Examination of Broad Symptom Improvement Resulting From Mindfulness-Based Stress Reduction in Breast Cancer Survivors

Lengacher, C.A. et al. (2016). Journal of Clinical Oncology. vol. 34(24). pp. 2827-2834

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Purpose :The purpose of this randomized trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program in improving psychological and physical symptoms and quality of life among breast cancer survivors (BCSs) who completed treatment. Outcomes were assessed immediately after 6 weeks of MBSR(BC) training and 6 weeks later to test efficacy over an extended timeframe.

Patients and Methods: A total of 322 BCSs were randomly assigned to either a 6-week MBSR(BC) program (n = 155) or a usual care group (n = 167). Psychological (depression, anxiety, stress, and fear of recurrence) and physical symptoms (fatigue and pain) and quality of life (as related to health) were assessed at baseline and at 6 and 12 weeks. Linear mixed models were used to assess MBSR(BC) effects over time, and participant characteristics at baseline were also tested as moderators of MBSR(BC) effects.

Results :Results demonstrated extended improvement for the MBSR(BC) group compared with usual care in both psychological symptoms of anxiety, fear of recurrence overall, and fear of recurrence problems and physical symptoms of fatigue severity and fatigue interference (P < .01). Overall effect sizes were largest for fear of recurrence problems (d = 0.35) and fatigue severity (d = 0.27). Moderation effects showed BCSs with the highest levels of stress at baseline experienced the greatest benefit from MBSR(BC).

Conclusion :The MBSR(BC) program significantly improved a broad range of symptoms among BCSs up to 6 weeks after MBSR(BC) training, with generally small to moderate overall effect sizes.

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Which is better for gastric cancer patients, perioperative or adjuvant chemotherapy: a meta-analysis

Zhao, J-H. et al. BMC Cancer | Published online: 12 August 2016

N0007047 Cancer of stomach; photomicrograph
Image source: Wellcome Images // CC BY-NC-ND 4.0

Image shows photomicrograph of mucoid carcinoma of the stomach.

Background: The preferred chemotherapy method for gastric cancer continues to be matter of debate. We performed a meta-analysis to comparing prognosis and safety between perioperative chemotherapy and adjuvant chemotherapy to identify the better chemotherapy option for gastric cancer.

Methods: We searched the PubMed, EMBASE, Cochrane Library, and Ovid databases for eligible studies until February 2016. The main endpoints were prognostic value (hazard ratio [HR] for overall survival [OS] and 1-, 2-, 3-, and 5-year survival rate), response rate of chemotherapy, radical resection rate, post-operative complication rate, and adverse effects of chemotherapy.

Results: Five randomized controlled trials and six clinical controlled trials involving 1,240 patients were eligible for analysis. Compared with the adjuvant chemotherapy group, the perioperative chemotherapy group had significantly better prognosis (HR, 0.74; 95 % CI, 0.61 to 0.89; P < 0.01). The difference between the two groups remained significant in the studies that used combination chemotherapy as the neoadjuvant chemotherapy regimen (HR, 0.59; 95 % CI, 0.46 to 0.76; P < 0.01) but were not significant in the studies that used fluoropyrimidine monotherapy (HR, 0.93; 95 % CI, 0.56 to 1.55; P = 0.84). Furthermore, the two groups showed no significant differences in the post-operative complication rates (relative risk, 0.98; 95 % CI, 0.63 to 1.51; P = 0.91) or adverse effects of chemotherapy (P > 0.05 for all adverse effects).

Conclusion: Perioperative chemotherapy showed improved survival compared to adjuvant chemotherapy for gastric cancer. In addition, combination chemotherapy resulted in better survival compared to monotherapy in the neoadjuvant chemotherapy regimens.

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Physical Activity Associated With Fewer Cancers

Jenks, S. (2016) JNCI: Jnl of National Cancer Institute. Volume 108, Issue 8

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Even moderate leisure-time physical activity may protect against 13 cancers, according to a massive observational study that appeared May 16 in JAMA Internal Medicine (doi:10.1001/jamainternmed.2016.1548).

But which type of exercise brings the most benefit is not yet clear, researchers say, nor is exercise alone likely to account for its association with a lower cancer risk in colon, breast, and endometrial cancers, among others.

“Physical activity is not a stand-alone, magic bullet,” said William McCarthy, Ph.D., adjunct professor in the department of health services in the Fielding School of Public Health at the University of California, Los Angeles. “The biggest bang [in risk reduction] comes when exercise is coupled with a Mediterranean-style diet and not smoking.”

Still, McCarthy said, the recent joint study by researchers at the National Cancer Institute and the American Cancer Society highlights exercise’s importance to cancer risk and overall health, despite what he described as years of skepticism in the scientific community. “It’s a shot in the arm for those of us doing exercise studies for years,” he said.

Researchers at both organizations analyzed pooled data for the self-reported leisure-time physical activities of 1.44 million people in 12 U.S. and European studies conducted between 1982 and 2004. Analyzing data from those combined studies gave investigators greater statistical power than a single study.

Read the original article abstract here

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Pancreatic cancer resists personalized medicine: What researchers are doing to fight back

ScienceDaily. Published online: 4 August 2016

B0007659 Pancreatic cancer cells
Image source: Anne Weston, LRI, CRUK – Wellcome Images // CC BY-NC-ND 4.0

Image shows false colour scanning electron micrograph of pancreatic cancers cells grown in culture.

Researchers are taking a new, patient-directed approach to treating pancreatic cancer. Rather than relying on conventional cell lines that have defined effective drug targets for other types of cancers, they are creating and sequencing cell lines from a cancer patient’s own tissue. Their results reveal that pancreatic tumors are more varied than previously thought and that drug sensitivity is unique to each patient.

In the study, the team turned to a library of cancer drugs, representative of what’s available to patients, and tested each individually against a panel of different cell lines: either conventional pancreatic cell lines, which are often used by researchers and pharmaceuticals, or cell lines that the team developed directly from cancer patients. While conventional pancreatic cell lines were more sensitive to standard drugs used in pancreatic cancer treatment, cell lines from patients were not, with only a “handful” responding to any single-agent treatment.

Read the full commentary here

Read the research abstract here

Bowel cancer: 29% of UK hospitals not following guidance on testing younger patients

Lyons K. The Guardian. Published online: 8 August 2016

Research shows almost 50 hospitals not screening under-50s for Lynch syndrome, an inherited disorder related to the cancer.

B0009747 Venous invasion of colorectal cancer, modified histology
Image source: Richard Kirsch and Raw’n’ Wild – Wellcome Images // CC BY-NC-ND 4.0

Almost 50 hospitals around the country are failing to provide crucial screening tests for younger people diagnosed with bowel cancer, according to a leading cancer research charity.

People under the age of 50 who are diagnosed with bowel cancer are not being tested for Lynch syndrome in 29% of hospitals around the country. Lynch syndrome is an inherited disorder, and testing for it helps detect those at greater risk of recurrence, helps inform treatment options, and identifies those with family members who may also be at risk of bowel cancer.

In 2014, the Royal College of Pathologists changed its guidance to make the testing of bowel cancer patients for Lynch syndrome mandatory after diagnosis. But research conducted by Bowel Cancer UK and the Royal College of Pathologists and released on Monday shows that this advice is not being followed.

Image shows venous invasion of colorectal cancer, modified histology.

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Drinking filter coffee could reduce the risk of malignant melanoma – results from the (NOWAC) Study.

Lukic, M. et al. BMC Cancer. 2016 16:562

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Background: Coffee contains biologically-active substances that suppress carcinogenesis in vivo, and coffee consumption has been associated with a lower risk of malignant melanoma. We studied the impact of total coffee consumption and of different brewing methods on the incidence of malignant melanoma in a prospective cohort of Norwegian women.

Methods: We had baseline information on total coffee consumption and consumption of filtered, instant, and boiled coffee from self-administered questionnaires for 104,080 women in the Norwegian Women and Cancer (NOWAC) Study. We also had follow-up information collected 6–8 years after baseline. Multiple imputation was used to deal with missing data, and multivariable Cox regression models were used to calculate hazard ratios (HR) for malignant melanoma by consumption category of total, filtered, instant, and boiled coffee.

Results: During 1.7 million person-years of follow-up, 762 cases of malignant melanoma were diagnosed. Compared to light consumers of filtered coffee (≤1 cup/day), we found a statistically significant inverse association with low-moderate consumption (>1–3 cups/day, HR = 0.80; 95 % confidence interval [CI] 0.66–0.98) and high-moderate consumption of filtered coffee (>3–5 cups/day, HR = 0.77; 95 % CI 0.61–0.97) and melanoma risk (p trend = 0.02). We did not find a statistically significant association between total, instant, or boiled coffee consumption and the risk of malignant melanoma in any of the consumption categories.

Conclusions: The data from the NOWAC Study indicate that a moderate intake of filtered coffee could reduce the risk of malignant melanoma.

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