New chemotherapy approach offers breast cancer patients a better quality of life

The chemotherapy drug capecitabine gives patients a better quality of life and is as effective at preventing breast cancer from returning as the alternative regimen called CMF, when given following epirubicin. | ScienceDaily | Cancer Research UK

Around 4,400 patients on the TACT2 clinical trial were treated with the chemotherapy drug epirubicin followed by either capecitabine or CMF, after surgery.

Researchers at The Institute of Cancer Research, London, and the Cancer Research UK Edinburgh Centre found that capecitabine resulted in patients experiencing fewer side effects and having a better quality of life, and it was as effective at preventing cancer’s return as CMF.

Most patients experienced some side effects regardless of the treatment they were given. But those taking CMF were more likely to experience severe side effects including early menopause, nausea, infection, thrombosis, and anemia.

During the trial, patients were followed up after 12, 18 and 24 months, and then yearly for at least 10 years, to see if their cancer had returned and to monitor side effects. More than 85 per cent of patients did not experience their cancer returning for at least five years.

More detail at

Link to the research:

Cameron, D., et al.  Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer in the randomised UK TACT2 trial (CRUK/05/19): a multicentre, phase 3, open-label, randomised, controlled trial. The Lancet Oncology.

Breast cancer e-support program vs routine care

Zhu, J. et al. (2017) BMC Cancer. 17:291

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Background: Women with breast cancer undergoing chemotherapy suffer from a number of symptoms and report receiving inadequate support from health care professionals. Innovative and easily accessible interventions are lacking. Breast Cancer e-Support is a mobile Application program (App) that provides patients with individually tailored information and a support group of peers and health care professionals. Breast Cancer e-Support aims to promote women’s self-efficacy, social support and symptom management, thus improving their quality of life and psychological well-being.

Discussion: This is the first study of its kind in China to evaluate the use of a mobile application intervention with a rigorous research design and theoretical framework. This study will contribute to evidence regarding the effectiveness of a theory-based mobile application to support women with breast cancer undergoing chemotherapy. The results should provide a better understanding of the role of self-efficacy and social support in reducing symptom distress and of the credibility of using a theoretical framework to develop internet-based interventions. The results will provide evidence to support the implementation of an innovative and easily accessible intervention that enhances health outcomes.

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Measuring patients’ muscles to predict chemotherapy side effects

Measuring patients’ muscle mass and quality could potentially help doctors better identify patients at high risk for toxic side effects that could require hospitalizations, researchers report | ScienceDaily

Researchers at the University of North Carolina Lineberger Comprehensive Cancer Center report in the journal Clinical Cancer Research that a tool developed at UNC could potentially help doctors better identify patients at high risk for toxic side effects that could require hospitalizations.

Shlomit Strulov Shachar, MD, the study’s first author, said they found that low measures of muscle quality and quantity in patients with early-stage breast cancer were linked to serious side effects and hospitalizations. Based on their findings, the researchers believe measuring muscle composition could be helpful in predicting which patients will experience side effects from chemotherapy, and in determining appropriate drug doses.

Read the full overview here

Read the original research abstract here

Prevalence of cancer chemotherapy-related problems and associated supportive care

Wagland, R. et al. (2016) Supportive Care in Cancer. 24(12) pp. 4901–4911

Purpose: The purpose of this study was to identify the treatment-associated problems that most impact on patients undergoing cancer chemotherapy, how problems relate to experiences of supportive care and variations in experience between cancer treatment centres.

Conclusion: The most common and distressing chemotherapy-associated problems were identified. These problems are mitigated by quality supportive care. Routine measurement and monitoring of problem items and supportive care are warranted to facilitate benchmarking and service improvements both within and between cancer centres.

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Cost-effectiveness research in cancer therapy

Al-Badriyeh, D. et al. (2017) BMJ Open, 7:e012648

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Objective: To perform a first-time analysis of the cost-effectiveness (CE) literature on chemotherapies, of all types, in cancer, in terms of trends and change over time, including the influence of industry funding.

Conclusions: This analysis demonstrates clear trends in how the CE cancer research is presented to the practicing community, including in relation to journals, study designs, authorship and consultation, together with increased financial sponsorship by pharmaceutical industries, which may be more influencing study outcomes than other funding sources.

Read the full systematic review here

Overuse of chemotherapy among younger patients with colon cancer

Young and middle-aged patients with colon cancer are nearly two to eight times more likely to receive postoperative chemotherapy than older patients, yet there seems to be no added survival benefits for these patients | ScienceDaily

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Colorectal cancer is the third leading cause of cancer death in the U.S. There were more than 49,000 deaths in 2016, and more than 134,000 new cases are expected this year. While incidence and mortality rates among adults age 50 and older have decreased recently in the U.S., the same trend hasn’t been observed for patients 20 to 49. Treatment options remain to be defined for patients with young-onset colon cancer and their effects on prognosis are unclear.

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Read the original research article here

Cognitive Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls

Janelsins, M.C. et al. Journal of Clinical Oncology. Published online: December 28 2016

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Purpose: Cancer-related cognitive impairment is an important problem for patients with breast cancer, yet its trajectory is not fully understood. Some previous cancer-related cognitive impairment research is limited by heterogeneous populations, small samples, lack of prechemotherapy and longitudinal assessments, use of normative data, and lack of generalizability. We addressed these limitations in a large prospective, longitudinal, nationwide study.

Conclusion: Patients with breast cancer who were treated in community oncology clinics report substantially more cognitive difficulties up to 6 months after treatment with chemotherapy than do age-matched noncancer controls.

Read the full abstract here