Long-term cancer survival rates improve among U.S. teens, young adults

Group of young people Adolescent Young Adult Cancer week(Reuters Health) – Cancer survivors diagnosed as teens or young adults (AYA) are living longer now than young people diagnosed decades ago, largely because of advances in treatment, a U.S. study suggests.

Overall, among people diagnosed between ages 15 and 39, deaths from all causes from five through 10 years after diagnosis dropped to 5.4% among those diagnosed with cancer in 2005-2011, from 8.3% among young people diagnosed in 1975-1984.

The patterns were similar for survival up to 15 years after diagnosis, researchers report in the Journal of the National Cancer Institute.

“As more and more patients are surviving beyond that five-year timepoint, and because adolescents and young adults have many potential years of life remaining after cancer, they are an important population in which to study long-term outcomes,” said study coauthor Chelsea Anderson, a postdoctoral fellow at the American Cancer Society at Atlanta.

Anderson’s team analyzed data from a U.S. population-based cancer registry, focusing on 282,969 people diagnosed with cancer at ages 15 to 39 between 1975 and 2011, who survived at least five years after diagnosis.

The authors followed patients from five years after cancer diagnosis until death or the end of 2016.

Most survivors in the sample were white women, 30 to 39 years old when diagnosed with cancer. The most common cancer was breast cancer, for which mortality rates dropped from 15.9% of patients diagnosed in 1975-1984 to 10.1% in 2005-2011.

The most significant drops in death rates between the earliest and most recent diagnosis periods was seen in patients with leukemia (28.6% to 6.6%), non-Hodgkin lymphoma (13.0% to 3.6%), central nervous system tumors (25.0% to 17.2%) and kidney cancer (10.7% to 4.4%).

This was driven mainly by fewer deaths caused by the primary cancer between these periods – down to 4.2% from 6.8%.

Not all cancers have seen the same level of improvement, however. There was little improvement in mortality over the same period for patients with colorectal, bone, cervical/uterine, bladder cancers and sarcomas.

The cancers that showed little improvement were ones that typically affected adults, said Dr. Kara Kelly, chief of Roswell Park Oishei Children’s Cancer and Blood Disorders program and professor of pediatrics at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences in New York.

“This may, in part, be related to how there aren’t as many clinical trials for these cancers,” Kelly, who was not involved in the study, told Reuters Health by phone.

“The greatest improvements were seen in patients with cancers that are also more prevalent in children – and these improvements in childhood cancer have resulted from clinical trials,” she said.

While the study affirms improvements in preventing deaths from primary cancers, Kelly said it didn’t provide details about how other races and ethnicities fared.

The data set the researchers used also doesn’t detail types of treatments or how well patients were managed if they relapsed, she said.

As young adult patients are transitioning to independence and many are uninsured or under-insured, it is critical to understand the access they have to treatment, Kelly said.

Kelly also pointed out the need for less toxic treatments to reduce mortality rates.

Overall, the findings demonstrate the progress made over the past few decades in improving outcomes among long-term survivors of adolescent and young adult cancers, Anderson said by email.

“Some cancer types have not shared in these improvements, and these survivors may be priority groups for efforts to improve long-term surveillance and reduce late mortality from cancer among adolescents and young adults,” she said.

SOURCE: bit.ly/2wQGcsR Journal of the National Cancer Institute, online March 3, 2020.

Coronavirus: What People with Cancer Should Know

A chart from the CDC detailing precautions to take to help avoid contracting Covid-19.What is coronavirus, or COVID-19?

Coronaviruses are a large family of viruses that are common in people and many different species of animals. CDC is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus that was first detected in China and has now been detected in the United States and many other countries. The virus has been named SARS-CoV-2, and the disease it causes has been named coronavirus disease 2019, which is abbreviated COVID-19.

This is a rapidly evolving situation and the risk assessment will be updated as needed.

If I have cancer, am I at higher risk of getting or dying from COVID-19?

Some types of cancer and treatments such as chemotherapy can weaken your immune system and may increase your risk of any infection, including with SARS-CoV-2, the virus that causes COVID-19. During chemotherapy, there will be times in your treatment cycle when you are at increased risk of infection.Adults and children with serious chronic health conditions, including cancer, are at higher risk of developing more serious complications from contagious illnesses such as COVID-19.

If I have cancer, how can I protect myself?

There is currently no vaccine to prevent COVID-19 or specific treatment for it. The best way to prevent illness is to avoid being exposed to the virus. Precautions for avoiding COVID-19 are the same as for other contagious respiratory illnesses, such as influenza (flu).

The US Centers for Disease Control and Prevention (CDC) recommends everyday preventive measures to help prevent the spread of respiratory infections, including:

  • Avoid large social gatherings and close contact with people who are sick
  • Avoid unnecessary person-to-person contact, such as handshakes
  • Avoid touching your eyes, nose, and mouth
  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; after blowing your nose, coughing, or sneezing; and before and after coming in contact with others
  • Get a flu vaccine

CDC recommends additional actions to help keep people at high risk for developing serious complications from COVID-19 healthy in the event of a COVID-19 outbreak in your community, including:

  • Stay home as much as possible
  • Make sure you have access to several weeks of medication and supplies in case you need to stay home for prolonged periods of time
  • When you do go out in public, avoid crowds
  • Avoid cruise ship travel and nonessential air travel

NCI provides tips and resources for the cancer community to prepare for any emergency.

I receive cancer treatment at a medical facility. What should I do about getting treatment?

Call your health care provider and follow their guidance.

I participate in a clinical trial at a medical facility. What should I do?

Call your clinical trial research team and follow their guidance.

What should I do if I have symptoms of an infection?

Call your health care provider if you think you have been exposed to COVID-19 and have symptoms of an infection.

Related Resources:

Multiple Myeloma Clinical Trial Benefits

Multiple Myeloma is a type of blood cancer that starts in white blood cells called plasma cells, which help your body fight infections. Mutations occur when the genetic material in plasma cells changes, causing plasma cells to become problematic myeloma cells. As myeloma cells multiply, they crowd out normal blood cells inside bone marrow, and that’s when symptoms can appear.

In this video from the National Institutes of Health (NIH), Pamela shares her reasons for choosing to participate in a clinical trial to help treat her stage 3B multiple myeloma.  Find more information about clinical trials in your community here.

Sources: www.nih.gov, www.multiplemyelomaandyou.com

Sanford’s Cook is the First to Undergo Procedure to “Zap” Lung Cancer

From FirstHealth.org
Nov 20, 2019

Pinehurst patient first in NC to undergo clinical trial for lung cancer.

Terri Cook of Pinehurst, NC

PINEHURST—A routine physical in 2015 revealed lung cancer in non-smoker Terri Cook. A surgeon removed her upper right lobe and scans every six months for two years revealed no more cancer. Then in November 2017, the only time she went to a scan without her husband, the doctor reported “one, maybe two” concerning lesions on her lower right lobe. Cook held it together in front of her physician, but that brave face didn’t last when she told her husband.

Since Cook had a previous lobectomy, a second surgery was not an ideal situation, so her doctor offered two options: radiation or microwave ablation, the latter offered through a clinical trial to determine efficacy of a new type of lung cancer treatment. “When I heard ‘clinical trial’ I immediately thought ‘guinea pig,’” she said.

Her physician explained that colleague Michael Pritchett, D.O, MPH, pulmonary specialist at Pinehurst Medical Clinic and director of the Chest Center of the Carolinas, had just returned from the United Kingdom where he assisted with a bronchoscopy with microwave ablation, a procedure in which a flexible probe is inserted through the mouth, routed directly to the cancerous lesion and “zapped” with microwave energy. Dr. Pritchett had been selected as one of the few providers in the United States to offer this procedure through a clinical trial.

“My physician and I had developed a good rapport over the years, and he said if it were his wife, he would recommend the clinical trial,” said Cook. She and her husband acted on his recommendation and Dr. Pritchett performed the procedure on June 29, 2018.

Cook made national history that day in June, explaining, “I was the very first person in the United States to receive this procedure. Everyone was so excited and there were lots of people in the room watching.” She reported minimal discomfort after the procedure and after an overnight stay in the hospital, she recovered quickly at home.

The second of the concerning lesions initially reported also turned out to be cancerous, so Dr. Pritchett made a special request for Cook to be not only the first American to receive the procedure, but also the ninth. He was granted the second procedure for her and completed it on March 15, 2019. The United States received 20 slots for the clinical trial, and Cook was a good candidate to have it twice. The Mayo Clinic is the only other site for this trial.

“I feel wonderful now!” said the 64-year-old grandmother of two with a third on the way. “I can breathe!”

Cook is now almost a year and half out from her initial ablation, and the follow-up CT scans show no evidence of cancer.

Cook reported that everyone she worked with, including Dr. Pritchett and the entire staff at Reid Heart Center, was wonderful. “I felt truly cared for,” she said.

A substitute teacher from Sanford, Cook reflected on her participation in this clinical trial and reported, “I think it’s amazing what can be done now — and right in Pinehurst! Every time I teach in Pittsboro, my colleagues assume my medical care was in Chapel Hill. When I told them Pinehurst, they said, ‘really?’ and I replied, “Yes, really!”

 

Patients and their families seeking more information about clinical trials at FirstHealth of the Carolinas can visit https://www.firsthealth.org/reference/clinical-trials or talk with the patient’s physician.  Find cancer clinical trials in your community by visiting https://southeastclinicaloncology.org/clinical-trials/

 

Act Seeks to Expand Clinical Trial Access to Patients on Medicaid

From www.curetoday.com
By Brielle Benson, Feb 20, 2020

ASCO representatives visit Capitol HillClinical trial routine care costs (including X-Rays, lab work, doctor visits and more) are not covered for people who are insured by Medicaid, leading to certain groups being underrepresented in clinical trials. However, the Clinical Treatment Act (H.R. 913) is trying to change that.

“The Treatment Act is really about ensuring accessibility for Medicaid patients for participation,” Dr. Melissa Dillmon, the Chair of the Association for Clinical Oncology’s (ASCO) Government Relations Committee said.

ASCO is one of more than 100 organizations that urged Congress this week to include the act in the upcoming “must pass” health care extenders package that is expected to be passed on May 22, 2020.

The Clinical Treatment Act would ensure that all patients on Medicaid have coverage of routine procedures and checkups associated with clinical trials. This could potentially boost the participation of minorities, who tend to be overrepresented in the Medicaid population, but underrepresented in clinical trials.

“It’s important when we look at clinical trials – especially in cancer – that we have racial and socioeconomic diversity so that it can be used in the real-world setting,” Dillmon said.

Representative Ben Ray Luján (D-NM) and Representative Gus Bilirakis (R-FL) introduced the act, which currently has 28 cosponsors representing both parties. Additionally, organizations such as the American Medical Association and the American Cancer Society Cancer Action Network have also voiced their support for the bill.

While some may be apprehensive to support H.R. 913 because they think it could increase costs, Dillmon said that is not true.

“One of the concerns is the financial part, and I hope we’re able to dispel that myth,” Dillmon added, noting that some states in the U.S. already have Medicaid coverage for clinical trial care costs, and there have been no reported increased costs there. And since the pharmaceutical company usually pays for the drug being tested, costs could even go down.

“Logically, one may think costs of care may go down. If the patient is on a clinical trial, there is no bill to Medicaid for the drug, and that’s often one of the most expensive parts of treatment,” Dillmon said.

Clinical trials are crucial to moving the field of cancer – and other serious illnesses – forward. The more patient populations they can include, the better outcomes can be for more Americans.

“Oncology has seen unprecedented successes right now in our treatment for cancer. We’ve had the single biggest improvement in the reduction in mortality. Our goal as physicians is to continue that fight and have even more survivors,” Dillmon concluded.