Excess weight and cancer risk

New figures from Cancer Research UK show that people who are obese now outnumber people who smoke two to one in the UK, and excess weight causes more cases of certain cancers than smoking.

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Almost a third of UK adults are obese and, while smoking is still the nation’s biggest preventable cause of cancer and carries a much higher risk of the disease than obesity, Cancer Research UK’s analysis revealed that being overweight or obese trumps smoking as the leading cause of four different types of cancer.

Excess weight causes around 1,900 more cases of bowel cancer than smoking in the UK each year. The same worrying pattern is true of cancer in the kidneys (1,400 more cases caused by excess weight than by smoking each year in the UK), ovaries (460) and liver (180).

The charity wants the Government to act on its ambition to halve childhood obesity rates by 2030 and introduce a 9pm watershed for junk food adverts on TV and online, alongside other measures such as restricting promotional offers on unhealthy food and drinks.

Full story: Obese people outnumber smokers two to one| Cancer Research UK

See also: Obesity ’causes more cases of some cancers than smoking’ | BBC News

Leeds Research: A miniature robot that could check colons for early signs of disease

University of Leeds | July 2019| A miniature robot that could check colons for early signs of disease

An  academic at the University of Leeds is a senior author of a piece of research that demonstrates it is technically possible to guide a tiny robotic capsule inside the colon to take micro-ultrasound images. The capsule, known as Sonopill, has taken an international consortium of scientists and engineers a decade to develop. 

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It is hoped that the technology will one day mean patients will not need to undergo an endoscopic examination- as the Sonopill is capable of intelligent magnetic manipulation. Based on the principle that magnets can attract and repel one another, a series of magnets on a robotic arm that passes over the patient interacts with a magnet inside the capsule, gently manoeuvring it through the colon (Source: University of Leeds).

The full news story is available from the University of Leeds

Full reference:

Norton, J.C. et al. | 2019| Intelligent magnetic manipulation for gastrointestinal ultrasound | Science Robotics | Vol. 4|31| eaav7725
DOI: 10.1126/scirobotics.aav7725

Abstract

Diagnostic endoscopy in the gastrointestinal tract has remained largely unchanged for decades and is limited to the visualization of the tissue surface, the collection of biopsy samples for diagnoses, and minor interventions such as clipping or tissue removal. In this work, we present the autonomous servoing of a magnetic capsule robot for in situ, subsurface diagnostics of microanatomy. We investigated and showed the feasibility of closed-loop magnetic control using digitized microultrasound (μUS) feedback; this is crucial for obtaining robust imaging in an unknown and unconstrained environment. We demonstrated the functionality of an autonomous servoing algorithm that uses μUS feedback, both on benchtop trials and in vivo in a porcine model. We have validated this magnetic μUS servoing in instances of autonomous linear probe motion and were able to locate markers in an agar phantom with 1.0 ± 0.9 mm position accuracy using a fusion of robot localization and μUS image information. This work demonstrates the feasibility of closed-loop robotic μUS imaging in the bowel without the need for either a rigid physical link between the transducer and extracorporeal tools or complex manual manipulation.

Diagnostic endoscopy in the gastrointestinal tract has remained largely unchanged for decades and is limited to the visualization of the tissue surface, the collection of biopsy samples for diagnoses, and minor interventions such as clipping or tissue removal. In this work, we present the autonomous servoing of a magnetic capsule robot for in situ, subsurface diagnostics of microanatomy. We investigated and showed the feasibility of closed-loop magnetic control using digitized microultrasound (μUS) feedback; this is crucial for obtaining robust imaging in an unknown and unconstrained environment. We demonstrated the functionality of an autonomous servoing algorithm that uses μUS feedback, both on benchtop trials and in vivo in a porcine model. We have validated this magnetic μUS servoing in instances of autonomous linear probe motion and were able to locate markers in an agar phantom with 1.0 ± 0.9 mm position accuracy using a fusion of robot localization and μUS image information. This work demonstrates the feasibility of closed-loop robotic μUS imaging in the bowel without the need for either a rigid physical link between the transducer and extracorporeal tools or complex manual manipulation.

Rotherham NHS staff can request a copy of this article here 

 

 

Which cancers would benefit most from earlier diagnosis? Colorectal and kidney, reports ONS

Office for National Statistics | June 2019 | Which cancers would benefit most from earlier diagnosis? 

A release from the Office for National Statistics (ONS) looks at the estimates for 5-year cancer survival estimates by stage and outlines how stage of diagnosis for different cancers affects health outcomes. The ONS reports that there are some cancers where earlier diagnosis would have a greater impact on survival. Although earlier diagnosis would increase overall net-survival for all cancers but kidney and colorectal would benefit most from earlier diagnosis. This is due to the drop-off in net-survival in these cancers once diagnosed at stages 3 and 4, and the fact that overall net-survival lies between stages 3 and 4.

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Cancer patients with colorectal cancer have an overall net-survival of 59.1% (the survival of cancer patients compared to the general population) for the 5 years following diagnosis. At stage 1 this is 93.4%.

For patients with kidney cancer, overall net-survival is 63.3%, compared with 88.9% at stage 1.

Full details are available from the ONS

 

 

Early cancer detection and survival to be prioritised by NHS

Monitoring one-year survival will be central to measuring progress in transforming cancer care, the Health and Social Care Secretary has announced.

Screening programmes will be overhauled and diagnosis made faster and more accurate with new state-of-the-art technology as part of a blueprint for rapidly improving cancer detection and survival the Health and Social Care Secretary Matt Hancock has announced.

Speaking in the House of Commons, the Health and Social Care Secretary set out how the NHS will deliver on its commitments to improve early detection of cancer.

In January, the NHS Long Term Plan set the ambition for three-quarters of all cancers to be detected at an early stage and 55,000 more people surviving cancer for 5 years each year by 2028. The Implementation Framework, agreed by the NHS, provides a blueprint for how this will be achieved at a local level. The one-year metric will be used to measure progress.

Steps in the framework include:

  • a radical overhaul of screening programmes
  • new state-of-the-art technology to make diagnosis faster and more accurate
  • more investment in research and innovation
  • the roll-out of new Rapid Diagnostic Centres across the country, building on the success of a pilot scheme with Cancer Resarch UK
  • NHS England extending lung health checks, targeting areas with the lowest survival rates
  • Health Education England increasing the cancer workforce, which will lead to 400 clinical endoscopists and 300 reporting radiographers by 2021

The document sets out the framework through which each of the 300 commitments in the Long Term Plan will be delivered – including the 20 headline commitments – as well as how government will monitor and support systems at a local level.

Full detail at Department of Health and Social Care

[NICE Technology appraisal guidance] Lenalidomide plus dexamethasone for previously untreated multiple myeloma

NICE | June 2019 | Lenalidomide plus dexamethasone for previously untreated multiple myeloma Technology appraisal guidance [TA587]

NICE has published evidence-based recommendations on lenalidomide (Revlimid) plus dexamethasone for previously untreated multiple myeloma in adults.

Full details from NICE 

Of interest: [Technology Appraisal Guidance] Lenalidomide plus dexamethasone for multiple myeloma after 1 treatment with bortezomib

 

[Technology Appraisal Guidance] Lenalidomide plus dexamethasone for multiple myeloma after 1 treatment with bortezomib

NICE | June 2019| Lenalidomide plus dexamethasone for multiple myeloma after 1 treatment with bortezomib Technology appraisal guidance [TA586]

NICE has published Evidence-based recommendations on lenalidomide (Revlimid) plus dexamethasone for multiple myeloma after 1 treatment with bortezomib in adults.

This guidance looks at the use of lenalidomide for multiple myeloma as second-line treatment. For third- or further-line use, please see NICE’s technology guidance on lenalidomide for the treatment of multiple myeloma in people who have received at least 2 prior therapies.

Full details from NICE 

Psychosocial interventions for informal caregivers of people living with cancer

Treanor,  C.J. | 2019| Psychosocial interventions for informal caregivers of people living with cancer| Cochrane Database of Systematic Reviews |6. Art. No| CD009912| DOI: 10.1002/14651858.CD009912.pub2.

Reviewers have assessed the effectiveness of psychosocial interventions designed to improve the quality of life (QoL), physical health and well‐being of informal caregivers of people living with cancer compared with usual care. Their findings have now been published by Cochrane. 

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Psychosocial support for informal caregivers of people living with cancer

Background

Increasingly, people who are not health professionals provide care for a partner, family member or friend affected by cancer, which can have negative effects on their health and well‐being. Psychosocial interventions that comprise psychological or social support and involve direct interaction between a healthcare professional and caregivers (or caregiver‐patient pairs) may help to address the negative health effects for caregivers.

Review question

What is the effectiveness of psychosocial interventions compared to usual care for informal caregivers of people living with cancer on a range of outcomes related to health and well‐being?

Results

We found19 trials that compared psychosocial interventions with usual care, in studies that included almost four thousand participants. Studies included caregivers of people affected by different cancers across all stages of the disease. There were differences in intervention make‐up. Intervention examples include providing information and/or teaching caregivers (or caregiver‐patient pairs) coping, communication or problem‐solving skills to manage symptoms or improve relationships. Interventions were delivered by nurses, psychologists or other professionals on an outpatient basis or at home via telephone.

There may be a minimal benefit for caregiver quality‐of‐life immediately after the intervention, but this may not last. Psychosocial interventions may have little to no effect on quality of life for patients six to 12 months post‐intervention, but we are uncertain whether or not interventions improve quality of life for patients immediately post‐intervention.

Psychosocial interventions may have little to no effect on caregiver depression, anxiety, distress and physical health and patient anxiety and distress at any time after the intervention, or on patient depression immediately and patient physical health six to 12 months post‐intervention. Psychosocial interventions probably have little to no effect on patient physical health immediately post‐intervention or patient depression three to six months post‐intervention.

Three studies reported adverse effects including increased distress and sexual function‐related distress and lower relationship satisfaction levels for carers, increased distress levels for patients, and intervention content that was seen as inappropriate for some participants. No studies looked at cost‐effectiveness or intervention satisfaction for caregivers or patients. Because the quality of evidence was low generally, findings must be treated with caution.

Conclusion

Psychosocial interventions do not impact to a clinically meaningful degree outcomes for caregivers irrespective of patient cancer stage or type. Perhaps, other outcomes (e.g. relationship quality) or other psychosocial interventions (e.g. meditation) may be more helpful for caregivers. Interventions should be subjected to better conducted trials. Intervention development should involve caregivers and pay particular attention to individual personal needs (Source: Cochrane).

Read the full review and abstract at Cochrane Library