News breaks in the cancer arena all the time. Sometimes it’s big, like word that a breakthrough drug has increased survival for a hard-to-treat cancer.
Sometimes it’s smaller. Any of it may matter to you and your family as you navigate your cancer journey. We do our best to keep you up to date with a monthly roundup of some of the most significant recent cancer news.
Cholesterol-Lowering Drugs Linked to Better Survival in Triple-Negative Breast Cancer
Statin therapy, which is typically prescribed to help lower cholesterol levels, may also improve overall survival (OS) and breast cancer–specific survival (BCSS) for women diagnosed with triple-negative breast cancer (TNBC), according to research published online on August 3 in the journal Cancer.
Researchers examined data from the Surveillance, Epidemiology, and End Results (SEER)–Medicare database and the Texas Cancer Registry–Medicare database to identify women age 65 and younger who were diagnosed with stage 1–3 breast cancer between 2008 and 2015. Among those, the researchers identified 2,281 women who had started a statin within 12 months of their diagnosis, 1,543 of whom were also diagnosed with TNBC. Findings showed that compared with women who were diagnosed with other breast cancer types, women with TNBC had a 30 percent improved OS and 58 percent improved BCSS. The findings also suggested that the statin benefit might be better in women with early stage TNBC, and that the type of statin — specifically lipophilic statins, such as Zocor (simvastatin), Lipitor (atorvastatin), Mevacor (lovastatin), Lescol (Fluvastatin), and Livalo (pitavastatin) — had a statistically significant influence on improving survival.
TNBC currently accounts for 10 to 15 percent of all breast cancers, according to the American Cancer Society. Because TNBC cells do not have progesterone or estrogen receptors and do not overexpress the human epidermal growth factor receptor 2 (HER2) protein, they do not respond to common hormone therapy or targeted drug therapy. Prior studies suggest that statins decrease the ability of breast cancer cells to divide and enhance the cancer cells’ tendency to self-destruct. While more research is needed, there may be a future role for statin therapy for TNBC.
Blood Test for Prostate Cancer Reduces Need for MRI, Biopsy Screening
A blood-based screening risk prediction model appears to perform just as well as traditional prostate-specific antigen (PSA) screening (which measures the level of the PSA protein in the blood) for detecting clinically significant prostate cancer. The new model also appears to reduce overtesting with magnetic resonance imaging (MRI) and biopsies, according to trial findings published online on August 12 in the journal The Lancet Oncology.
Swedish researchers assessed the impact of using a blood-based prostate cancer risk prediction model (called Stockholm3), compared with traditional PSA testing, in 2,293 men with elevated risk of developing prostate cancer. The participants provided an initial blood sample for analysis. Those who had elevated PSA levels were randomly selected for traditional biopsies or MRI to confirm diagnoses. Not only was a Stockholm3 score shown to be as sensitive for detecting prostate cancer, it detected more cancers than the PSA test. In addition, replacing the PSA test with a Stockholm3 risk tool in settings where MRI and targeted biopsies were used actually reduced the number of MRIs conducted by 36 percent and biopsies by 8 percent.
One problematic aspect of PSA screening is that it has been associated with overdetection of harmless, low-grade cancers; side effects (both psychological and physical) associated with the diagnostic process; and overtreatment. Improving the ability to sort out which prostate cancers are harmless and which require more aggressive testing and treatment would be a dramatic improvement in the screening process.
Higher Vitamin D Intake Linked to Reduced Early Colon Cancer Risk
Total vitamin D intake of 300 international units (IU) or more appears to be associated with as much as a 50 percent lower risk of developing early onset colon cancer (i.e., colon cancer before age 50) in women, according to study findings published online on July 6 in the journal Gastroenterology.
Harvard researchers prospectively assessed total vitamin D intake and risk for early onset colon cancer among 94,205 women enrolled in the Nurses Health Study II between 1991 and 2015. In the biannual follow-up questionnaire, the women were asked to report if they had had a colonoscopy or sigmoidoscopy procedure, the reason for the procedure, and whether or not polyps — precursors to colon cancer — were found. In the study, 111 early onset colon cancer cancers and 3,317 colorectal polyps were documented. Women who reported consuming at least 300 to 450 IU of vitamin D per day had a 49 percent lower risk of early onset colon cancer, compared with women who consumed <300 IU/day, while women reporting >450 IU/day had a 51 percent reduced risk. When the researchers looked at sources of vitamin D, they found that dietary vitamin D (e.g., from sources such as skim milk or fish) provided the strongest risk reduction (66 percent), compared with supplementary vitamin D (33 percent). Additionally, higher vitamin D intake (>600 IU/day) was associated with a 39 percent reduced risk of benign colon tumors, called adenomas, and a 15 percent reduced risk of a type of tumor known as a serrated polyp, which is harder to locate and usually does not become malignant. When the researchers adjusted for factors such as the use of multivitamins, body-mass index, calcium intake, physical activity, and smoking status, the results remained the same.
Colon cancer was, until recently, considered a disease of older individuals, but early onset colon cancer is now the third leading cause of cancer in young adults (20 percent of these cancers are now diagnosed in people between the ages of 20 and 54). Early onset colon cancer is also often more advanced at diagnosis. Although more research is needed, the current study suggests that upping intake of dietary vitamin D to at least 300 IU/day (which is equivalent to roughly three 8-ounce glasses of milk) may significantly reduce the risk of developing early onset colon cancer.
Working Out May Help Fight ‘Chemo Brain’ in People With Breast Cancer
Engaging in moderate-to-vigorous physical activity (PA) before and during chemotherapy treatment may help stave off cognitive decline (aka “chemo brain”) in breast cancer patients, according to a study published online on August 18 in the Journal of Clinical Oncology.
Washington University researchers measured self-reported physical activity levels before (within seven days) and within one and six months after the first chemotherapy sessions in 580 patients with breast cancer, compared with 363 cancer-free controls. They also assessed cognition measures, including perceived cognitive impairment, ability to maintain attention, and visual memory. Only 33 percent of patients met national PA guidelines (150 minutes of moderate-to-vigorous activity weekly) before treatment. But those that did had significantly better cognitive scores over time (including cognitive function and visual memory), compared with patients whose PA levels were lower. They also had sustained cognition and visual memory comparable to cancer-free peers who met national PA guidelines before the study, but they still reported more problems in overall cognition.
The findings don’t definitively link greater physical activity and the prevention of chemo brain. However, they do suggest that maintaining physical activity during treatment for breast cancer could be an important tool for protecting cognitive function. Additional studies will help tease out the connection.
FDA Cautions Against Robotically Assisted Mastectomy Surgery
The FDA has not established the safety and effectiveness of robotically assisted surgical (RAS) devices for mastectomy procedures to prevent or treat breast cancer, according to a statement issued on August 20.
RAS devices have been cleared for certain types of surgeries that are often performed on cancer patients (e.g., hysterectomies or prostatectomies). However, the FDA has not reviewed any clinical studies demonstrating safety or effectiveness of RAS devices for preventing or treating breast cancer, nor improvements in overall survival, cancer recurrence, or disease-free survival. Studies on RAS and mastectomy are being conducted, however, despite the potential clinical risk they pose to patients or participants.
The FDA recommends that all patients requiring surgery to prevent or treat breast cancer ask their surgeons beforehand if they plan on using robotically assisted surgery. If so, they suggest asking about the surgeon’s training, experience, and patient outcomes with RAS device procedures, as well as how many they have performed.