This week a new recommendation came out that people at high risk for lung cancer - particularly current or previous heavy smokers - should be screened for lung cancer with CT scans. This is another way that cancer can be detected at an earlier more treatable stage.
'Great,' we say. On the surface this seems like a good idea - catch a cancer early on and save more lives. Advanced testing options which have become relatively more accessible and affordable over the years have opened up testing options for millions.
But, and there is a big fat BUT here, does the additional screening add false positives which equal expense and stress for the patient? This is the same argument for women who have had breast cancer that they all should have MRIs in addition to mammograms each year to screen for recurrence.
All this wonderful new testing does great things. They find things that are something 'bad' and catch it early. They also find things that are big enough to see but too small to do anything about. And where does that leave the patient?
Medical advances are great but sometimes the advances exceed the capabilities that are required to diagnose and treat the findings.
This does not even touch on the issue of over testing and the emotional toll. Whether a positive or negative result, the testing experience is an emotional roller coaster ride for the patients. False positives and false negatives are realities in the results. Non test is 100% fallible so these do take place.
Me, personally, I am a big fan of the lets waiting and watching at this point. Unless I have symptoms I am not bounding off to see the doctor. I don't want more tests. I am happy this way.
Showing posts with label advances. Show all posts
Showing posts with label advances. Show all posts
New doesn't always mean better
Back in 2007 when I was diagnosed with breast cancer, all the patient boards were talking about this new kind of radiation called 'Mammosite' or brachytherapy. The advantage to it was you went twice a day for one week as opposed to once a day for 8 weeks. I asked my radiation oncologist and she said it was not yet available where I was treated. I was a tiny bit disappointed but figured I could suck it up and cope with daily visits for near 8 weeks. (The biggest pain about radiation treatment is having to go EVERY day for weeks.)
A few years later, I went to a cancer treatment conference at the same hospital and they said they were just beginning to offer this mammosite radiation to selected patients and explained the procedure how beads were inserted during surgery, etc. I felt a faint tinge of regret that I hadn't had the newer treatment type. It was newer so it must be better? Right?
Wrong. Now after it has been used for five years and on more than 50,000 women a clearer picture is emerging..
Often times there are treatment advances and cancer patients look back with regret 'why couldn't that treatment hve been available when I was being treated?' Not this time. No regrets for me.
A few years later, I went to a cancer treatment conference at the same hospital and they said they were just beginning to offer this mammosite radiation to selected patients and explained the procedure how beads were inserted during surgery, etc. I felt a faint tinge of regret that I hadn't had the newer treatment type. It was newer so it must be better? Right?
Wrong. Now after it has been used for five years and on more than 50,000 women a clearer picture is emerging..
- The outcome for patients is not necessarily better for women who have mammosite radiation than regular full breast radiation.
- There is a much higher rate of side effects with mammosite radiation - 35% vs. 18% for regular radiation.
- Mammosite radiation costs twice as much as traditional radiation.
Often times there are treatment advances and cancer patients look back with regret 'why couldn't that treatment hve been available when I was being treated?' Not this time. No regrets for me.
Stronger cancer drugs
There is a new type of cancer drug being investigated. They are called carboranes:
"Over the past decade, we have seen an increasing interest in using carboranes in drug design," said Mark W. Lee Jr., assistant professor of chemistry in College of Arts and Science. "Carboranes are clusters of three elements — boron, carbon and hydrogen. Carboranes don't fight cancer directly, but they aid in the ability of a drug to bind more tightly to its target, creating a more potent mechanism for destroying the cancer cells.
In the study, Lee and his research team used carboranes to build new drugs designed to shut off a cancer cell's energy production, which is vital for the cell's survival. All cells produce energy through complex, multi-step processes. The key to an effective drug is targeting the process that cancer cells depend on more than healthy cells. By increasing the binding strength of a drug, a smaller dose is required, minimizing side effects and increasing the effectiveness of the therapy. With carboranes, Lee found that the drug is able to bind 10 times more powerfully.
"The reason why these drugs bind stronger to their target is because carboranes exploit a unique and very strong form of hydrogen bonding, the strongest form of interactions for drugs," Lee said."
They have been tested on breast, lung and colon cancer and are very successful. They are also being tested on other forms of cancer. What is significant about their strength is that you can take a smaller dose which will have a stronger effect but will have fewer side effects. I'm all for fewer side effects in life.
Of course more research is needed so it won't be around anytime soon. But I still call this a significant advance.
"Over the past decade, we have seen an increasing interest in using carboranes in drug design," said Mark W. Lee Jr., assistant professor of chemistry in College of Arts and Science. "Carboranes are clusters of three elements — boron, carbon and hydrogen. Carboranes don't fight cancer directly, but they aid in the ability of a drug to bind more tightly to its target, creating a more potent mechanism for destroying the cancer cells.
In the study, Lee and his research team used carboranes to build new drugs designed to shut off a cancer cell's energy production, which is vital for the cell's survival. All cells produce energy through complex, multi-step processes. The key to an effective drug is targeting the process that cancer cells depend on more than healthy cells. By increasing the binding strength of a drug, a smaller dose is required, minimizing side effects and increasing the effectiveness of the therapy. With carboranes, Lee found that the drug is able to bind 10 times more powerfully.
"The reason why these drugs bind stronger to their target is because carboranes exploit a unique and very strong form of hydrogen bonding, the strongest form of interactions for drugs," Lee said."
They have been tested on breast, lung and colon cancer and are very successful. They are also being tested on other forms of cancer. What is significant about their strength is that you can take a smaller dose which will have a stronger effect but will have fewer side effects. I'm all for fewer side effects in life.
Of course more research is needed so it won't be around anytime soon. But I still call this a significant advance.
ASCO recap
The ASCO conference wrapped up this week. I did blog about it a week or so ago and now Cure Magazine has a special issue out on the latest from it. Its full of advances which is exciting to read. You should go read them yourself ifyou are interested but basically I can sum it up as 'Progress' with a capital P.
Yes there is a lot of research going on out there (because we need lots of research studies) and sometimes it seems like advances are announced but nothing really changes because 'more research is needed' or whatever reason. I think when you see a lot of research together, its different. The impact is much more significant. We need that.
Yes there is a lot of research going on out there (because we need lots of research studies) and sometimes it seems like advances are announced but nothing really changes because 'more research is needed' or whatever reason. I think when you see a lot of research together, its different. The impact is much more significant. We need that.
Clinical trials and long term after effects
So yesterday, after my deeply profound post on the long term affect effects of chemo, I went to a conference for people living with cancer. I sat through a couple of sessions on the state of cancer care and its future which were very interesting.
They were talking about new treatments coming out - for example additional treatments other than Herceptin for those who are Her2 positive. There were also some discussions on radiation treatment advances and how the new 3D and IMRT machines allow for more precise delivery of radiation - hence sparing nearby body parts which do not need to be scorched.
There was some conversation of things that are in clinical trials should be available soon or are even in the first round of human trials. So I started thinking about why are there no clinical trials for us longer term people? There was a clinical trial I wanted to participate in - for the recurrence vaccine. While I am not a fan of needles, I would be happy to get a series of shots if it could reduce my chance of recurrence. Then I found out it was only for people who were less than two years out from treatment so I was not eligible.
I understand that they want to have precise groups of volunteers in clinical trials which meet a specific set of criteria so they are comparing apples to apples with fewest possible interferences. These become very small groups. But it seems once you are through treatment, there are no trials available. And that seems wrong.
We are still people coping with a cancer diagnosis and once we get through treatment, we are excluded from research. No one seems to care about the long term effects. Too may potential variables which could interfere with a trial have entered our lives so no one wants to do any research with us. But we still count.
They were talking about new treatments coming out - for example additional treatments other than Herceptin for those who are Her2 positive. There were also some discussions on radiation treatment advances and how the new 3D and IMRT machines allow for more precise delivery of radiation - hence sparing nearby body parts which do not need to be scorched.
There was some conversation of things that are in clinical trials should be available soon or are even in the first round of human trials. So I started thinking about why are there no clinical trials for us longer term people? There was a clinical trial I wanted to participate in - for the recurrence vaccine. While I am not a fan of needles, I would be happy to get a series of shots if it could reduce my chance of recurrence. Then I found out it was only for people who were less than two years out from treatment so I was not eligible.
I understand that they want to have precise groups of volunteers in clinical trials which meet a specific set of criteria so they are comparing apples to apples with fewest possible interferences. These become very small groups. But it seems once you are through treatment, there are no trials available. And that seems wrong.
We are still people coping with a cancer diagnosis and once we get through treatment, we are excluded from research. No one seems to care about the long term effects. Too may potential variables which could interfere with a trial have entered our lives so no one wants to do any research with us. But we still count.
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