Entries in chemotherapy (22)


Could Breast Cancer Treatment Result in Cognitive Problems?

Ingram Publishing/Thinkstock(NEW YORK) -- The chemotherapy and radiation that helps to save patients' lives comes with their own costs, and not all of them are physical. Breast cancer survivors have more to worry about than a return of the disease.
A new online analysis in the journal Cancer, published by the American Cancer Society, finds they may have problems with some mental abilities years after treatment.
The authors compared women who were treated with chemotherapy and radiation, women who were treated with radiation only and women with no history of cancer. They confirmed previous research that chemotherapy can cause problems with memory and concentration up to three years after treatment ends.
But those who got radiation only often had problems similar to those who received both chemotherapy and radiation -- suggesting chemotherapy isn't solely to blame for these side effects.
The study found no evidence of cognitive problems from hormonal therapy such as tamoxifen.

Copyright 2011 ABC News Radio


Kara Kennedy's Heart Attack Related to Cancer Treatment?

Brian Snyder-Pool/Getty Images(WASHINGTON) -- The heart attack death of Kara Kennedy, the latest in the tragedy-touched Kennedy dynasty, may have been related to the aggressive cancer treatment she underwent about a decade ago, say her brother and a cardiologist.

The 51-year-old daughter of the late Sen. Edward M. Kennedy died Sept. 16 while working out at her Washington, D.C., gym.

"Depending upon where the lung cancer was, her heart could have taken a direct hit," said Dr. Sharonne N. Hayes, a cardiologist and founder of the Women's Heart Clinic at the Mayo Institute.

More details on Kara Kennedy's death are expected to be released by the Edward M. Kennedy Institute for the United States Senate as funeral arrangements are being made for Wednesday.

Kara Kennedy was diagnosed with lung cancer in 2002 and was initially told it was inoperable.  But with her father's help, she found a surgeon at Brigham and Women's Hospital in Boston who removed part of her right lung, followed by chemotherapy and radiation.

Her brother, former Rhode Island Rep. Patrick Kennedy, 44, said the grueling treatments had left his sister physically weakened.

For cancer patients who have aggressive chemotherapy and radiation, particularly in the chest, "there are some real heart risks," according to Hayes, who did not treat Kara Kennedy.  "The heart muscle can be weakened."

"This is probably widely underappreciated," she said.  "People are so fearful of cancer, but in order to save people from cancer, other organs are put at risk -- the heart, in particular."

Copyright 2011 ABC News Radio


Doctors Debate Controversial 'Hot Chemo' Treatment

Jupiterimages/Thinkstock(BOSTON) -- Is it a dangerous method of treating cancer or a source of hope for colon cancer patients?

"Hot chemo" is a treatment that involves opening up the entire stomach cavity, removing the colon and removing tumors by hand.  Then, the diseased area is directly blasted with hot chemotherapy.

Critics of the practice compare it to being disemboweled and bathed in hot poison.

"It is toxic, it is expensive," says Dr. Robert Mayer of Harvard.

He adds that no tests have been done studying hot chemo's effectiveness.

But Dr. Steve  Libutti who has performed the treatment, says it can work.

"I have certainly seen patients carefully managed through the course of therapy and come out of it without major toxicities," he says.

As more patients become aware of the hot chemo treatment, more studies will likely be performed.

Copyright 2011 ABC News


After Brain Surgery, U.K. Gradeschooler Can't Stop Giggling

BananaStock/Thinkstock(NEW YORK) -- Seven-year-old Enna Stephens is facing a daunting 16 months of chemotherapy and radiation after doctor's removed a tumor from her brain, but thanks to a bizarre side effect of the surgery: all she can do is laugh about it.

Enna suffers from pseudobulbar affect (PBA), a neurological disorder brought on by nerve damage that makes it difficult to control one's emotional response. Some patients with PBA cry uncontrollably, others get angry, but for Enna, it has manifested as frequent bouts of the giggles.

While PBA can cause normal reactions, such as a chuckle following a joke, to become exaggerated, the emotional responses sometimes run contrary to the actual emotion the patient is feeling, or have nothing to do with it at all.

"Different patients suffer it in different ways," says Dr. Brian Greenwald, medical director of brain injury rehabilitation at the Mount Sinai Rehabilitation Center in New York City, who did not treat Enna. "Sometimes they'll be hysterically crying but not actually feel upset. Sometimes they are angry but it comes out as laughter. It can be incredibly frustrating to live with because it starts to interfere with one's social and professional life," he says.

In cases of traumatic brain injury, PBA can be a sign of damage to the brain and will often subside with time as the brain heals. For those with degenerative conditions, such as Parkinson's or Alzheimer's, however, PBA tends to worsen over time.

According to Enna's doctors, there is something to smile about: they believe the cancer was completely removed and there is an 80 percent chance it won't return, doctors told the U.K. press.

Copyright 2011 ABC News Radio


Researchers Say Tarceva Should Be Used as First-Line Therapy Instead of Chemo

Jupiterimages/Thinkstock(SHANGHAI) -- Patients with a particular type of non-small-cell lung cancer that is positive for a marker called EGFR can be treated with targeted therapy.  A drug called Tarceva is FDA approved and indicated for use in patients who fail to respond to initial chemo treatments.  But a new a study from the Shanghai Pulmonary Hospital in China shows that maybe Tarceva should be given to patients as a first-line therapy -- and not only after chemo has failed.  Their findings were published in Lancet Oncology.

Researchers treated 165 previously untreated EGFR-positive lung cancer patients with either Tarceva or the standard chemo regimen.  Turns out that the disease didn’t progress for 13 months in those treated with Tarceva, compared with only 4.6 months in those getting chemo.  Tarceva was also associated with fewer side effects.  

But, the authors don’t provide any data on whether Tarceva actually prolonged life in these patients, and other studies of similar targeted therapies have not shown a benefit in overall survival.

Despite this, the authors conclude that Tarceva “ important for first-line treatment of patients with advanced EGFR mutation-positive NSCLC [non-small-cell lung cancer].”
It should be noted, however, that this study was funded by Roche, the company that manufactures Tarceva.

Copyright 2011 ABC News Radio


Breast Cancer Patients Fight to Stay Fertile Post-Chemo

Jeffrey Hamilton/Lifesize/Thinkstock(COLUMBUS, Ga.) -- Carly Byrd's worst fear isn't dying from the cancer that has claimed both her breasts and invaded her immune system; it's that the treatment she needs to live might crush her dreams of having children.

Byrd is still battling for her life four years after she was first diagnosed with breast cancer at the age of 25.  Despite multiple lumpectomies, a double mastectomy and radiation therapy, she now needs aggressive chemotherapy -- a cocktail of toxic drugs that causes her to lose her hair and appetite, and could rob her of her fertility, too.

"My oncologist told me there was a 30 percent chance that the chemo I had to have would toss me into early menopause," said Byrd, who said she has dreamed of being a mom her whole life.  "When cancer and the procedures to treat it start taking real things away from you, it's a big pill to swallow."

Roughly 12 percent of breast cancer patients are under 45, but the chemotherapy they need to beat their illness can push them into early menopause.  Cryopreservation, a procedure that freezes and stores eggs, embryos or ovaries until the cancer is gone, can help patients put motherhood on ice.  However, it takes time, money and forethought -- all of which may be in short supply for women fighting for their lives.

But a new drug that suppresses ovarian function could help breast cancer patients, like Byrd, preserve their fertility without delaying chemotherapy or breaking the bank, according to an Italian study.  Patients who took triptorelin, an injectable gonadotropin releasing hormone (GnRH) analogue, one week before chemo and every four weeks throughout their treatment were 17 percent less likely to experience early menopause than patients who did not.

The results were published Wednesday in the Journal of the American Medical Association.

"In comparison with cryopreservation strategies, GnRH analogue-induced ovarian suppression has the advantages that it does not require a male partner, is simple to administer, does not require delaying chemotherapy, and is less invasive and less expensive," Dr. Lucia Del Mastro, an oncologist at the National Institute for Cancer Research in Genoa, Italy, and colleagues wrote in their report.

The rate of early menopause was 8.9 percent in patients who took triptorelin, compared to 25.9 percent in patients who did not.  The study authors, and authors of an accompanying editorial, suggest the drug could broaden the options for breast cancer patients who hope to have children.

Copyright 2011 ABC News Radio


Preventing Early-Onset Menopause in Young Breast Cancer Patients

Photodisc/Thinkstock(GENOVA, Italy) -- It is estimated that about six to seven percent of breast cancers are diagnosed in women under the age of 40, and chemotherapy in this young population carries a particular side effect risk not seen in older women: that of early-onset menopause.  

Between 10-50 percent of young breast cancer patients experience chemo-induced menopause, and the degree of risk is dependent on their age at the time of treatment.  Unfortunately, early-onset menopause means infertility and a multitude of menopause-associated side-effects, and the fear of these effects have been reported to influence treatment decisions in almost a third of young women with breast cancer.  But now, a study published in the Journal of the American Medical Association reports that suppressing the hormonal function of the ovaries during chemotherapy can reduce the risk of early menopause in young patients.
Researchers at the Istituto Nazionale per la Ricerca sul Cancro in Italy split 281 young breast cancer patients into two groups, giving one a drug that suppresses the activity of the ovaries while they were undergoing chemotherapy while giving the other group chemotherapy only. One year after the end of the chemotherapy cycle, there was no difference between the groups in the anti-tumor effect of the chemotherapy regimens.  But, only 9 percent of the women who received the ovary-suppressing drug experienced early-onset menopause compared with 26 percent of those who did not get the additional treatment.  

The authors conclude that “this treatment can therefore be offered to premenopausal patients with breast cancer who wish to decrease the risk of permanent ovarian failure associated with chemotherapy.”
Copyright 2011 ABC News Radio


Chemo Drug Shortage Puts Cancer Patients at Risk

Jupiterimages/Stockbyte/Thinkstock(NEW YORK) -- A shortage of Taxol, an intravenous chemotherapy workhorse for ovarian, breast, lung, and colon cancers, demonstrates once again how vulnerable U.S. hospitals and clinics are to an increasingly unreliable pharmaceutical supply chain. The shortfalls continue to leave patients at risk.

Paclitaxel, the generic version of Taxol, joins 196 other drugs on a shortage list compiled by the American Society of Health-System Pharmacists in Bethesda, Md.

Although no one has been able to quantify the number of lives jeopardized by the shortages, the lengthy list underscores that the country is in the midst of a "public health crisis of drugs overall," said Cynthia Reilly, director of the group's practice development division.

Paclitaxel made the list May 13, with a June 16 update. Additions in the last month include such chemotherapy mainstays as doxorubicin, daunorubicin, carboplatin, vincristine and cytarabine; the quick-acting anesthetic propofol; the injectable painkiller Fentanyl and injectable forms of several powerful antibiotics: clindamycin, ciprofloxacin, and gentamicin.

For more than a year, "we've been having a crescendoing of drugs that are in short supply. This has been going on for some time now," said Dr. Michael P. Link, a Stanford University pediatric oncologist who serves as president of the American Society of Clinical Oncology. He called the paclitaxel crunch "another add-on."

In response to an ABC News request for comment about their paclitaxel supplies, a dozen major U.S. hospitals and medical centers said they hadn't experienced a shortage. Among them: the Fred Hutchinson Cancer Research Center in Seattle, Duke University in Durham, N.C., the University of Rochester Medical Center in New York, the University of Michigan Comprehensive Cancer Center in Ann Arbor, Maimonides Cancer Center in Brooklyn, N.Y., Georgetown University's Lombardi Comprehensive Cancer Center in Washington, D.C., and Indiana University-Purdue University in Indianapolis.

Still, some of the largest and most renowned U.S. medical centers reported being short of paclitaxel, along with other important drugs. "In my 25 years as a cancer MD, I have never, never seen this," said Dr. Jay Brooks, chairman of hematology-oncology at the Ochsner Clinic Foundation and Hospital in New Orleans, where 800 doctors and 20 oncologists "work together to shift drugs where needed for patients."

Burgeoning drug shortages in the past decade, particularly among injectable generics, suggest that the U.S. pharmaceutical business is operating under "an economic model that apparently is no longer tenable," said Dr. Neal J. Meropol, chief of hematology and oncology at University Hospitals Case Medical Center in Cleveland.

He suggested the system might need to change if producers cannot make adequate profits on low-cost generic drugs "to make it worthwhile to continue producing them with a high degree of reliability."

Copyright 2011 ABC News Radio


Doctors Call to Stop Chemotherapy Overuse, Cut Cancer Costs

Thomas Northcut/Thinkstock(RICHMOND, Va.) -- Annual costs of cancer care are expected to rise to more than $173 billion dollars by 2020, a nearly $70 billion increase since 2006, according to the National Cancer Institute.

But limiting chemotherapy for patients with metastatic or recurrent cancers would not only dramatically cut exorbitant medical costs but would also improve a patient's quality of life, two oncologists suggest in a paper published Wednesday in the New England Journal of Medicine.

While cycles of chemotherapy vary depending on the type of cancer, authors Dr. Thomas Smith and Dr. Bruce Hillner suggest that oncologists limit treatment for patients who are not responding to three cycles of chemotherapy.

This recommendation is one of 10 Smith and Hillner outlined as a response to a challenge posed by a colleague to suggest changes in the practice of medical oncology that could save the nation billions of dollars.

Current guidelines by the American Society of Clinical Oncologists already recommend stopping treatments that do not seem to benefit the patient.  But many oncologists fail to put these guidelines into practice, said Smith, a medical oncologist and palliative care specialist at Virginia Commonwealth University's Massey Cancer Center.

Although chemotherapy may no longer be beneficial for end-stage cancer patients, many oncologists choose to continue treatment, said Smith.

Previous studies suggest that as many as 20 percent of patients are getting chemotherapies in their last two weeks of life. Instead, Smith suggests spending the time beforehand to discuss end-of-life care with patients.

Copyright 2011 ABC News Radio


Four-Drug Chemo Combo Offers More Time for Pancreatic Cancer Patients

Paul Tearle/Thinkstock(NANCY, France) -- A new French study suggests that regular treatment, including a four-drug chemotherapy combo, can almost double the survival time in patients with fatal pancreatic cancer.

Researchers in the study divided 342 patients with advanced stage pancreatic cancer into two groups, giving one group the standard treatment and the other FOLFIRINOX -- the four-drug combination therapy.

Results published in the New England Journal of Medicine show that the median survival time improved from almost 7 months for patients receiving the traditional treatment, to just over 11 months for patients receiving the combo.  Despite the improved survival time, patients in the combo group suffered greater side effects, however.

The study authors conclude that the FOLFIRINOX regimen can stabilize patients for a greater amount of time while delaying degradation of quality of life. 

Copyright 2011 ABC News Radio

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