Can Vitamins and anti-oxidants increase the risk of breast cancer coming back?

Yes, Dietary supplements can be harmful.

Vitamins and Minerals are absolutely essential nutrients for a Healthy body and a Healthy mind. Anyone not eating a healthy balanced should look what nutrients they might be missing.

But on the other hand, taking too much of vitamins and minerals, when they are not needed, could be harmful to the body.

There is widespread use of dietary supplements during cancer treatment, in the hope they can reduce side effects but many do not think about the disadvantages.

An American study of Breast cancer patients undergoing Chemotherapy looked at the effect of taking dietary supplements such as anti-oxidants, iron, vitamin B12, and omega-3 fatty acids.

Breast cancer patients who took the dietary supplements during chemotherapy were found be harmed by them. They had a higher chance of cancer coming back compared to people who did not take these supplements. The supplements also increased risk of death in those the supplements.

Beware supplements when used improperly, can be harmful.

Dietary Supplement Use During Chemotherapy and Survival Outcomes of Patients With Breast Cancer Enrolled in a Cooperative Group Clinical Trial (SWOG S0221)

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Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Are COVID-19 vaccines safe in cancer patients having immunotherapy?

Yes, Pfizer vaccine is safe.

A recent study published in the esteemed Lancet Oncology Journal shows that the vaccine is well tolerated in patients having immunotherapy.

Unlike cancer chemotherapy, immunotherapy works differently. It works by releasing the in-built brakes holding down the immune system thereby boosting the body’s immune system against cancer.

There has been some theoretical concerns whether this might lead to COVID vaccine causing more side effects.

Reassuringly, the Vaccine side effects were NO different from those seen in people not having immunotherapy. The Vaccine also did NOT increase the immunotherapy side effects.

Immunotherapy is increasingly used widely in treatment of cancer are often better tolerated than chemotherapy.

So the study is good news for tens of thousands of patients on immunotherapy and any cancer patient who has hesitated before, should seriously consider having the vaccine now

COVID infection could be very nasty in cancer patients and all evidence points to the benefits of vaccine far outweighing any risks from the Vaccine.

References

Short-term safety of the BNT162b2 mRNA COVID-19 vaccine in patients with cancer treated with immune checkpoint inhibitors
The Lancet Oncology. Published: April 1, 2021
Barliz Waissengrin et al. DOI:https://doi.org/10.1016/S1470-2045(21)00155-8

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Is the COVID-19 Coronavirus vaccine safe for use in patients having chemotherapy and immunotherapy?

Yes, the available indirect evidence indicates that the anticipated benefits overweigh the potential risks.

Cancer patients, particularly those on chemotherapy have compromised immune systems and hence more vulnerable to COVID-19 Coronavirus complications.

The guidelines indicate that anticipated benefits of vaccine are greater than unknown risks from the Coronavirus vaccines.

The Vaccine trials deliberately included lot of healthy people. Very few people with cancer, particularly cancer patients on active treatment, were included in the COVID-19 trials. So there is not much direct evidence regarding efficacy and safety of Vaccines in cancer patients. But indirect evidence significantly favours Coronavirus vaccination in cancer patients.

Flu vaccines are regularly used in cancer patients without any major side effects specific to cancer patients. No increase in incidence or severity of drug side effects were seen in immunotherapy patients having flu vaccines.

On balance, Vaccination is most likely to be of utmost benefit for most advanced cancer patients on active treatment.

References:

ESMO STATEMENTS FOR VACCINATION AGAINST COVID-19 IN PATIENTS WITH CANCER.

Guidance: COVID-19: the green book, chapter 14a
Coronavirus (COVID-19) vaccination information
for public health professionals. (UK),

Cochrane: Influenza (flu) vaccination for preventing influenza in adults with cancer

Safety of Inactivated Influenza Vaccine in Cancer Patients Receiving Immune Checkpoint Inhibitors
Curtis R Chong et al. Clin Infect Dis. 2020.

ESMO: CANCER PATIENT MANAGEMENT DURING THE COVID-19 PANDEMIC.

Kuderer NM Choueiri TK Shah DP et al.
Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020; 395: 1907-1918

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Cancer treatment delays during the pandemic

The Staff at National Health Service in UK are doing an admirable job during the pandemic. In the particular, the frontline staff (“patient-facing”) are showing great courage in face of great difficulties and are primarily driven by altruism.

But the pressures of pandemic means many routine scans and hospital clinic appointments have been cancelled particularly during the first wave. There is a great worry about delayed diagnosis of cancer and delayed treatment of cancer.

A paper in BMJ reports that cancer patients survival can be significantly compromised.

But, as with everything else in life, things are not always what they look like at first impression. Even things that are logical and common sense at first glance do not turn out to be simple and clear.

Firstly, delays and cancellations of scans paradoxically could have psychologically benefited some cancer patients . This might seem counterintuitive or even an outrageous statement.

But there are some cancers which are being over diagnosed. A Cancer diagnosis does not always mean a death sentence. Some cancers do not cause problems for a long time or never in the life time of a person. These cancers do not need to be diagnosed promptly. Not being diagnosed with these cancers prevents the psychological burden of a cancer diagnosis. This “over diagnosis” would be expectedly less during pandemic.

Secondly, treatment delays could be caused by a cancer that is advanced and the need for time consuming additional investigations and procedures. Sometimes delays are caused by patients needing to see many medical specialists for the treatment. So it’s the aggressive cancer and the complex patient care that would cause the delay and is responsible for poor outcome rather than the delay by itself.

Read the BMJ article and make your views known.

Mortality due to cancer treatment delay: systematic review and meta-analysis
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4087 (Published 04 November 2020)
Cite this as: BMJ 2020;371:m4087

Overdiagnosis in Cancer
H. Gilbert Welch, William C. Black
JNCI: Journal of the National Cancer Institute, Volume 102, Issue 9, 5 May 2010, Pages 605–613, https://doi.org/10.1093/jnci/djq099

Disparities in head and neck cancer: assessing delay in treatment initiation
Urjeet A Patel et al. Laryngoscope. 2012 Aug.

Khorana AA, Tullio K, Elson P, Pennell NA, Grobmyer SR, Kalady MF, et al. (2019) . Time to initial cancer treatment in the United States and association with survival over time: An observational study. PLoS ONE 14(4): e0215108. doi:10.1371/journal.pone.0215108

Cancer and COVID-19

Cancer patients, as expected, did badly during the 1st wave of the COVID-19 pandemic

Data presented at ESMO ( European Society of Medical Oncology) shows that Cancers had – higher rates of Hospitalisation, higher risk of Complications and increased risk of Death.

Elderly cancer patients on the whole did very badly but surprisingly cancer patients under age of 50 did far worse than their peers without cancer.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Can Hair dyes cause cancer?

Yes, there is a possible increased risk of some types of skin and breast cancer as well as ovarian cancer.

Permanent hair dyes are widely used. A recent study published in BMJ suggests that use of Hair dyes might be risky.

This large study from United States enrolled 117 200 women in the Nurses’ Health Study. The women reported on personal use of permanent hair dyes, and were followed for 36 years. So overall it is a high quality observational study.

Read the full paper and Caveats at the BMJ website.

References

Personal use of permanent hair dyes and cancer risk and mortality in US women: prospective cohort study

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2942 (Published 02 September 2020)

Cite this as: BMJ 2020;370:m2942

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Exciting new immunotherapy treatment !

Test tube lab

The holy grail of cancer treatment is design a drug that is highly lethal to cancerous tissue but completely spares the normal tissues.

Scientists at Cardiff University have discovered immune cells which could provide such a clever treatment.

It is still early days. The principle has been proven in lab. But to be a useful treatment that can be used in cancer patients, it is still far off.

This particular novel form of immunotherapy using T cells is still in early stages and so many hurdles have to be overcome before this discovery could be employed in cancer treatment.

Nevertheless, it has certainly excited many researchers in the field of cancer and the paper has been published by a premier scientific journal.

 

References:

Original scientific paper. Genome-wide CRISPR–Cas9 screening reveals ubiquitous T cell cancer targeting via the monomorphic MHC class I-related protein MR1

BBC news. Immune discovery ‘may treat all cancer’. By James Gallagher. Health and science correspondent

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Does alcohol increase of breast cancer?

Yes, Alcohol does substantially increase the risk of Breast cancer.

Very few people seem to be aware of the risks.

Previously it was thought that heavy drinking is responsible for harmful cancer effects.

But studies from U.K and U.S.A have subsequently shown that even light to moderate drinking can increase the risk of breast cancer.

A very large study involving more than 1,250,000 middle-aged women in the United Kingdom ( enrolled in the Million Women Study) showed that “Low to moderate alcohol consumption” in women increases the risk of breast cancer and certain other cancers.

In a study involving more than 88,000 women from United States, also showed that light to moderate drinking increases the risk of breast cancer.

So keep counting the alcohol units during the festive time.

References

1. U.K. Study: Moderate alcohol intake and cancer incidence in women.

2. U.S.A study. Light to moderate intake of alcohol, drinking patterns, and risk of cancer: results from two prospective US cohort studies. BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h4238 (Published 18 August 2015). Cite this as: BMJ.2015;351:h4238

3. Telegraph. Drinking alcohol raises risk of cancer by snapping DNA, scientists find.

4. Telegraph U.K. Just one in five women at risk of breast cancer know alcohol increases the danger.

Can milk cause cancer?

blur calcium close up dairy

Photo by Pixabay on Pexels.com

A vegan group’s recent advertisement claimed that “cow’s milk contains 35 hormones, including oestrogen … some of these are linked to cancer”.

Advertising Standards Authority (ASA) in U.K banned the vegan group’s advert  as it found the groups claims misleading.

Does the evidence stack up?

First of all, I have to emphasize that “Human Mothers milk” is the best nutrition a new born baby can have…even though it might have various natural hormones.

But “mass produced diary milk” is a different matter.

A large observational study from ” Central Sweden”  found that “High milk intake was associated with higher risk of death and higher fracture incidence in women”. The paper was published in the prestigious BMJ journal in 2014. I suspect the substances used in mass production of diary milk might be the culprit rather than natural milk itself.

So the jury is out on this question. In the mean time, moderation is the key as Cows’ milk does contain many beneficial substances.  Switching to sugary, fizzy drinks or other artifically produed milk alternatives is not sensible either.

Related Links

Milk intake and risk of mortality and fractures in women and men: cohort studies

BMJ Letter: S Sundar. Milk and mortality: the potential effects of modern milk production

Telegraph: Vegan group’s advert wrongly linking cow’s milk to cancer is banned.

Independent: Vegan group’s advert wrongly linking cow’s milk to cancer gets UK ban