Smyth, D. Cancer Nursing Practice. Vol 15(5). pp. 15-15. Published in print: 10 June 2016
Pancreatic cancer is a significant cause of cancer mortality, with a poor five-year survival rate: 5% compared with 85% or more for breast cancer. In this Chinese study, two independent examiners undertook a retrospective analysis of the records of 38 patients with pathologically proven disease and surgically treated curative or palliative disease. They looked at whether there was a difference in the rates of detection and staging of the disease in two non-invasive diagnostic measures: computed tomography (CT) and magnetic resonance imaging (MRI).
Almost 80% of children and adolescents currently treated for cancer or leukemia will be long term survivors. Paediatric oncologists are concerned that side effects such as low fertility, infertility and early menopause can reduce the quality of life for survivors. Indeed, in females, cancer treatments can result in premature ovarian insufficiency (POI). Therefore, preserving fertility in young girls is becoming a key issue for improving quality of life. However, only a few teams performing OTC in children have reported on their practice.
The paper reports on 13 years’ experience of ovarian tissue cryopreservation before sterilising treatment. The aim of the study on OTC in 36 girls at risk of early menopause, aged between 2 and 19 years old, at the Clermont-Ferrand City Paediatric Oncology Department is to assess how effective, feasible and risky this treatment is.
Laparoscopy was used to collect a third of each ovary that was frozen by a slow cooling protocol. Histological analysis of one random sample of each harvested ovarian tissue fragment was routinely performed before freezing.
The study uncovers unresolved issues in the practice of OTC. The minimum age to offer OTC remains undetermined, there is no current consensus on the quantity of ovarian cortex to be harvested for cryopreservation or whether best practice is to remove an entire ovary or to remove part of each ovary. Detecting ovarian damage is difficult too as it is not standardised, and re-introducing cancer cells via an ovarian graft because of malignant cells in frozen thawed ovarian tissue remains a concern.
Dorff, T. B. et al. BMC Cancer. 2016 16:360. Published online: 10th June 2016
Background: Short-term starvation prior to chemotherapy administration protects mice against toxicity. We undertook dose-escalation of fasting prior to platinum-based chemotherapy to determine safety and feasibility in cancer patients.
Methods: 3 cohorts fasted before chemotherapy for 24, 48 and 72 h (divided as 48 pre-chemo and 24 post-chemo) and recorded all calories consumed. Feasibility was defined as ≥ 3/6 subjects in each cohort consuming ≤ 200 kcal per 24 h during the fast period without excess toxicity. Oxidative stress was evaluated in leukocytes using the COMET assay. Insulin, glucose, ketones, insulin-like growth factor-1 (IGF-1) and IGF binding proteins (IGFBPs) were measured as biomarkers of the fasting state.
Results: The median age of our 20 subjects was 61, and 85 % were women. Feasibility criteria were met. Fasting-related toxicities were limited to ≤ grade 2, most commonly fatigue, headache, and dizziness. The COMET assay indicated reduced DNA damage in leukocytes from subjects who fasted for ≥48 h (p = 0.08). There was a non-significant trend toward less grade 3 or 4 neutropenia in the 48 and 72 h cohorts compared to 24 h cohort (p = 0.17). IGF-1 levels decreased by 30, 33 and 8 % in the 24, 48 and 72 h fasting cohorts respectively after the first fasting period.
Conclusion: Fasting for 72 h around chemotherapy administration is safe and feasible for cancer patients. Biomarkers such as IGF-1 may facilitate assessment of differences in chemotherapy toxicity in subgroups achieving the physiologic fasting state. An onging randomized trial is studying the effect of 72 h of fasting.
The charity AntiCoagulation Europe has launched a campaign Blood Clots Cancer and You to raise awareness of cancer associated thrombosis (CAT).
It is vitally important that both cancer patients and health care professionals are aware of the risk of CAT.
In order to raise awareness a diary video has been developed that helps patients to understand the risks of CAT and what signs and symptoms to look out for and what they should do if they suspect they have a blood clot (CAT).
Over 4000 lives a year are needlessly lost because of cancer associated thrombosis.
Help save some of those lives by encouraging patients to be aware of the risk of CAT and what they can do to help themselves.
It has been estimated that the new test will increase screening uptake by around 10% – meaning an additional 200,000 people could be tested each year. This means that hundreds of lives could be potentially saved, the Department of Health said.