Once a week chemotherapy is not superior to Chemotherapy given once every 3-weeks

Advanced ovarian cancer is treated by chemotherapy. A pre ious study of Japanese ovarian cancer patients RT showed significantly increased survival in those treated with dose-dense weekly paclitaxel compared to the standard three-weekly schedule.

Data from an international trial called ICON8 was presented at the ESMO Virtual Congress 2020, this week.

The final analysis of ICON8 “provides conclusive evidence that although weekly dose-dense chemotherapy can be successfully administered as first-line treatment for ovarian cancer, it has no survival advantage over the standard chemotherapy given once every 3 weeks.

ICON8: Overall survival results in a GCIG phase III randomised controlled trial of weekly dose-dense chemotherapy in first line epithelial ovarian, fallopian tube or primary peritoneal carcinoma treatment. Citation. Annals of Oncology (2020) 31 (suppl_4): S551-S589. 10.1016/annonc/annonc276

ESMO Daily Reporter: OVARIAN CANCER: FIRST-LINE DOSE-DENSE CHEMOTHERAPY IS NOT SUPERIOR TO STANDARD 3-WEEKLY CHEMOTHERAPY.

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 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.

Plain English Medical Letters to Patients

Writing letters to patients in plain English without medical jargon is a gift that only a few doctors possess.

Personalising complex medical terminology in a letter dictated over a few minutes is NOT an inherent skill possessed by many doctors including those who are native English speakers.

Dictating Plain English medical letters would take considerable time and effort – particularly if letters are going to succinctly summarise everything from a medical consultation.

In UK, with regards to Cancer, we are lucky to have cancer charities who do a good job of providing information in plain English ( E.g Cancer Research UK, Macmillan Cancer Support, Prostate Cancer UK).

Cancer Patients in UK also have the support of Cancer Nurse Specialists ( CNS ) who do a fantastic job of guiding patients through their cancer journey and clarify all medical jargon to patients.

Other specialities might not have the resources that are available to cancer patients. But, on the whole, Clinic Time slots are precious. Many UK specialists have long waiting lists.

So if further time and effort is to be expended in busy clinics for dictating plain English Letters – in addition to the usual Medical letters to GP – good clinical evidence is needed to demonstrate that separate plain English letters do benefit patients in a meaningful way.

Please do read the BMJ article and put forward your views in the rapid response section.

Access the article at: http://bmj.com/cgi/content/full/bmj.m949

Toll-free link:
http://bmj.com/cgi/content/full/bmj.m949?ijkey=nxJ9CdIVHKZW1Jd&keytype=ref

Disclaimer:

The views expressed here are my personal views and do not represent the views of any other professional organisation I am associated with…

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.

Is whole milk harmful ?

In years gone by , many viewed milk as a wholesome healthy food. Government encouraged consumption of milk by providing free milk.

But in recent years, milk is viewed with suspicion.

Vegans shun milk and diary products.

Perhaps the Vegans got it right all along at least as far as whole milk is concerned.

A very large study involving 168 153 women and 49 602 men was published recently in British Medical Journal. The study found that whole milk intake is associated with increased risk of death from heart problems and from some cancers such as lung cancer, ovarian cancer, and prostate cancer.

Interestingly “Cheese and yogurt intake was NOT associated with increased risk of death”.

The risk was also less with “skimmed or low fat milk”.

References

1. Government Cheap Milk Scheme. Br Med J 1940; 2 doi: https://doi.org/10.1136/bmj.2.4170.806-b (Published 07 December 1940)

2. Vegetarian diets. BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b2507 (Published 08 July 2009)

3. Associations of dairy intake with risk of mortality in women and men: three prospective cohort studies. BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6204 (Published 27 November 2019). Cite this as: BMJ 2019;367:l6204

Veliparib : Another new drug for treatment of Ovarian Cancer

Veliparib trial data has certainly brought more options to the table in treatment of advanced Ovarian cancer.

Trial data presented at ESMO congress at Barcelona shows that first line therapy with Veliparib is beneficial.

Acknowledgement: Copyright of Slides: Authors and ESMO

References

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.

New drug combination for Ovarian Cancer (Olaparib and Bevacizumab)

New trial data presented at the ESMO cancer Congress 2019 in Barcelona, Spain, show excellent results for the combination of Olaparib and Bevacizumab. The combination looks likely to become standard of care in at-least a subgroup of patients.

The expert discussing the trial data did raise the possibility that most benefit seems to come from Olaparib in patients with BRCA mutations and whether Olaparib alone instead combination is enough for this group. More data is awaited.

References

1. ESMO 2019 congress press release. Ovarian Cancer: More Women Benefit from Maintenance Combined Targeted Therapy [ESMO 2019 Press Release]

Acknowledgement: Copyright of Slides: Authors and ESMO

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.

Niraparib : New treatment for new diagnosed Ovarian Cancer

A landmark study presented at ESMO congress at Barcelona shows significant benefits for maintenance treatment with the drug Niraparib.

Niraparib is likely to become a standard treatment in a much more widely group of advanced ovarian cancer patients.

Many clinicians will be weighing up Niraparib Vs Olaparib in Some patients and Niraparib vs Bevacizumab in other groups of patients.

Reference

1. Niraparib Prolongs PFS in Patients with Newly Diagnosed Advanced Ovarian Cancer. ESMO press release.

Acknowledgement: Copyright of Slides: Authors and ESMO

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