Missing an occasional dose of medicine may not seem like a big deal, but for kids with acute lymphoblastic leukemia (ALL), it can have dire consequences. Now City of Hope researchers have assessed the factors that can contribute to so-called medication non-adherence. One of their more surprising discoveries: Having multiple adults involved with administering medication actually lowers the likelihood that kids will take the drugs as they should.
The results will be presented at the American Society of Clinical Oncology annual meeting on June 1.
“ALL is a highly treatable cancer, but patients need to take ongoing oral chemotherapy for two years after the initial remission to reduce likelihood of relapses,” said Smita Bhatia, M.D., M.P.H., senior author of the study and the Ruth Ziegler Chair in Population Sciences at City of Hope. “By identifying factors linked to non-adherence, we can identify at-risk patients and intervene to ensure that they stay on track with the medication schedule.”
City of Hope researchers had already found that not non-adherence to medication regimens can triple a patient’s risk of relapse. They also knew that almost half of pediatric ALL patients don’t take their medication as they should. Understanding the reasons for such non-adherence is a first step in reducing the risk of relapse.
In their new analysis, Bhatia, Wendy Landier, Ph.D., R.N., assistant professor in the Department of Population Sciences, and their colleagues studied 462 pediatric ALL patients taking maintenance oral chemotherapy. Using a combination of questionnaires, demographic data and devices that track when the drug bottles were opened, the researchers found that the following factors are associated with non-adherence: » Continue Reading
For women with hormone receptor-positive breast cancer – the most common type of breast cancer worldwide – the American Society of Clinical Oncology (ASCO) is now recommending a decade of follow-up care with tamoxifen.
The update to the ASCO guidelines, announced today, reflects the findings of five studies that have been reported since the last update to the recommendation in 2010. In the two largest randomized studies with the longest follow-up, women who took tamoxifen for 10 years had a survival advantage compared to those who took the drug for five years. In addition, women who took the drug longer had a lower risk of breast cancer recurrence and of breast cancer appearing in their other breast.
A five-year regimen of tamoxifen had been the standard treatment, but because of the growing body of research pointing to a benefit in a longer course, many doctors already had recommended a decade-long regimen for their patients.
“This is something we’ve been doing here at City of Hope for at least the last year or so,” said Courtney Vito, M.D., a staff surgeon and surgical oncologist. “I think that it is important to note that even with early stage breast cancer, there is a risk of relapse and what we’re learning is estrogen receptor-positive breast cancer can relapse as many as 20 years out.” » Continue Reading
For patients with BRCA mutation-associated breast cancer, the experimental drug ABT-888 — also known as veliparib — is showing promise as a treatment, according to phase II clinical trial results that will be reported at the upcoming annual meeting of the American Society of Clinical Oncology.
“Normal cells use an enzyme called PolyADP ribose polymerases (PARP) to repair DNA damage, but cancer cells can exploit PARP to resist DNA-damaging radiation and chemotherapy,” explained Somlo. “Because veliparib works by blocking this protein, we wanted to see whether it has any benefit against breast cancer.”
Somlo and Jeffrey Weitzel, M.D., director of City of Hope’s Division of Clinical Cancer Genetics, focused on BRCA-related breast cancer because the associated genes also code for DNA repair proteins. BRCA gene dysfunctions already compromise the cancer’s ability to self-repair, so an additional knockout of PARP enzymes may induce cancer cells to self-destruct or render them especially susceptible to DNA-damaging therapies. » Continue Reading
Treatment for many cancers, such as lung cancer, is getting more sophisticated all the time, featuring therapies tailored to the very DNA of individual patients, increasingly advanced surgical techniques, and screenings that can pinpoint risk with greater accuracy than ever before. But when the time comes for a woman with breast cancer to make decisions about her treatment, her personal medical history and risk factors are not the only factors she considers, and may not even be the driving ones.
In fact, a recent University of Michigan study concluded that fear, genetic tests and advanced imaging techniques (regardless of their results) were tied to an increased likelihood that women would opt for a preventive double mastectomy.
For some women, this is the right move – specifically those who have a genetic susceptibility or strong family history of cancer. But there’s no evidence that removing a healthy breast will improve the chance of survival for women who do not have a strong family history or a genetic risk factor.
Yet, the number of women who opt for preventive double mastectomy more than doubled between 1998 and 2003. » Continue Reading
Electronic cigarettes, or e-cigs, can indeed help smokers kick their tobacco cigarette habit, new research suggests, bolstering supporters’ claims that the devices can be beneficial. The research is generating considerable media attention, with headlines suggesting that e-cigarettes have been vindicated, but reaction from some smoking experts has been far more muted, even skeptical.
The new study, published in the journal Addiction this week, suggests that smokers who use e-cigarettes as a means to quit have up to a 60 percent better chance at succeeding than smokers who used a licensed nicotine replacement therapy product, such as a nicotine patch or gum, or smokers who used no aid at all.
Researchers analyzed data gathered from 2009 through 2014 on nearly 6,000 smokers who had made at least one attempt to quit smoking tobacco cigarettes in the past year.
Of those surveyed, 464 had used only e-cigarettes to try to quit, 1,922 had used only over-the-counter nicotine replacement, and 3,477 had attempted to quit without any aid.
The outcome was self-reported and adjusted for key potential confounders such as nicotine dependence. The researchers found that the quitting rate for participants who used e-cigarettes was 1.63 times higher than the rate for people who used nicotine replacement therapy and 1.61 times higher than the rate for people using no aid. » Continue Reading
Every patient story is unique and, so in its own way, inspiring. Here, Michele Sturt – a runner, a nurse and a mother of four – shares her story of non-Hodgkin lymphoma and of her ultimate treatment at City of Hope.
I was diagnosed with non-Hodgkin lymphoma in 2007 when I was 54 years old. I had been a runner since I was in my early twenties and used running as my gauge to my personal wellness status. How fast, how much effort, how many aches and pains, how many personal bests … these have been my general health parameters for many years. In other words, aside from various weekend warrior accidents, I had been quite healthy until I was told I had non-Hodgkin lymphoma.
I had noticed that I was really having a hard time keeping up with my running friends. I was working too hard and not getting anywhere fast. I also had a single small inguinal lymph node that was new. It didn’t bother me other than I knew it wasn’t normal. Besides being a runner, I am also a nurse practitioner in internal medicine.
First, I waited the obligatory four to six weeks to see if it would go away. I also complained to one of the doctors I work with, and she felt I should have the node biopsied and be done with it. The general surgeon gave me the option of waiting longer before doing anything, but at that point I wanted the node out and evaluated. I was tired but had no other symptoms.
My diagnosis was non-Hodgkin lymphoma, specifically indolent follicular B cell, a slow-growing, not curable but treatable form of lymphoma.
So, now what? I didn’t feel like I had cancer. I had lived an unusually clean and healthy life, although crazy busy and active, and I was the last person you would expect to have cancer, unless you knew what I knew – it’s a dice throw and I just crapped out. With only one oncologist available in my hometown of Petoskey, Michigan, at that time, I needed to figure out where to go for answers. » Continue Reading
The news for pancreatic cancer is admittedly not good. Although overall cancer death rates continue to decline in the United States, pancreatic cancer is one of the few cancers with death rates projected to continue to rise in the next 15 years.
That’s why research is crucial. That’s why City of Hope is crucial.
By 2030, pancreatic cancer is expected to become the second-leading cause of cancer-related death in the United States, surpassing breast, prostate and colorectal cancers, according to a new study published this week in Cancer Research, a journal of the American Association for Cancer Research. Liver cancer will be the third-leading cause of cancer-related death, researchers predicted.
Lung cancer is currently the No. 1 cause of cancer-related death in the United States and will maintain that distinction, according to the report. (City of Hope’s Dan Raz, M.D., co-director of the Lung Cancer and Thoracic Oncology Program, has much to say on how to save lives from lung cancer, specifically through lung cancer screening.)
As for pancreatic cancer, Joseph Kim, M.D., City of Hope surgical oncologist and head of upper gastrointestinal surgery, says researchers and physicians are working to change the grim outlook for such diseases. » Continue Reading
For lung cancer patients whose tumors are resistant to a class of chemotherapy called tyrosine kinase inhibitors (TKI), a drug called cabozantinib may be able to undo that resistance, according to a new City of Hope study.
The results will be presented at the American Society of Clinical Oncology’s annual meeting on June 3.
“Previous studies have shown that in patients with nonsmall cell lung cancer linked to a EGFR gene mutation, the proteins MET and VEGF promote tumor growth and make it resistant to TKI chemotherapy,” said Karen Reckamp, M.D., M.S., co-director of the Lung Cancer and Thoracic Oncology Program and first author of the abstract. “Because cabozantinib can block both of these proteins, we want to see if can can reverse that drug resistance as well.”
For this phase II trial, Reckamp and her colleagues studied 35 patients with advanced, EGFR-mutant nonsmall cell lung cancer whose disease had progressed despite TKI therapy. The patients were given 40 milligrams of cabozantinib in addition to 150 milligrams of TKI drug erlotinib daily for 28 days, and were then examined to determine whether their tumors had responded to the combination therapy. » Continue Reading
Those shorts with that shirt? Which skirt with that blouse? Which sandals? These are standard summer-season questions many people ask themselves before leaving the house on a sunny day. A better question might be: Which sunscreen? Consumer Reports has found that labels might not be the best guide, with only two – repeat, two – of 20 products actually living up to their SPF, or sun protection factor, claims after a good dunking. Most of the rest were 4 to 40 percent below the touted number on the labels.
In fact, the July issue of the magazine recommended only seven of the products they tested, with both high-end and bargain price tags. WebMD provides a full list of the ratings.
Consumer Reports points out that no sunscreen blocks all rays, and that SPF refers only to UVB rays, not UVA rays. It even offers up a nifty graphic on the ratio between SPF and UVB protection.
As Vijay Trisal, medical director of community practices at City of Hope, has said: “People need to look for a sunscreen that contains at least one of the following: ecamsule, avobenzone, oxybenzone, titanium dioxide, sulisobenzone or zinc oxide.” These ingredients provide broad-spectrum protection, reducing damage from both UVA and UVB rays. » Continue Reading
Symbolism is powerful. Just ask any of the City of Hope doctors, nurses or patients who participated in The Baton Pass at City of Hope’s recent Bone Marrow Transplant Reunion.
The Baton Pass is a joint campaign by Stand Up To Cancer (SU2C) and Siemens to raise funds for SU2C’s cancer research efforts. It launched March 19 on ABC’s “Good Morning America” and will conclude Sept. 5. In between, the Baton will appear at events across the country.
One of those events was City of Hope’s annual reunion of bone marrow transplant recipients and their families, as well as the doctors and nurses who cared for them.
Watch them stand up to cancer.