England smoking ban cuts children hospital admissions

Thousands of children may have been spared serious illness and admission to hospital by the smoking ban in England, research has shown.  The law making it illegal to smoke in public indoor places saw 11,000 fewer children being admitted to hospital each year with lung infections, the study found.

Researchers analysed more than 1.6 million hospital admissions of children aged 14 and under across England between 2001 to 2012.

They found that the introduction of the smoking ban in 2007 was followed by an immediate reduction of 13.8 per cent in the number of admissions for lower respiratory tract infections.

Admissions for upper respiratory tract infections also decreased but at a more gradual rate. The sharpest falls were seen in the most deprived children.

BBC report

Reference: Been, Jasper et al. Smoke-Free Legislation And Childhood Hospitalisations For Respiratory Tract Infections European Respiratory Journal (2015): ERJ-00146-2015. 29 May 2015.

Researchers uncover how breast cancer can spread to bone

Breast cancer cells can release a chemical that alters the structure of bones, making it easier for the cancer to spread, according to new laboratory research.

If confirmed in patients with breast cancer, it could lead to new ways to prevent the disease from spreading.

Building on previous findings, the scientists, based at the University of Sheffield, found that when breast cancer cells release a chemical called lysyl oxidase (LOX), it makes bone tissue a fertile ground for cancer cells to spread or metastasis.

An estimated 85 per cent of secondary breast cancers spread to the bone, and this can impact the success of treatment.

Reference: Cox, Thomas et al. The Hypoxic Cancer Secretome Induces Pre-Metastatic Bone Lesions Through Lysyl Oxidase. Nature (2015)

Eating a Mediterranean diet could cut womb cancer risk

Women who eat a Mediterranean diet could cut their risk of womb cancer by more than half (57 per cent), according to a study published recently in the British Journal of Cancer.

The Italian researchers looked at the diets of over 5,000 Italian women to see how closely they stuck to a Mediterranean diet and whether they went on to develop womb cancer.

The team broke the Mediterranean diet down into nine different components and measured how closely women stuck to them. The diet includes eating lots of vegetables, fruits and nuts, pulses, cereals and potatoes, fish, monounsaturated fats but little meat, milk and other dairy products and moderate alcohol intake.

Researchers found that women who adhered to the Mediterranean diet most closely by eating between seven and nine of the beneficial food groups lowered their risk of womb cancer by more than half (57 per cent).

Those who stuck to six elements of the diet’s components reduced their risk of womb cancer by 46 per cent and those who stuck to five reduced their risk by a third (34 per cent).

But those women whose diet included fewer than five of the components did not lower their risk of womb cancer significantly.

Reference: Filomeno et al. Mediterranean diet and risk of endometrial cancer: a pooled analysis of three Italian case-control studies. British Journal of Cancer 2015.153

Chemotherapy before surgery benefits patients with advanced ovarian cancer

Women with advanced ovarian cancer have fewer side effects and tend to have a better quality of life if given chemotherapy before surgery, according to a Cancer Research UK study published in The Lancet.

The CHORUS trial, conducted at the Medical Research Council Clinical Trials Unit at University College London, challenged the international standard for treating advanced ovarian cancer.

550 women with the disease took part in the trial, with 276 given the standard treatment of surgery followed by six cycles of chemotherapy, and 274 had surgery after three cycles of chemotherapy.

The Cancer Research UK funded trial found that post-surgery complications and death within 28 days of surgery was most common among women given surgery first. Women who received delayed surgery suffered fewer symptoms, a reduction in overall side effects and had a lower death rate.

Delaying surgery also reduced the amount of time the patient spent in the hospital after surgery – a benefit to both the patient and NHS resources.

The CHORUS trial is the largest surgical trial of its kind in the UK and second largest in the world. It aimed to see if this new treatment strategy was a good alternative to the traditional approach.

Reference:  Kehoe et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. The Lancet.

Earlier chemotherapy extends lives of men with advanced prostate cancer

A UK-led trial has found that combining a chemotherapy drug with hormone treatment extended the lives of men with advanced prostate cancer.

The drug, called docetaxel, is typically only offered if standard hormone treatment has failed. But these findings, that will be presented at the American Society of Clinical Oncology (ASCO) conference show treating patients whose cancer has already spread earlier extended survival by almost two years.

Experts say the results provide sufficient evidence to suggest that the treatment should be offered to newly diagnosed men whose disease has already spread.

In the study of 2,962 men, those who received docetaxel plus standard hormone therapy at the start of their treatment lived an average of 10 months longer than those who received only hormone treatment.

For patients whose cancer had already spread beyond the pelvis, the average increase in life expectancy was 22 months.

The results form part of the STAMPEDE trial (Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy), the largest trial of its kind for men with prostate cancer.

More detail at Cancer Research UK

A healthy lifestyle before diagnosis may improve bowel cancer survival

UK researchers claim living a healthy lifestyle before diagnosis could improve a person’s chances of surviving bowel cancer.

Findings from Imperial College London suggest eating a balanced diet, keeping physically  active and maintaining a healthy weight were associated with an improved likelihood of survival.

The large European Prospective Investigation into Cancer and Nutrition (EPIC) study, published in BMC Medicine, analysed data from 520,000 men and women from 10 countries over six years. Of these men and women from the study, 3,292 were diagnosed with bowel cancer.

Lead researcher, Dora Romaguera, from Imperial College London wanted to investigate if the same healthy lifestyle choices that help prevent bowel cancer could also improve the survival rates of people diagnosed with the disease.

The study participants completed questionnaires about their medical history, diet and lifestyle at the start of the study, while height and weight measurements were also taken.

Having a healthy weight and high consumption of plant foods had the strongest associations with survival.  There was also an association seen with women who breastfed and improved survival.

Reference: Romaguera et al. Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study BMC Medicine (2015) 13:107

Men with high oestrogen levels could be at greater risk of breast cancer

Men with naturally high levels of the female hormone oestrogen may have a greater risk of developing breast cancer, according to research by an international collaboration including Cancer Research UK published recently in the Journal of Clinical Oncology.

This is the first time a link between oestrogen levels in the blood and male breast cancer has been identified, despite its connection to breast, womb and ovarian cancers in women.

Men with the highest levels of oestrogen were two and a half times more likely to develop breast cancer than men with the lowest levels of the hormone.

Reference: Brinton et al. Prediagnostic sex steroid hormones in relation to male breast cancer risk. Journal of Clinical Oncology.

UK researchers improve ovarian cancer detection test

Measuring changes in the level of a protein in the blood detects more cases of ovarian cancer than a single measurement on its own, according to the research team behind a large screening trial.

The new method, detailed in the Journal of Clinical Oncology, appears to be able to detect twice as many women with the disease than existing techniques, and could ultimately lead to routine ovarian screening.

But experts cautioned that the overall results of the trial need analysing before they will know for sure whether screening can reduce deaths from ovarian cancer.

Levels of the CA125 protein have long been used to test for ovarian cancer, but converting this knowledge into a reliable screening test has proved elusive.

The team, led by researchers at University College London (UCL), developed a calculation of ovarian cancer risk based on changing levels of the protein in women’s blood.

They used the method on samples taken from women on the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) – a 14-year-long trial of more than 200,000 UK women.

The test correctly identified more than eight out of 10 (86 per cent) women with ovarian cancer.

The conventional test, which relies on a fixed cut-off point for CA125 levels to detect the disease, generally only identifies about four in 10 women, the researchers say.

Reference: Risk Algorithm Using Serial Biomarker Measurements Doubles the Number of Screen-Detected Cancers Compared With a Single-Threshold Rule in the United Kingdom Collaborative Trial of Ovarian Cancer Screening  Journal of Clinical Oncology Published online before print May 11, 2015

Very overweight teens may double their risk of bowel cancer in middle age

Being very overweight in your teens may double the risk of developing bowel cancer by the time you are middle aged, suggests research published online in the journal Gut.

During the monitoring period, which spanned an average of 35 years, researchers tracked the health of almost 240,000 Swedish men who had been conscripted into the military between the ages of 16 and 20 in 1969-76.

At enlistment, the men had a health check, which included weight and height, and ESR levels. The men were then monitored for bowel cancer up to 2010, using national cancer registry data.

The study found that Obesity in young adulthood, classified as a BMI of more than 30, was associated with a 2.38 higher risk of developing bowel cancer.

This is an observational study so no definitive conclusions can be drawn about cause and effect, but the researchers say that the findings suggest that both BMI and inflammation during adolescence may have a role in the development of bowel cancer.

Reference: Adolescent body mass index and erythrocyte sedimentation rate in relation to colorectal cancer risk. Kantor, E. D. et al. Gut. Published Online First: 18 May 2015

Pictorial health warnings on the packaging of tobacco products

 The World Health Organisation has published Evidence brief: how large pictorial health warnings on the packaging of tobacco products affect knowledge and behaviour. This briefing shows that combined written and graphic health messages on the packaging of tobacco products are more effective than text-only warnings. Studies have shown that pictorial health warnings increase quit attempts and decrease smoking uptake.  Pictorial health warnings, including graphic, fear-arousing information, have proven to be particularly effective.