More evidence not all prostate cancers need treatment

Monday, Jul 22, 2013

UNITED STATES – In a study of older men who had died from causes other than prostate cancer, almost half were found to have prostate tumours.

And up to half of those tumours detected on autopsy would have qualified for treatment had doctors known about them while the men lived, though none had been the cause of death.

That suggests the criteria for treatment “might be worth reexamining,” according to the study authors, and adds to a growing body of evidence that a wait-and-see approach might be better than treatment for many prostate cancers.

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Be cruel to be kind to dying cancer patients

Thursday, Aug 29, 2013
The Straits Times
By Andy Ho

SINGAPORE – Many patients with terminal cancer are not aware that the palliative chemotherapy or radiotherapy they are getting doesn’t cure.

Palliative therapy is meant to shrink the size of tumours that cause pain, cough or other physical symptoms of cancer and also slow the progress of cancer enough to extend life somewhat. But it does not cure.

Many patients consent to such treatment in the mistaken belief that it can cure them, in part because of mixed signals from doctors. Doctors should be gentle but firm in getting patients to understand that palliative therapy may prolong life but won’t cure the cancer. Worse yet, it can have very bad side effects.

Only with such honesty can patients properly consent to or refuse such therapy. It is also kind because the truth will enable them to plan for the end better too.

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Many cancer patients expect palliative care to cure

Thursday, Jun 27, 2013

NEW YORK – In a survey of patients with terminal lung cancer, nearly two-thirds did not understand that radiation treatments intended only to ease their symptoms would not cure their disease.

Among the nationwide sample of patients with advanced lung cancers, four out of five thought the radiation would help them live longer and two in five believed it might cure their cancers.

“Radiation therapy can be used to relieve symptoms caused by metastatic lung cancer, such as pain from bony metastases, shortness of breath from lung tumours, or neurologic symptoms, such as weakness, from brain metastases,” said the study’s lead author, Dr. Aileen Chen of the Dana-Farber Cancer Institute in Boston.

Patients with metastatic lung cancer usually live less than a year, she told Reuters Health, and their radiation treatments are intended to improve quality of life for the time that remains, so Chen was surprised that so many patients believed they would cure them. 

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Wait-and-see may be best for early prostate cancer

Tuesday, Jun 18, 2013
By Genevra Pittman

NEW YORK – Watching and routinely examining men with early, slow-growing prostate cancer is more effective and cheaper than sending them to surgery or radiation right away, according to a new study.

The findings are based on a model of 65- to 75-year-old men that takes into account costs of tests, treatment and missed work, treatment side effects, men’s quality of life and their chance of dying from prostate cancer.

“Most of the men who are diagnosed in this country these days have low-risk prostate cancer,” said Dr. Julia Hayes, who led the new study at the Dana-Farber Cancer Institute Boston.

That type of disease may never grow large or fast enough to threaten a man’s life. But treating it can cause side effects such as incontinence and impotence.

“There’s a huge group of men out there who are probably treated unnecessarily,” Hayes told Reuters Health.

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Diet change boosts survival in men with prostate cancer

Tuesday, Jun 11, 2013

Men who ate more healthy fats from vegetables, nuts and olive oil after a diagnosis of prostate cancer saw better survival rates than peers whose diets were unchanged, a US study said Monday.

The findings in the Journal of the American Medical Association (JAMA) Internal Medicine suggest that dietary improvements can be an important way to lower the death risk among men whose prostate cancer has not spread.

“Consumption of healthy oils and nuts increases plasma antioxidants and reduces insulin and inflammation, which may deter prostate cancer progression,” said lead author Erin Richman, a postdoctoral scholar in the University of California San Francisco Department of Epidemiology and Biostatistics.

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Leukaemia survivor endures over 15 years of late-effects pain

Saturday, Jun 15, 2013
Mind Your Body, The Straits Times
By Ng Wan Ching

SINGAPORE – Ms Rachel Chin is all grown up now and raring to get on with her life.

She will soon be starting a distance learning degree in events management with the Southern Cross University in Australia.

Looking at her now, it is hard to imagine the suffering she has had to endure since she was diagnosed with leukaemia at 3 1/2 years old.

The effects from the cancer treatment have lessened over the years but, in the beginning, they were “horrible”, she recalled.

Ms Chin, who will be turning 21 later this year, is matter-of-fact about the problems which began after her bone marrow transplant: skin rash, mouth ulcers, sore eyes and extreme sensitivity to the sun.

Ms Chin had two relapses of her cancer before she received a bone marrow transplant at the age of 12.

She missed about a year of school after the transplant, but was able to keep up academically.

Her late effects are primarily related to the cumulative chemotherapy she underwent after she was diagnosed with leukaemia and the transplant, said her physician, Dr Tan Poh Lin, senior consultant at the division of paediatric haematology-oncology at the National University Hospital.

When Ms Chin could go back to school, there would be many days she felt good enough to do so initially, but would have to turn back during the car ride there.

“My eyes would swell up and tear badly and I would not be able to see. My mum would have to take me home,” said Ms Chin.

The skin rash would erupt just as suddenly. But, by far, the worst late effect was mouth ulcers.

Ulcers would crop up inside her mouth and be so painful that she would not be able to open her mouth.

“Even air would hurt my mouth,” she said.

The effects would occur at different times.

The rashes, sore eyes, sun sensitivity and mouth ulcers are the effects of graft-versus-host disease (GVHD), in which the donor’s cells mount an attack on the recipient’s cells.

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Survivors of childhood cancer prone to adult illness: study

Wednesday, Jun 12, 2013 AFP

WASHINGTON – Patients who successfully battled cancer during childhood face an extraordinarily high rate of chronic illness during their grown-up years, according to study published Tuesday.

The research released by the Journal of the American Medical Association (JAMA) tracked 1,700 adult survivors of childhood cancer, and found that the vast majority were combating one or more chronic ailments.

“The percentage of survivors with one or more chronic health conditions prevalent in a young adult population was extraordinarily high,” said lead researcher Melissa Hudson and her colleagues at St. Jude Children’s Research Hospital and the University of Tennessee College of Medicine, Memphis.

The study found that 80.5 percent of adults were suffering with at least one chronic ailment by the age of 45.

The subjects in the study were most likely to suffer from ailments to the lungs, heart, auditory, nervous or endocrine systems.

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