This latest 10-year follow-up, funded by Cancer Research UK, confirms these benefits and shows that very few women (around six per cent) experience a relapse of cancer within the same breast, regardless of whether or not they have a shorter course of radiotherapy after surgery.

Chief investigator Professor John Yarnold, professor of clinical oncology at The Institute of Cancer Research (ICR) and honorary consultant at The Royal Marsden NHS Foundation Trust, said: “We have shown conclusively that less can be more in breast cancer radiotherapy. Three weeks of radiotherapy is as good as five weeks – as well as being more convenient and less tiring for patients and cheaper for the health service.

“The risk of breast cancer recurring continues beyond five years, and side-effects of radiotherapy can often develop many years after treatment, so these long-term results provide a very important reassurance that the shorter treatment course is definitely the best option for patients. Some doctors may have been hesitant to change their practice on the basis of five-year results, but these long-term findings should convert those sceptics.”

The same team is now setting out to investigate whether even fewer doses of radiotherapy could be just as effective, as part of a new Phase III randomised controlled trial of 4,000 women called FAST-FORWARD. The trial will compare the new standard 15-dose course of radiotherapy treatment, delivered over three weeks, with an even shorter five-dose course, delivered over one week.

Jo Haviland, a senior statistician at the ICR, added: “The START trial has had a huge impact on changing the standard of care for women with breast cancer in the UK, and increasingly around the world. Recruitment is already underway for the new FAST-FORWARD trial we are co-ordinating, to see if we can further improve treatment and spare both women and the health system the burden of extra treatments.”

Kate Law, Cancer Research UK’s director of clinical research, said: “What’s really exciting is that, as a result of this trial, women are already benefiting from the added physical and emotional wellbeing of needing fewer hospital visits for their treatment. Minimising the long-term side effects of treatment is becoming increasingly important as cancer patients live longer. We hope that women around the world will now be able to benefit from this improved standard of care.”

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National audit reveals improvements in lung cancer care

Wednesday 5 December 2012

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Trial reveals 10 years of tamoxifen halves later deaths from commonest kind of cancer

Wednesday 5 December 2012

Cancer Research UK Press Release

Ten years of tamoxifen treatment can approximately halve the number of deaths from  the most common form of breast cancer during the second decade after diagnosis,  according to the results of the Cancer Research UK- funded ATLAS trial published in the Lancet today (Wednesday).

Around three-quarters of women with breast cancer in the UK are diagnosed with oestrogen-receptor positive (ER+) disease, which is driven by the female hormone, oestrogen.  After any surgery, radiotherapy or chemotherapy, many women receive some years of endocrine treatment with a drug like tamoxifen or with an aromatase inhibitor, to prevent any remaining cancer cells being ‘re-fuelled’ by oestrogen.

Tamoxifen taken daily for five years – the current standard duration of treatment – is already known to reduce death rates by around a third throughout the first 15 years after diagnosis, as the protective effects continue for at least a decade after the five years of treatment has ended.

The new trial investigated whether continuing to take tamoxifen for a total of 10 years would reduce the breast cancer death rate still further.

The international ATLAS study, also co-funded by the Medical Research Council, recruited nearly 7,000 women with ER+ breast cancer who were completing five years of tamoxifen treatment. They were randomly allocated, half to stop treatment immediately and half to continue for five more years.  All were followed for an average of another eight years.

Initially there was little difference in outcome from the two groups, because throughout the first decade both groups were protected by the first five years of treatment. But, after year 10 the additional benefits of longer treatment emerged in the group that continued taking tamoxifen. Among them, the risk of dying during the second decade from breast cancer was further reduced by about a quarter – on top of the substantial benefits due to the first five years of treatment.

Most of the extra protection from taking the drug for longer occurred after the end of the 10-year treatment period.

Dr Christina Davies, a Cancer Research UK scientist at Oxford University and leader of the ATLAS study, said: “Around three-quarters of all UK women with breast cancer have hormone sensitive disease, and ATLAS shows that 10 years of tamoxifen helps save lives not just during the decade women are taking the drug, but also during the second decade after diagnosis.”

In post-menopausal women tamoxifen increases the risk of endometrial – or womb – cancer. The ATLAS results showed that the extra risk of dying from this disease was two per thousand women who took tamoxifen for five years, and four per thousand women who took tamoxifen for 10 years. The reduction in the numbers of deaths from breast cancer after 10 years of tamoxifen was about 30 times as great as this increase in the numbers of endometrial cancer deaths.

Cancer Research UK is a major funder of breast cancer research in the UK. Our research has contributed to developing treatments that mean that eight out of 10 women now survive their breast cancer for more than five years, compared with five out of 10 women in the 1970s. And 64 per cent of women now survive their breast cancer for at least 20 years.

Martin Ledwick, Cancer Research UK’s head information nurse, said: “This important study adds further clarity to the question about the length of time women should take tamoxifen.  Although treatment for hormone receptor positive breast cancer has become more complex in recent years with some women receiving aromatese inhibitors, these results will help in deciding the length of treatment for women who are prescribed tamoxifen alone.”

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Britons want bowel cancer screening recommendation

Wednesday 5 December 2012

Cancer Research UK Press Release

Britons want a recommendation from the NHS on whether to attend bowel cancer screening, along with all the information on benefits and risks, according to research published in the British Journal of Cancer today.

The study involved interviews with nearly 2,000 UK adults aged 50-80, asking if they would prefer a recommendation to be screened for bowel cancer from the NHS or advised to make the decision themselves. They were also asked if they wanted to know about all the risks and benefits.

Eighty four per cent wanted an NHS recommendation to attend screening and more than three quarters of those asked wanted all the available information.

There was no difference in the preference for a recommendation between richer and poorer people or between older and younger. But men were more likely than women to want a recommendation.

By 2025, it is predicted that bowel screening will save over 2,000 lives from bowel cancer each year in the UK.  Like all screening tests, bowel cancer screening is not perfect. People sometimes get a ‘false positive’ result. This means they are sent for follow-up tests (which can be worrying and they have risks of their own) but nothing is found. People also sometimes get false negatives, meaning a cancer could be missed.

New technologies are being developed and introduced into the bowel cancer screening programme in England. In 2010, Cancer Research UK helped to fund a trial into the use of the Flexi-scope*.  This new one-off test for people in their mid-fifties can prevent bowel cancer from developing by finding and removing polyps that could otherwise turn into cancers. The government has promised to fund a national programme of Flexi-scope screening due to start early next year.

Professor Jane Wardle, lead author and director of Cancer Research UK’s Health Behaviour Research Centre at UCL, said: “We have seen that most people who wanted a screening recommendation also wanted all the available information. This suggests that advice from an expert is an important part of the decision-making process and not an alternative to it.

“The study also showed that most people in the UK have a high level of trust in the NHS, which may explain why so many people are so keen to have a clear recommendation from it.”

Sara Hiom, director of information at Cancer Research UK, said: “This study gives a much clearer picture about what information people want when being invited to bowel screening. This is very timely and we hope it will help the development of new information for the public.

“The study’s importance goes beyond the information provided by the NHS – it will also help cancer charities like Cancer Research UK to develop the information we offer to the public about screening.

“Cancer Research UK funds research into new methods and technologies to prevent and detect bowel cancer earlier, as well as to improve the outcomes for people who are diagnosed with bowel cancer. But it’s essential that this work is coupled with accessible information for the general public.”

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Study backs flexi-scope for bowel screening

Tuesday 4 December 2012

Using an internal camera called a flexi-scope to screen for signs of bowel cancer can greatly reduce deaths from the disease, according to a review of previous evidence.

The authors say the results, published in PLoS Medicine, "provide grade A evidence" for the inclusion of the technique in national bowel screening programmes.

The UK government has committed to introduce the technique by 2016, after a landmark UK trial funded by Cancer Research UK showed it could reduce deaths by 43 per cent.

Flexible sigmoidoscopy - also known as flexi-sig or flexi-scope - involves using a flexible tube with a camera and light at the end to look into the lower part of the large bowel. It can spot both early-stage cancers and pre-cancerous polyps.

Led by Dr Joseph Elmunzer from the University of Michigan Medical Center, the review analysed the combined results of five randomised controlled trials, including the UK trial.

It found that, overall, the number of new cancers among those who were screened using flexible sigmoidoscopy was reduced by almost a third (32 per cent), while deaths from bowel cancer were halved.

"These findings provide grade A evidence for the inclusion of flexible sigmoidoscopy in colorectal cancer screening guidelines, akin to the justification afforded to fecal occult blood testing by prior randomized controlled trials," the report's authors said.

"A flexible sigmoidoscopy-based strategy appears highly effective in reducing the incidence and mortality of this malignancy in average-risk patients."

Cancer Research UK welcomed the results, and called for more information on how the roll-out of flexi-scope screening was progressing.

"The results of this overall analysis are similar to our 2010 findings," said Sarah Williams, the charity's health information officer.

"The government has earmarked £60 million to incorporate this test into the national bowel screening programme in England by 2016, and we want to see the new test rolled out without delay.

"We also call on the health services in Scotland, Wales and Northern Ireland to commit to introducing this technique as soon as feasible.

"Flexible sigmoidoscopy saves lives - the sooner it's available on the NHS, the better."

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Death rates from ovarian cancer have fallen by 20 per cent over last decade

Tuesday 20 November 2012

Cancer Research UK Press Release

The rates of women dying from ovarian cancer in England have fallen from 11.2 women in every 100,000 (3,820 cases) in 2001 to 8.8 per 100,000 (3,453 cases) in 2010 – a drop of around 20 per cent, according to a new report by the National Cancer Intelligence Network published today.

And the most notable drop in deaths over the last 10 years has been among women aged 40-69 years old.

The report also showed that survival for ovarian cancer has increased since the mid-1980s – women surviving their disease for at least a year has risen from 57 to 73 per cent and five year survival has increased from 33 to 44 per cent.

But the report found the chance of surviving the disease varies widely between ages, becoming increasingly worse with age, even after adjusting for the higher background mortality in the older population generally. For women aged 15-39 diagnosed with ovarian cancer, 84 per cent survived their disease for at least five years compared with just 14 per cent of those aged over 85 years at diagnosis.

In 2009 almost half of women diagnosed with ovarian cancer were in their 60s or 70s – and over 80 per cent of deaths were in women aged 60 or over.

Dr Andy Nordin, gynaecological oncologist at East Kent Hospitals University NHS Foundation Trust and study author, said: “Our new report is very encouraging and shows a fall in the rates of women dying from ovarian cancer – a type of cancer that has always been notoriously hard to treat. This is because ovarian cancer is a group of different disease types, which is difficult to diagnose and commonly presents as advanced disease. This drop in deaths may reflect improvements in detecting and treating the disease, such as improvements in scanning, surgery and chemotherapy treatments.  Additionally, over the past decade, ovarian cancer patients throughout the UK have experienced better management due to organisation of ovarian cancer care in specialist gynaecological cancer centres, planning of care by teams of cancer experts and specialist surgery by specially trained and accredited gynaecological oncologists.”

The report also highlights that the incidence rates for developing the disease have remained fairly stable since the late 1980s although they have dropped slightly in the last few years.

Dr Nordin, added: “We know the risk of developing some types of ovarian cancer may be related to the number of times a women ovulates during her lifetime. And anytime that she stops ovulating such as during pregnancy and breast feeding, early menopause and taking the contraceptive pill all help to protect against the disease developing.  The fall in incidence could therefore partially reflect the widespread use of hormonal contraceptives since the ‘60s.”

Chris Carrigan, head of the National Cancer Intelligence Network (NCIN), said: “As  ovarian cancer can be very hard to diagnose and treat this report was important to help us learn as much as we can about the numbers of women who develop the disease, how many survive and how many die.”

Ovarian cancer is the fifth most common cancer in women in the UK with around 7,000 cases diagnosed each year.

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More than 33,000 childhood cancer survivors living in the UK

Wednesday 14 November 2012

Cancer Research UK Press Release

An estimated 33,000 long-term survivors of childhood cancer - the vast majority of whom are cured - will be living in the UK by the end of 20121, according to new figures from Cancer Research UK.

The news underlines the tremendous progress that has been made in the fight against children’s cancer over the past 50 years.

In the late 1960s fewer than three in 10 children survived their disease for at least five years. Today that figure has risen to almost eight in 102. But, there is still a need for better treatments to help more of the 1,600 children diagnosed with cancer each year in the UK survive the disease.

The assessment comes as Cancer Research UK launches its annual Little Stars Awards, in partnership with brands-for-less retailer TK Maxx, to recognise the bravery of children who have undergone cancer treatment.

Some types of childhood cancer have seen huge improvements thanks to research into new treatments.

For leukaemia, the most commonly diagnosed cancer in children, clinical trials have been at the heart of this progress. In the 1960s, there were very few treatments available for the disease but, since the 1970s, trials have tested the use of chemotherapy and other treatments. This has led to more than 80 per cent of children surviving their disease for five years or more.

The most common childhood liver cancer – hepatoblastoma - has also seen five year survival rates quadruple from around 20 per cent in the late 1970s to around 80 per cent today. Early trials focused on offering children new combinations of chemotherapy to treat the disease and, more recently, trials have looked at maintaining these improvements in survival rates while reducing the side-effects.

Professor Josef Vormoor, a Cancer Research UK childhood leukaemia expert in Newcastle, said: “What we’ve achieved for some childhood cancers, such as leukaemia, over the last 30 years has been fantastic. This has been thanks to researchers and doctors working together to trial new and improved treatments that offer children and their family’s new hope of beating the disease.

“But, we urgently need better treatments for those children we can’t cure yet, particularly for those with cancers such as neuroblastoma and some types of brain tumours. And, for cancers where treatments are successful we need more targeted drugs so that the children we treat can live full lives without any long term side effects.”

To help more children survive cancer in the future Cancer Research UK is funding a range of trials and research projects.

In neuroblastoma, where 64 per cent of children survive their disease for five years or more, a pioneering therapy called immunotherapy is now being offered to children. This treatment uses the body’s immune system to attack the cancer and recently a new trial was opened to offer this treatment to children with neuroblastoma that has returned who currently have few treatments available.

For a type of bone tumour called Ewing’s sarcoma, where 64 per cent of children survive their disease for five years or more, Cancer Research UK is funding a trial that will test a combination of chemotherapy drugs to see if they are more effective and have fewer side effects than the standard treatments currently used.   

Cancer Research UK’s Little Star Awards, in partnership with TK Maxx, recognise the bravery and courage of children who confront cancer. Every child nominated receives the accolade in the form of a trophy and certificate signed by celebrities.

TK Maxx has supported Little Stars since 2008. To date they have raised a staggering £9 million to help beat children’s cancers.

Eight-year old Amarvir Chatha, from Ilford, Essex, was diagnosed with acute lymphoblastic leukaemia in September 2010 and was so ill at one point it was touch and go whether he would survive.

Amarvir’s mother Nikki, pictured below, said: “We couldn’t believe it when we first heard Amarvir had leukaemia – those first 24 hours were the longest of our lives. But, thankfully he slowly responded well to the treatment and pulled through.”

Amarvir has now finished his intensive treatment and is on maintenance treatment until January 2014. Earlier this year Amarvir received a Little Star Award.

Nikki added: “We came so close to losing Amarvir and we’ll never forget that, we never take life for granted anymore.  We owe his survival to the incredible advances that have been made in children’s cancer research.”

Professor Peter Johnson, Cancer Research UK’s chief clinician, said: “Despite improvements in treatment, around 250 children still lose their lives to the disease each year in the UK. As a major funder of research into childhood cancers in the UK, Cancer Research UK is working towards a future where all children are cured of cancer. We’re funding a range of trials to develop new treatments for cancers where we currently have few treatment options, such as aggressive neuroblastoma, and we hope these efforts will mean there are even more childhood cancer survivors in the UK in the years to come.”

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

Wednesday 7 November 2012

Cancer Research UK Press Release

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

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

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

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

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

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

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

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Smokers leave a history of their addiction in DNA

Tuesday 6 November 2012

Cancer Research UK Press Release

Smokers are leaving a history of addiction in their DNA that may help to measure their risk of cancer, according to research presented at the NCRI Cancer Conference today.

Researchers at Imperial College London and the Human Genetics Foundation (HuGeF) in Italy have identified a number of sites in the DNA of blood that have been chemically tagged as a result of smoking. These tags are also detectable in lung tissue and could be used to measure the increased risk of certain cancers such as breast and bowel, as well as lung.

Smoking leaves a footprint on the surface of the DNA but the sequence of genetic code remains the same. This is known as an “epigenetic” modification. Once you give up smoking, these tags start to disappear although they never quite match the unmarked DNA of a non-smoker.

In this initial study, measuring DNA tagging in blood samples from smokers and non-smokers allowed the researchers to investigate the link between smoking and these tags. The study also looked at the risk of developing breast and bowel cancer in relation to these DNA tags, with plans to expand the work into other areas such as lung cancer*.

While smoking is associated with bowel cancer risk, a link between smoking and breast cancer has not been proven but the researchers believe that previous studies haven’t had the same genetic or epigenetic measures of smoke exposure available. This research will make that information available to scientists so they can spot any DNA tags that might be attributable to any risk that might exist.

Dr James Flanagan, Breast Cancer Campaign scientific fellow at Imperial College London and co-author of the research, said: “This research may help to build a test that will be able to look at a person’s epigenetic information at the molecular level and measure in great detail the added risk of cancer from exposures such as smoking.

“Previous research into smoking has often asked people to fill out questionnaires, which have their obvious drawbacks and inaccuracies. Using this approach, we will be able to read the fingerprint on a person’s DNA to tell us a story of how their habit may have changed over the course of their life.”

Professor Paolo Vineis, chair in environmental epidemiology at Imperial College London’s School of Public Health and head of the HuGeF laboratory in Italy, said: “This research will help us to build a molecular profile of cancer risk, where we can screen people and quantify the exposure they’ve had to a number of risk factors over their lifetime, just by examining a blood sample.

“We hope that smoking is just the start – further work will look into other factors like alcohol and start to measure the risk an individual has built up over a lifetime of exposure to these contributors to cancer.”

Dr Jane Cope, director of the NCRI, said: “This is a very interesting piece of research that applies basic biology to everyday life to reveal just how much damage smoking can do to the fundamental biology of a person. If these early results hold true in more detailed studies, this finding could play an important role in understanding smokers’ cancer risk in the future.”

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

Tuesday 6 November 2012

Cancer Research UK Press Release

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

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

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

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

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

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

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

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

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

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First figures help set the standard for gynaecological cancer surgery

Monday 5 November 2012

Cancer Research UK Press Release

The first UK multicentre figures showing that one in five women having major gynaecological cancer surgery have some sort of complication will help set standards in the NHS, according to research presented at the NCRI Cancer Conference today.

The initial findings of the UK Gynaecological Oncology Surgical Outcomes and Complications (UKGOSOC) audit also reveal that one in 30 women experience a serious complication, which may need another operation or procedure.

The detailed and verified figures come from an interim analysis of more than 1,600 operations carried out across 10 centres in the UK between April 2010 and July 2011. The final results from the full audit, covering the outcomes of around 3,000 operations, will be released later this year.

Surgeons entered details about each patient’s general health, the complexity of their operation and any complications encountered into online computer records. This meant that information about complications could be entered directly from the operating theatre or from the wards if they occurred after surgery. The UKGOSOC audit also sent patients a follow up card 6-8 weeks after surgery.

Understanding the complication rates will help set NHS benchmarking standards, allowing nationwide performance in this area of cancer treatment to be better understood. It will also help doctors to better advise patients on the full risks involved in their treatment decisions.

Professor Usha Menon, head of the Gynaecological Cancer Research Centre at UCL and lead author of the audit, said: “In contrast to the wealth of data regarding complication rates following chemotherapy and radiotherapy, there have been no multicentre figures on complication rates following surgery for gynaecological cancers. This has meant that we have been unable to properly counsel our patients in preparation for surgery.

“It’s hugely satisfying that we now have robust figures and, while complication rates of one in five may seem high, it’s similar to the only other comparable figure available from an Australian study. These numbers also need to be evaluated alongside the survival rates, which should be available in the near future.”

Dr Andy Nordin, a consultant gynaecological oncologist and co-author of the audit, said: “This work is giving us a complete picture of each patient’s treatment, from the operating theatre to eight weeks after they’ve been discharged. In addition to the complication rates, it provides other key information, including details of patients' medical history along with the complexity of their operation.

“We hope to see this electronic data collection process brought into routine practice to improve the information collected by the NHS and to help us to continue to improve surgical outcomes in the UK. The findings, along with the hard work involved in data collection, may well prove useful in other countries too.”

Dr Jane Cope, director of the NCRI, said: “All surgery carries risks and it’s important that patients know that there may be complications during and after their operations. Setting nationwide benchmarks will be an important step in helping doctors and patients better understand the effectiveness of current treatment. Doctors and surgeons can then go on to develop improvements, which will give better outcomes for the patients of the future.”

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Personalised prostate cancer screening may save thousands from unnecessary treatment

Monday 5 November 2012

Cancer Research UK Press Release

Targeting prostate cancer screening based on a man’s age and genes could potentially save thousands of men from unnecessary treatment and save the NHS millions of pounds. The research is presented at the NCRI Cancer Conference in Liverpool today (Monday).

The researchers, funded by Cancer Research UK, developed a theoretical model to compare the effectiveness and cost of two different approaches to prostate cancer screening.

The model showed that a personalised approach – based on a man’s age and looking for the common genes that increase the risk of prostate cancer – would result in fewer deaths from the disease and cost tens of millions less for the NHS to roll out compared to screening all men aged 55 to 79 every four years with the PSA test.

The model also showed 50 per cent fewer men would need to be screened and 18 per cent fewer men would be diagnosed with the disease – possibly reducing the problem of over-diagnosis and saving men from unnecessary treatment that can lead to side effects like impotence and incontinence.

Men in the UK are not screened for prostate cancer as part of a national screening programme. This is because the only available test, the PSA test, is not an accurate indicator of whether a man does have cancer and cannot reliably tell if a cancer is aggressive and so needs treatment.

Instead, men who ask for a PSA test are given information by their GP to help them understand the pros and cons before they decide whether they want to go ahead with the test.

Study author Dr Nora Pashayan, a Cancer Research UK clinician scientist at University College London, said: “We don’t have a screening programme for prostate cancer because the benefits are outweighed by the harms. Identifying men who are more likely to develop prostate cancer and targeting them for screening could potentially save thousands of men from overdiagnosis and unnecessary treatment. We’re now refining our model to develop more definite predictions which will then need to be tested in trials to see if this approach will have the effect we predict.”

Each year over 40,000 men are diagnosed with prostate cancer in the UK, with over 10,500 men dying from the disease.

Professor Peter Johnson, Cancer Research UK’s chief clinician, said: “There is great uncertainty about the usefulness of screening for prostate cancer using the PSA test, with many men finding it difficult to weigh up the pros and cons. This research suggests an important way to select men for whom testing may be more worthwhile, which points us in the right direction for the future. Cancer Research UK is already funding research that is looking at targeting screening to men at a higher risk of developing the disease.”

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Bowel screening helps to detect early cancers before they have the power to kill

Sunday 4 November 2012

Cancer Research UK Press Release

Bowel screening is detecting more cancers when they are less mature and have less aggressive biological characteristics according to new research presented at the NCRI Cancer Conference in Liverpool this week.

The research shows that screening is not only able to pick up more early stage bowel cancer but also that more patients whose cancer is picked up via screening were found to have fewer of the characteristics which make it more likely to have spread. This includes when the tumour grows into blood vessels in the patients tissue surrounding the tumour, making it more likely to go on to spread.

Doctors from the University of Glasgow examined 394 bowel cancer patients in Scotland, 288 whose cancer was diagnosed through screening compared with 106 whose cancer was not detected through screening.

They found that patients diagnosed through screening were more likely to be younger, have earlier stage disease, were less likely to be anaemic and were less likely to have the biological characteristics that give tumours the power to spread.

In particular, patients were also less likely to have high levels of inflammation in their blood (modified Glasgow Prognostic Score). A raised modified Glasgow Prognostic Score is a feature that has recently been shown to predict poorer outcome following a diagnosis of bowel cancer.

Dr David Mansouri, study author and Clinical Research Fellow at the University of Glasgow, said: “Our new study tells us that as well as the bowel cancers being picked up through screening being less likely to have spread by the time they are diagnosed, there were also more patients with features that may increase the chances of survival. It adds to what we already know about the benefits of bowel screening and shows there may well be other advantages to screening. The next step will be to repeat our work with a larger number of patients.”

Dr Jane Cope, director of the NCRI, said: “Deaths from bowel cancer are still very high in the UK – more than 16,000 a year – and only around half of patients survive their disease for more than ten years. But we also know that when bowel cancer is found at the earliest stage, there is an excellent chance of survival and more than 90 per cent of people survive at least five years. So early diagnosis is crucial, and it’s important we find out as much we can about the disease so that more lives can be saved.”

Bowel cancer is the third most common cancer with more than 41,000 people diagnosed with the disease each year.

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HPV test for oral cancers may improve patient outcomes and treatments

Saturday 3 November 2012

Cancer Research UK Press Release

A new test designed to classify tonsil and throat cancers into one of two groups should help deliver the right treatment to the right patients, according to research being presented at the NCRI Cancer Conference in Liverpool next week.

The RNAscope* test can be carried out in hospitals and looks for the presence of the Human papillomavirus (HPV) in oropharyngeal cancers**. Doctors will be able to use the results to classify these cancers as HPV positive or negative and offer treatment accordingly.

Researchers at Liverpool and Newcastle universities analysed 79 oropharyngeal tumour samples for HPV using different techniques. They found that the accuracy of classification in the RNAscope test was similar to that of more complex laboratory results.

Previous research has found the risk of death from HPV positive oropharyngeal cancer to be between 50-80 per cent lower than HPV negative tumours but patients are usually younger so may face a lifetime of treatment-related side effects. The researchers hope that, by classifying the HPV status of the cancer, clinicians can offer eligible patients less intensive treatment with reduced side-effects.

They also believe that it will make it easier to recruit patients for clinical trials as they can specifically screen patients for HPV positive or negative cancers. The HPV testing used in clinical trials is not always accurate and no uniform testing standard exists within the NHS. This research has the potential to solve the problem for NHS practice and clinical trials.

Oropharyngeal cancers linked to HPV are on the rise and previous research has shown HPV-related cancers to be biologically different from other head and neck cancers, leading to new avenues of treatment.

Andrew Schache, study author based at the University of Liverpool, said: “Testing the HPV status of cancers will allow us to pick the most appropriate patients for clinical trials and hopefully help to develop new medicines based on a better understanding of these cancers.

“We’ve shown that the new test, which can easily be carried out in an NHS Pathology laboratory, has the same accuracy and reliability as more complex research laboratory testing. It has the potential to benefit NHS patients because it will help to ensure that they get the most appropriate treatment for their cancer.”

Mr Schache, whose research was funded by the Wellcome Trust and Royal College of Surgeons, has been awarded a Richard Hambro prize*** for this work.

Dr Jane Cope, director of the NCRI, said: “The study was carried out on only a small number of patients so it’s important for further work to be done to ensure the reliability of such a test. Until further research confirms these results, the risk would be that the wrong treatment was offered to a patient based on the outcome of the test.

“But the accuracy so far is proving to be very promising and this work will help us to target patients in the most effective way possible, which is essential if we are to improve survival and reduce side effects in treatment.”

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Experimental combination therapy trial for breast cancer patients no longer responding to treatment

Friday 2 November 2012

Cancer Research UK Press Release

Cancer Research UK’s Drug Development Office (DDO) has joined forces with academia and industry to trial an experimental drug from AstraZeneca called AZD4547 in combination with existing therapies, to treat post-menopausal women whose breast cancer has spread and is no longer responding to standard treatment.

The Phase IIa clinical trial will be run through the Cancer Research UK and NIHR Experimental Cancer Medicine Centre (ECMC) in conjunction with the Imperial Clinical Trials Unit Section on cancer (ICTU-Ca), Imperial College London. It will recruit post-menopausal women with oestrogen positive breast cancer* who are no longer responding to either anastrozole or letrozole – standard treatments for this patient group.

The trial will be divided into two groups. In one group, patients will receive AstraZeneca’s experimental treatment AZD4547 alongside either anastrozole or letrozole. In the second group, patients will be treated with exemestane alone. The trial will evaluate whether the combination of this experimental drug with an existing therapy that has begun to fail may halt the progression of the disease, and make the tumour respond again to the original therapy.

AstraZeneca is the first pharmaceutical industry partner to join the ECMC Combinations Alliance, which launched in 2011. The alliance aims to increase patient access to trials of potential new cancer treatments by combining molecularly-targeted experimental drugs developed and owned by the company – with standard chemotherapy, radiotherapy and other new drugs.

This study is the third launched by the Alliance, and AstraZeneca is providing both supply of AZD4547 and additional funding, with Cancer Research UK’s DDO also providing support.  Imperial College London is sponsoring the trial.

Chief investigator, Professor Michael Seckl, at Imperial College London, said: “The opening of this trial is great news. It’s an incredibly tough part of my job telling breast cancer patients that they are no longer responding to the drugs they are taking. We hope that this trial will be a step forward in finding new and better ways to treat advanced breast cancer, to increase survival from this disease.

“More women are surviving breast cancer than ever before. But while we’re making great progress in developing new targeted treatments there’s still an urgent need for medicine that will treat the disease once it has spread.”

Andrew Foxley, clinical programme director for AZD4547 at AstraZeneca, said: “AstraZeneca has a long-standing commitment to cancer research and has developed medicines that are making a meaningful difference for people with breast cancer. We believe that collaboration is crucial to finding solutions in the fight against cancer and are pleased to partner with others in the UK who share our dedication to bringing new medicines to patients.”

Dr Ian Walker, head of alliance management at Cancer Research UK’s DDO, said: “This is the third trial we’ve launched through collaboration with AstraZeneca – with others in the pipeline. This unique alliance is powering UK research to bring together combinations of new and existing drugs in early clinical trials to find better ways to treat patients and increase survival from a range of cancers.

“Without this important alliance these trials might not be possible. We want to build on the foundations established with AstraZeneca to add additional partners to collaborate with us in the future. Our aim is to set up cross-company agreements to provide access to a larger number of potential treatment combinations.”

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NICE recommends new treatments for advanced melanoma

Friday 2 November 2012

Two new treatments for advanced melanoma skin cancer have been recommended for use by NICE, the healthcare guidance body for England and Wales.

Final draft guidance documents have now been issued for both vemurafenib and ipilimumab. Manufacturers of the treatments have agreed to provide discounts.

Vemurafenib, which is also known as Zelboraf and is manufactured by Roche, has been recommended for the treatment of melanoma that has spread. And ipilimumab, marketed by Bristol-Myers Squibb under the name Yervoy, is recommended for the treatment of advanced melanoma in people who have previously received chemotherapy.

Professor Peter Johnson, Cancer Research UK's chief clinician, said: "We're delighted that discounts on the price of these drugs mean that NICE has been able to approve vemurafenib and ipilimumab for routine use on the NHS.

"Although they are not cures, these treatments represent real signs of progress through our understanding of biology for people with advanced skin cancer - a disease where new treatments are long overdue."

The Health Technology Evaluation Centre director at NICE, Professor Carole Longson, said that without the introduction of new treatments, the prospects for patients with advanced melanoma are "very poor". Their quality of life is also likely to be affected by the condition, she added.

Vemurafenib and ipilimumab are the first new drug treatments for advanced melanoma for over a decade. Currently, the disease is managed with a chemotherapy drug called dacarbazine.

In respone to initial negative verdicts from NICE, the manufacturers of both treatments issued additional analysis. This, along with the discounts offered, meant that NICE was able to rule that the treatments represent a cost-effective use of NHS resources.

Cancer Research UK's Professor Johnson added: "This is a good example of NICE and the pharmaceutical companies working together to ensure that effective cancer treatments get from research to the patients who need them. We want to see responsible pricing from the outset so that patients are not left in limbo."

Professor Longson described the new drugs as "breakthrough treatments" for skin cancer and as such represent a major step forwards for patients.

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Bowel cancer 'chemo swap' shrinks tumours, making surgery safer and easier

Thursday 1 November 2012

Cancer Research UK Press Release

GIVING some bowel cancer patients six weeks of chemotherapy before surgery can significantly shrink their tumour, making it easier to remove and potentially reducing the chances of the cancer coming back, according to results from a major Cancer Research UK-funded pilot study published this month in Lancet Oncology1.

Giving chemotherapy before surgery is already standard practice for several other cancers of the digestive system – including oesophageal, stomach and rectal cancers. This may be more effective at killing off any cancer cells that have broken away and spread elsewhere in the body, than if chemotherapy is delayed until after surgery.

But until now doctors had deemed it too risky to use this approach for colon cancers (part of the bowel) because, if tumours fail to respond to this treatment they continue growing, risking a potentially fatal blockage in the colon that requires emergency surgery. Another challenge was to pick out which patients needed chemotherapy before surgery.

These results - from the pilot of the ‘FOxTROT’ trial - show that, using the latest CT imaging techniques, it is possible to safely and accurately select colon cancer patients who could benefit from having chemotherapy before surgery.

A total of 150 patients took part in the study from 35 hospitals around the UK. They were each randomly assigned to receive either six weeks of the oxaliplatin-based chemotherapy before surgery, followed by 18 weeks afterwards, or the standard treatment of 24 weeks of the same chemotherapy after surgery. All patients had ‘locally advanced’ tumours, that had grown through the colon wall or into nearby body organs but not spread to other part of the body.

Among those given six weeks of chemotherapy prior to surgery - followed by 18 weeks afterwards - 31 per cent (29 out of 94) of patients’ tumours shrank significantly, with two patients’ tumours reported as completely disappearing.

Chief Investigator Professor Dion Morton, from the University of Birmingham, said: “These feasibility results show that pre-operative chemotherapy can be delivered safely and efficiently, paving the way for a larger phase III study which, if successful, could completely change the way we treat colon cancer within five years.

“Shrinking the tumours beforehand makes them easier to remove, reducing the chances of any of the tumour being left behind. Importantly, all of the patients we treated in this way were well enough to proceed with their surgery and they were no more likely to have complications that extended their hospital stay afterwards.”

The trial also looked at adding a new targeted drug called panitumumab to some patients’ treatment. Previous research has shown that this drug can help people with colon cancer that has spread, although this is the first time it has been used in patients prior to surgery.

But panitumumab only works in tumours that don’t have faults in a gene called K-RAS. So first the researchers wanted to find out if it might be possible to carry out K-RAS testing on patients’ tumours quickly enough to use panitumumab before surgery.

Professor Morton added: “We were able to show that genetic testing of patients’ tumours could be carried out within an eight day timeframe – quickly enough to allow patients to potentially benefit from the latest targeted treatments without delay to their surgery or chemotherapy. This has never before been attempted in this group of patients and represents a major step forwards that could see more patients benefitting from such treatments in the future.”

Alan Sugden, 64, from Kidderminster, was diagnosed with colon cancer in 2009, after initially going to his GP with suspected haemorrhoids and later being referred for a colonoscopy.

He was told by his doctors that he had probably had the cancer for about two years and when he found out he was eligible to join the FOxTROT trial, he jumped at the chance.

Alan said: “The trial definitely helped me. Having the chemotherapy before my operation helped shrink my tumour which made it easier for the surgeon. I think it’s essential that people keep signing up to these type of trials to push forward the research. My cancer was treatable and that’s thanks to the work of organisations like Cancer Research UK who keep investing in these areas.

“I have since become a granddad for the first time and am enjoying spending time with my beautiful new baby granddaughter. I continue to travel and have just come back from another lovely holiday to Portugal. Life goes on and you have to make the most of things and keep on going.”

Alan will continue to be monitored on the FOxTROT trial until 2014.

Liz Woolf, head of Cancer Research UK’s patient information website, CancerHelp UK, said: “Although we will need to wait for the results of the phase III trial before we know if this treatment can help prevent colon cancer coming back and improve survival, these initial results are hugely encouraging. Around 1,000 patients from around the world are needed to take part in this larger study. If successful, this could potentially change the course of treatment for thousands of colon cancer patients in the future.”

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Cancer Research UK's response to the breast screening review

Tuesday 30 October 2012

Cancer Research UK Press Release

Dr Harpal Kumar, chief executive of Cancer Research UK, said: “The independent review shows screening saves lives.

“Screening remains one of the best ways to spot the very early signs of breast cancer, at a stage when treatment is most likely to be successful.

“Yet, as the review shows, some cancers will be diagnosed and treated that would never have caused any harm. Clearly, everyone wants to minimise this.

“But because we can’t yet tell which cancers are harmful and which are not, we cannot predict what will happen in an individual woman’s case.
 

“We think it’s vitally important for women to have access to clear information about breast screening, the balance of benefits and harms and the fact that they could be diagnosed with and treated for a cancer that might not cause them harm.

“So, on balance, taking all the evidence into account, Cancer Research UK recommends that women go for breast screening when invited.
“Research is advancing at pace and we hope that in the future there will be a number of new techniques that we can use alongside the screening programme to make it more sophisticated and reduce the numbers of women having unnecessary treatment.

“Until this is possible, we’d recommend women who have had something unusual picked up through screening to seek full advice and discuss all possible options with their breast cancer specialist team.

“We urge the screening programme to update the breast screening information leaflet in the light of the findings of the independent review.”

More information:

• A press release from the Independent Breast Screening Review panel (PDF) 
• More information about the Independent Breast Screening Review and its findings
• A Q&A for women considering breast screening
• A detailed infographic summarising the findings
• Blog post: How can we improve breast screening?

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Scientists discover potential new ‘roots’ of breast cancer

Friday 26 October 2012

Cancer Research UK Press Release

Scientists have discovered new types of early cells in mammary glands, uncovering clues to the origins of different breast cancers - and potential new drug targets, according to findings published in Breast Cancer Research.

The team at Cancer Research UK’s Cambridge Research Institute identified at least two types of early cells, called progenitor cells. Unlike stem cells, which can develop into any type of cell and keep on dividing, progenitor cells can only divide a limited number of times. Previously scientists only knew of one type of progenitor cells in mammary glands.

Cancer is thought to begin in cells that can produce many daughter cells, which form the tumour mass. So different progenitor cells may explain why there are different types of breast cancer.

The team discovered that one group of progenitor cells, called oestrogen positive progenitors, had oestrogen receptors. This protein receives signals from the sex hormone, oestrogen. The other group - oestrogen negative cells - lacked this receptor.

Oestrogen positive progenitor cells survive better in a low oestrogen and progesterone environment - similar to the breast tissue of post-menopausal women. This suggests that tumours in post-menopausal women may develop from these cells, but further experiments are needed to confirm this.

The oestrogen negative progenitor cells have a genetic fingerprint resembling an aggressive type of breast cancer called basal-like breast cancer, more likely to affect younger women. This suggests the disease may develop from the oestrogen negative progenitors.

Study author, Dr John Stingl, at Cancer Research UK’s Cambridge Research Institute, said: “This exciting discovery reveals that mammary glands are much more complicated than scientists initially thought. Uncovering new types of ‘mother’ cells may explain why there are different types of breast cancer, and why young and older women tend to get different types. It could also provide new starting points for ways to diagnose and treat the disease in the future.”

Dr Julie Sharp, Cancer Research UK’s senior science information manager, said: “This research takes us right to the root of how breast cells develop. This fresh understanding could reveal new ways to block the development of cancer and tell us more about what happens when tumours become resistant to treatment.

“Cancer Research UK is a major funder of breast cancer research in the UK. Our research has contributed to progress that means eight out of 10 women now survive breast cancer for more than five years, compared with five out of 10 women in the 1970s. But there’s much more to do. Research like this will build on our understanding of breast cancer to bring forward the day when we can beat this disease.”
 

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Combining imaging and gene analysis could transform breast cancer diagnosis

Wednesday 24 October 2012

Cancer Research UK Press Release

COMBINING two approaches - one that digitally scans images of tumour samples and another that analyses genetic information - gives a more accurate prediction of how breast cancer will behave. The research is published today in Science Translational Medicine1.

Researchers at the Cancer Research UK Cambridge Research Institute have built a computer system that automatically analyses microscopy images of hundreds of breast cancer samples. The new approach looks at the makeup of the cells within a tumour, normally undertaken by a pathologist looking down a microscope, and combines these images with the key genetic changes that are crucial for the development of breast cancer.

Compared to carrying out these tests individually, the new system was more accurate and could give researchers more detailed information about a woman’s breast cancer.

Survival from a type of breast cancer called oestrogen receptor negative can be predicted by the number of white blood immune cells that have entered the tumour. The new test increased the accuracy of predictions based on this from 67 to 86 per cent.

The researchers also found a new way to predict survival based on the arrangement of supporting cells within the cancer. Known as the stroma, these cells play a role in encouraging the growth of breast cancers and are not detected in current tests.

Dr Florian Markowetz, the lead researcher at Cancer Research UK’s Cambridge Research Institute, said: “Cancers are a mix of different cells – not just cancer cells – they also include those from the immune system and others that support the structure of the tumour. These cells play an important role in how cancers behave, but this information is not currently detected in tests that focus on the genetic makeup of the cancer.

“By bridging the gap between the ‘two cultures’ of pathology and genomics our research has a huge potential for better understanding breast cancer.”

Professor Carlos Caldas, also based at Cancer Research UK’s Cambridge Research Institute, said: “This research complements our study earlier this year that found breast cancer was in fact at least ten different diseases. This now takes us a step closer to being able to use this knowledge in the clinic and directly benefit women with breast cancer.”

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: “Combining the visual information from a breast tumour with knowledge of its genetic makeup using computer systems could have a profound impact on how cancer clinics of the future work, enabling doctors to offer women treatments that are tailored to their individual breast cancer.”

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Nerve genes linked to pancreatic cancer

Wednesday 24 October 2012

Detailed genetic analysis of nearly 150 pancreatic tumours has given new clues about how the disease develops and spreads.

The research from Australia suggests that genes involved in nerve cell growth could have a role in the development of the disease, and opens the door to improving treatment of this notoriously hard-to-treat cancer.

Scientists from the University of Queensland and Sydney's Garvan Institute of Medical Research analysed the genetic faults in the pancreatic tumours of 142 patients.

The results, published in Nature, make up Australia's first report and contribution to the International Cancer Genome Consortium (ICGC) . The consortium brings together the world's top scientists to catalogue the genetic faults in 50 different cancer types.

The survival rate for pancreatic cancer in the UK has more than doubled in the past 40 years, but fewer than one in five people survive their disease for more than a year.

Professor Sean Grimmond and Professor Andrew Biankin led the research. They and others analysed the genetic code of pancreatic tumours. These sequences were then compared with that of healthy tissue to identify the genetic changes involved in pancreatic cancer.

"This study demonstrates that so-called 'pancreatic cancer' is not one disease, but many. While tumours may look very similar under the microscope, genetic analysis reveals as many genetic variations in each tumour as there are patients," Professor Biankin said.

"As well as identifying 16 significant genes, we also identified a new pathway we think is important in pancreatic cancer. Called the 'axon guidance pathway', it normally regulates the way the brain and the nervous system develop. We don't know whether cancer has hijacked the same mechanisms or is using the same molecules to do different things."

The study could have implications for understanding the spread of pancreatic cancer as well as its treatment, according to Dr Thorsten Hagemann, a Cancer Research UK expert based at Barts Cancer Institute:

"Pancreatic cancer often spreads alongside the surrounding nerves, so it could be very significant that this team have found faults in genes involved in nerve cell growth in pancreatic tumours. One theory is that pancreatic cancer breaks out and spreads to other parts of the body along the nerve axons - this work could help us understand what is driving this spread.

"The faults in this pathway could also help to explain the pain people with pancreatic cancer often experience, as well as common symptoms of late-stage disease such as weakness and wasting of the body.

He said further work is needed, but "the possibility of future treatments that target this pathway is an exciting one, and this research also indicates that we could look for these gene faults to help predict which cancers are more likely to come back after surgery".

Cancer Research UK are leading ICGC projects in oesophageal and prostate cancer.

Copyright Press Association 2012

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Protein levels could predict if bowel cancer patients will benefit from Avastin

Tuesday 23 October 2012

Cancer Research UK Press Release

Comparing levels of specific proteins that the drug Avastin targets could identify patients with advanced bowel cancer who will benefit from the treatment, according to research published in Clinical Cancer Research1 today.

Avastin, or Bevacizumab, has been shown to increase survival from bowel cancer in around 10 to 15 per cent of patients, but it has been impossible to predict who will benefit.

Avastin works by targeting and blocking the VEGF-A protein, two major forms of which are VEGF165 and VEGF165b.

VEGF165 helps cancers to grow new blood vessels, so they can get food and oxygen from the blood - all cancers need a blood supply to be able to survive and grow.

Its sister protein, VEGF165b, has the opposite effect and acts as a brake on this growth.

Cancer Research UK funded scientists at the University of Bristol looked at the effect Avastin had on patients2 with different levels of VEGF165b and compared this with patients who were not given the drug at all.

Those with low levels of VEGF165b survived three months longer without the disease progressing compared to patients not treated with Avastin. But patients with higher levels of the protein saw no benefit from Avastin and survived no longer than those who were not given the drug.    

Avastin blocks both forms of VEGF-A, so in patients with lower levels of VEGF165b more Avastin may be available to block the blood vessel promoting protein VEGF165, eventually starving the cancer.

Professor David Bates, lead researcher from the University of Bristol’s School of Physiology and Pharmacology, said: “Avastin has shown great potential for a minority of people with bowel cancer, but it’s been impossible to predict who will benefit from the drug. Currently, Avastin is not approved by NICE for patients with advanced bowel cancer because they feel that the benefit to an unknown minority of patients does not justify the cost of treatment.

“We now need to look at cancer samples from a larger group of patients about to start taking Avastin and determine if the amount of VEGF165b can accurately identify those patients that will benefit and so potentially open a new treatment option for some people with advanced bowel cancer.”

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: “New targeted treatments can be hugely beneficial for certain patients, depending on the characteristics of their tumour. But, we don’t always know who these patients are. This work takes researchers a step closer to developing a suitable test so doctors can give Avastin to those people it will really make a  difference to.”

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Breast cancer cells spread by digging their escape route

Monday 22 October 2012

Cancer Research UK Press Release

Breast cancer cells puncture  holes into neighbouring tissues and crawl though the spaces they create to spread around the body, according to research published in the Journal of Cell Biology.

Scientists at Cancer Research UK’s Beatson Institute in Glasgow discovered that there are high levels of a protein called N-WASP in breast cancer cells.

The protein helps form branches with sharp points on the cell surface by rearranging the cell’s internal ‘skeleton’, made of a protein called actin. Actin is essential in all cells for structural support, movement and shape changes.

The branches with sharp points – called pseudopodia – can grab onto and poke holes into the extracellular matrix, the supporting tissue in-between cells. And the team showed that enzymes attach to the protrusions and dig into the extracellular matrix, creating larger spaces.
 
Cancer cells invade their surrounding environment by a combination of pushing and pulling into the newly created spaces – movement which is captured for the first time in 3D on video.

The scientists showed that removing N-WASP from cells resulted in much blunter protrusions, to which fewer enzymes became attached. This reduced the ability of the cells to puncture their surrounding extracellular matrix and spread.

Lead author, Dr Laura Machesky, at Cancer Research UK’s Beatson Institute in Glasgow, said: “Our exciting results reveal a completely new process by which cells can break away from a tumour to invade surrounding spaces and spread around the body. We found that cells assemble specialised structures, with the ability to hold onto the surrounding tissue matrix and dig tunnels into it, which they can then crawl through.

“Our research suggests that N-WASP is a promising target for the development of drugs to combat cancer spread.  We were particularly intrigued because blocking N-WASP activity didn’t affect healthy cells, so we think that N-WASP could be specifically targeted to prevent cancer spread.”

Dr Julie Sharp, Cancer Research UK’s senior science information manager, said: “This important research reveals fresh understanding of how cancer spreads, which will help scientists to translate discoveries into effective treatments to beat cancer.

“Most cancer deaths are caused when cancer cells travel to new sites within the body and grow as secondary tumours so there’s an urgent need to find a way to stop this happening.
“We’re funding groundbreaking lab research into how cancer cells move around the body as well as important clinical trials which aim to combat the advanced disease. Finding the best ways to tackle cancer spread will save thousands more lives every year.”

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