What factors do cancer patients believe contribute to the development of their cancer? (New South Wales,Australia)

Objective  

To analyze Australian cancer patients’ beliefs about factors contributing to the development of their cancer.     

Did quality of life for older cancer survivors improve with the turn of the century in the United States?

ObjectivesAlthough survival after a cancer diagnosis has improved considerably over the past 20 years, little is known about trends in health-related quality-of-life (HRQOL) for older prostate, breast, and lung cancer survivors.MethodsUsing a population-based registry with longitudinal patient reported outcomes (the National Cancer Institute Surveillance, Epidemiology and End Results database linked to Medicare Health Outcomes Survey), we analyzed Medicare Advantage patients diagnosed with cancer during 1998–2011, who completed surveys regarding HRQOL through 2013. ‘Early Era’ patients were treated during 1998–2003; ‘Late Era’ patients were treated during 2006–2011. After propensity score matching, post-diagnosis changes in health utility (HU), Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were calculated and compared between the two eras.ResultWe identified 208 older patients with prostate, 276 with breast and 76 with lung cancer who were treated in the ‘Early Era’ and matched to equal numbers in the ‘Late Era’. Mean age of patients in early and late era was 72 and 73 years, respectively. The mean post-diagnosis decline in health utility for patients treated in the ‘Late Era’ was not significantly different from the ‘Early Era’ for any cancer (Prostate [early vs. late]: ?0.06 vs. -0.03, p = .09; Breast: ?0.03 vs. ?0.04, p = .65; Lung: ?0.07 vs. ?0.07, p = .95); nor for Physical Component Summary or Mental Component Summary scores.ConclusionOlder patients treated for prostate, breast or lung cancer in the later era reported similar outcomes of changes in HRQOL compared to earlier era patients.     

What causes breast cancer? A systematic review of causal attributions among breast cancer survivors and how these compare to expert-endorsed risk factors

Purpose

The aim of this paper was to review published research that analyzed causal attributions for breast cancer among women previously diagnosed with breast cancer. These attributions were compared with risk factors identified by published scientific evidence in order to determine the level of agreement between cancer survivors’ attributions and expert opinion.

Methods

A comprehensive search for articles, published between 1982 and 2012, reporting studies on causal attributions for breast cancer among patients and survivors was undertaken. Of 5,135 potentially relevant articles, 22 studies met the inclusion criteria. Two additional articles were sourced from reference lists of included studies.

Results

Results indicated a consistent belief among survivors that their own breast cancer could be attributed to family history, environmental factors, stress, fate, or chance. Lifestyle factors were less frequently identified, despite expert health information highlighting the importance of these factors in controlling and modifying cancer risk. This review demonstrated that misperceptions about the contribution of modifiable lifestyle factors to the risk of breast cancer have remained largely unchanged over the past 30 years.

Conclusions

The findings of this review indicate that beliefs about the causes of breast cancer among affected women are not always consistent with the judgement of experts. Breast cancer survivors did not regularly identify causal factors supported by expert consensus such as age, physical inactivity, breast density, alcohol consumption, and reproductive history. Further research examining psychological predictors of attributions and the impact of cancer prevention messages on adjustment and well-being of cancer survivors is warranted.     

What has senescence got to do with cancer?

Cancer therapeutics are primarily thought to work by inducing apoptosis in tumor cells. However, various tumor suppressors and oncogenes have been shown to regulate senescence in normal cells, and senescence bypass appears to be an important step in the development of cancer. Cellular senescence limits the replicative capacity of cells, thus preventing the proliferation of cells that are at different stages of malignancy. A recent body of evidence suggests that induction of senescence can be exploited as a basis for cancer therapy.     

What does physics have to do with cancer?

Large-scale cancer genomics, proteomics and RNA-sequencing efforts are currently mapping in fine detail the genetic and biochemical alterations that occur in cancer. However, it is becoming clear that it is difficult to integrate and interpret these data and to translate them into treatments. This difficulty is compounded by the recognition that cancer cells evolve, and that initiation, progression and metastasis are influenced by a wide variety of factors. To help tackle this challenge, the US National Cancer Institute Physical Sciences-Oncology Centers initiative is bringing together physicists, cancer biologists, chemists, mathematicians and engineers. How are we beginning to address cancer from the perspective of the physical sciences?     

Does high soy milk intake reduce prostate cancer incidence? The Adventist Health Study (United States)

Objectives: Recent experimental studies have suggested that isoflavones (such as genistein and daidzein) found in some soy products may reduce the risk of cancer. The purpose of this study was to evaluate the relationship between soy milk, a beverage containing isoflavones, and prostate cancer incidence.Methods: A prospective study with 225 incident cases of prostate cancer in 12,395 California Seventh-Day Adventist men who in 1976 stated how often they drank soy milk.Results: Frequent consumption (more than once a day) of soy milk was associated with 70 per cent reduction of the risk of prostate cancer (relative risk=0.3, 95 percent confidence interval 0.1-1.0, p-value for linear trend=0.03). The association was upheld when extensive adjustments were performed.Conclusions: Our study suggests that men with high consumption of soy milk are at reduced risk of prostate cancer. Possible associations between soy bean products, isoflavones and prostate cancer risk should be further investigated.     

Is mode of breast cancer detection associated with cancer treatment in the United States?

BACKGROUND: The prognosis for women who have breast cancer detected by mammography is more favorable than that for women who have breast cancer detected by other methods, even after controlling for tumor characteristics. In the current study, the authors explored whether detection by mammography was associated with greater use of guideline-consistent breast cancer treatment among patients with recently diagnosed breast cancer in the United States. METHODS: The authors evaluated the association between mode of breast cancer detection (mammography vs other) and use of guideline-consistent treatment in 1006 women aged > or =40 years who were diagnosed in 2000. These patients were sampled from the Surveillance, Epidemiology, and End Results Program as part of the Patterns of Care studies. The analyses controlled for the potential confounders of clinical, demographic, and health system characteristics in multivariate logistic regression models. RESULTS: Breast cancer patients who were diagnosed by mammography were more likely to be aged > or =55 years, to have lower stage disease, and to be treated in larger hospitals than patients who were diagnosed by other methods (P < .05). Women whose breast cancer was diagnosed by a method other than mammography were more likely to receive guideline-consistent treatment than women who were diagnosed by mammography in unadjusted (odds ratio, 1.39; 95% confidence interval, 1.07-1.80) and multivariate analyses (odds ratio, 1.43; 95% confidence interval, 1.05-1.95). CONCLUSIONS: The current results indicated that women who had breast cancer detected by methods other than mammography were slightly more likely to receive guideline-consistent therapy than women who had breast cancer detected by mammography. Future research exploring mode of detection, guideline-consistent treatment, and survival among patients with recently diagnosed breast cancer may inform understanding of factors associated with breast cancer prognosis.     

How have patient advocates in the United States benefited cancer research?

Cancer patient advocates represent those affected by cancer and have a broad view of cancer research. They are involved in many diverse cancer research committees, where they can help tackle old problems from new perspectives that often differ from government, academic, medical and scientific approaches. In this role, patient advocates have aided the development of educational dialogue between investigators and patient communities and assisted in streamlining cancer research policies and clinical trials.     

Are rural Ohio Appalachia cancer survivors needs different than urban cancer survivors?

Introduction  

Limited information is available about rural cancer survivors’ needs and if they differ from urban cancer survivors.     

What happens now? Psychosocial care for cancer survivors after medical treatment completion

The growing population of adults living with a history of cancer in the United States mandates attention to quality of life and health in this group, as well as to the implementation of evidence-based interventions to address psychosocial and physical concerns at completion of medical treatments and beyond. The goals of this article are to document the need for attention to psychosocial domains during the re-entry and later phases of the cancer survivor trajectory, offer an overview of current evidence on efficacy of psychosocial interventions during those phases, and offer suggestions for application and research regarding post-treatment psychosocial care.     

Do breast cancer risk factors modify the association between hormone therapy and mammographic breast density? (United States)

Objective To evaluate whether the association between hormone therapy (HT) and breast density differs by levels of breast cancer risk factors. Methods We evaluated 80,867 screening mammograms from 39,296 postmenopausal women from Washington State. We estimated odds ratios and 95% confidence intervals for dense breasts (Breast Imaging Reporting and Data System categories 3 “heterogeneously dense” and 4 “extremely dense”) compared to fatty breasts (categories 1 “almost entirely fat” and 2 “scattered fibroglandular”) among HT users compared to never users. We separately examined former HT use and current HT use by type (estrogen plus progestin therapy (EPT) and estrogen-only therapy (ET)). We stratified the associations by age, BMI, race, family history, and reproductive and menopausal factors. Results Current EPT users had a 98% (1.87–2.09) greater odds of having dense breasts and current ET users had a 71% (1.56–1.87) greater odds compared to never users. Current HT users were more likely to have dense breasts if they were older, had more children, or younger at first birth compared to never users; these associations were stronger among EPT users than ET users. Conclusions HT, particularly EPT, may reduce protective effects of older age, parity, and younger age at first birth on mammographic density.     

Occupation and breast cancer in women 20–44 years of age (United States)

Objective: To examine the relation between breast cancer risk and job history among women 20–44 years of age who participated in a multi-center, population-based, case–control study. Methods: Participants consisted of women newly diagnosed with breast cancer (1642) and controls identified by random-digit dialing (1494). Details about the three longest jobs were collected and coded by an industrial hygienist. Odds ratios and 95% confidence intervals were calculated and adjusted for age, study site, and other breast cancer risk factors. Results: Several occupational and industrial categories were found to influence breast cancer risk. Stratification of the study population by parity revealed differences in breast cancer risk between the two groups for several occupational categories, including teachers, librarians or counselors (increased risk only among parous women) and natural scientists and mathematicians (decreased risk only among nulliparous women). Conclusions: This is among the first population-based case–control studies to examine occupational history and breast cancer risk in young women, with the ability to consider a wide array of potential confounders, including reproductive characteristics. This study provides further evidence of an increased breast cancer risk for several occupations and industries. Other findings were not as strongly supported by previous investigations.     

Alternative therapies for curing cancer: what do patients want? What do patients need?

Despite her scientific training and experience in medical practice, after being diagnosed with an indolent non-Hodgkin's lymphoma, the author was subjected to intense pressure about alternative therapies from well-meaning friends and relatives. While insulated at first from these forces, disease recurrences and progression increased her vulnerability to the lure of seemingly gentler approaches. A data-driven study of alternative therapeutic methods, however, convinced the author that investigational strategies offered her a better chance of cure or improvement than unproven alternative methods. She offers guidelines for physicians about what patients want, and emphasizes the importance of hope, caring, and information.     

What do early bone scans tell about breast cancer patients?

In 1978, 1012 out of a total of 1888 Danish breast cancer patients registered for a nationwide therapeutical trial were bone-scanned to find osseous metastases. A re-reading group (N.R., O.M. and S.P.N.) interpreted 842 of the scans produced in the twelve participating hospitals. Specific criteria were used for grading the scintiscans. Of the 842 scans 682 were performed within 30 days of the operation and were defined as initial. The re-reading group found 50 (7%) of these scans to be equivocal and 46 (7%) to be indicative of bone metastases at the time of operation. The number of X-ray-verified bone metastases was only 5 (0.6%). The frequency of positive bone scans correlated with the age of the patients and tumor size, but not with clinical staging at the time of operation, number of positive axillary lymph nodes or degree of tumor anaplasia. Recurrences and death rates during a 2-yr follow-up period correlated significantly with initial clinical staging. In the clinical low-risk group a positive initial bone scan worsened the prognosis, but this was not statistically significant for all patients grouped together. Although the prognostic value of the initial bone scan per se is dubious, it serves as a guidance for elective X-ray examination and as a basis for comparing subsequent scans.     

What do breast cancer patients benefit from staging bone scintigraphy?

BACKGROUND: A review and analysis of breast cancer treatment records were conducted to establish criteria for performing disease staging by bone scintigraphy in Japanese breast cancer patients. METHODS: Records from 5538 consecutive Japanese breast cancer patients from January 1988 to December 1998 were reviewed and analyzed to determine bone metastasis status at the time of initial treatment. Correlation between metastasis to bone and factors known before and after surgery was analyzed using logistic regression. RESULTS: The overall incidence of metastasis to bone was 2.13% [95% confidence interval (CI): 1.77-2.55%, 118/5538]. Multivariate logistic analysis revealed that tumor size, nodal involvement and histopathology correlated with metastasis to bone. Patients with tumors larger than 30 mm had a significantly higher probability of metastasis to bone, as did patients with lymph node evaluation results N > or = 1. The incidence of metastasis to bone was 0% in patients with stage 0 disease, 0.08% in stage I patients, 1.09% in stage II patients, 9.96% in stage III patients and 34.04% in stage IV patients. Stage II patients were sub-classified by tumor size T (small, 21-30 mm; and large, 31-50 mm), nodal involvement N and histopathology. The incidence of metastasis to bone in stage II patients was higher in patients with large tumors, scirrhous carcinoma or invasive lobular carcinoma or both. CONCLUSION: Bone metastasis correlated with tumor size (T), lymph node involvement (N) and histopathology. Using the criteria that bone scintigraphy is not necessary in populations with a < 1% incidence of bone metastasis, but is recommended at incidence > 3%, the following conclusions were drawn. Staging by bone scintigraphy provided no benefit to patients whose disease was stage I or less, stage II with small tumors or stage II with large tumors marked by low-grade histopathology (papillotubular cancer). Bone scintigraphy is recommended in patients whose disease is stage II with large tumors marked by high-grade histopathology (scirrhous or invasive lobular cancer), stage III or stage IV. Consequently, staging by bone scintigraphy could be avoided in 71% (3943/5538) of Japanese breast cancer patients.