Putting caffeine in sunscreen could provide greater protection against skin cancer new research suggests.Scientists believe the chemical found in coffee absorbs ultraviolet radiation when applied to the skin and prevents tumours after exposure to sunlight.

They found in experiments that mice were slower to develop skin cancer if they were genetically engineered to suppress a particular enzyme, as caffeine does.

Writing in the Proceedings of the National Academy of Sciences, the academics say their findings suggest that the protective effects of sunscreen could be enhanced by adding caffeine.

“Combined with the extensive epidemiologic data linking caffeine intake with decreased skin cancer development, these findings suggest the possibility that topical caffeine application could be useful in preventing UV-induced skin cancers.

“An additional appealing aspect of topical application of caffeine is that it directly absorbs UV and thus also acts as a sunscreen, potentiating the efficacy of topical UV protection.”

Commenting on the research, Prof Dot Bennett, Professor of Cell Biology at St George’s, University of London, said the team had made “interesting progress” but went on: “The authors suggest adding caffeine or related molecules to sunscreens. First one might want to check there is no adverse effect of caffeine on the incidence of other cancers, especially melanoma (pigmented skin cancer), which kills over four times as many people as squamous cell carcinoma. But caffeine lotion might promote tanning a little, since this family of molecules stimulates pigment cells to make more pigment.”

Previous research has suggested that drinking coffee could reduce risk of developing skin cancer, as caffeine appears to kill off cells that have been damaged by ultraviolet radiation from the sun before they become cancerous.

In the new experiment, researchers at Rutgers University in the US genetically engineered mice to have a reduced function of ATR, an enzyme that “rescues” damaged cells. Caffeine is known to suppress ATR, causing the damaged cells to die rather than turn cancerous, so the mice were mimicking its effect.

When the mice were exposed to UV light, the modified ones developed tumours three weeks later than unmodified ones.  After 19 weeks, the subject mice had 69 per cent fewer tumours than the unmodified ones.

From: http://www.telegraph.co.uk/Caffeine-in-sunscreen-could-protect-against-skin-cancer

Scientists have discovered how cancerous cells can grow their way out of tumours, offering clues for new drugs to prevent cancers spreading.They say they have identified a protein called JAK which helps cancerous cells generate the force needed to move.

Writing in Cancer Cell, they say the cells contract like muscle to force their way out and around the body.

Cancer Research UK said the study provided fresh understanding of ways to stop cancer spreading.

When cancers spread, a process known as metastasis, they become more difficult to treat, as secondary tumours tend to be more aggressive. It is thought that 90% of cancer-related deaths occur after metastasis.

Scientists at the Institute of Cancer Research, who investigated the chemicals involved in cell migration in melanoma – skin cancer – say cancerous cells can move in two ways.

They can “elbow” their way out of a tumour or the tumour itself can form corridors down which the cells can escape.

Lead researcher Professor Chris Marshall said both processes were being controlled by the same chemical.

“There is a common theme of using force, force generated by the same mechanism – the same molecule, called JAK,” he said.

JAK is not a new culprit in cancer. It has been linked to leukaemia, so some drugs are already being developed which target the protein.

“Our new study suggests that such drugs may also stop the spread of cancer,” Professor Marshall said.

“The test will be when we start to see whether any of these agents will stop the spread. We’re thinking of clinical trials in the next few years.”

Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: “A huge challenge in successfully treating cancer is stopping it from spreading around the body, and keeping cancer that has already spread at bay.

“Discovering how cancer cells can funnel grooves though tissues, to squeeze away from primary tumours and spread to new sites, gives scientists fresh understanding of ways to stop cancer spread – literally in its tracks.”

From: http://www.bbc.co.uk/news/health-14530143

Researchers have found a gene which increases the chance of developing ovarian cancer six fold.About one woman in 70 is at risk of developing ovarian cancer, which claims more than 4,200 lives a year.

However, for those with a faulty RAD15D gene, the risk is raised to one in 11.

The discovery was made by scientists at the Institute of Cancer Research, which is connected to The Royal Marsden hospital in London.

Professor Nazneen Rahman, head of genetics and epidemiology, said: “At this level of risk, women may wish to consider having their ovaries removed after having children, to prevent ovarian cancer occurring.”

At the moment the discovery, published in the journal Nature Genetics, is limited to the knowledge that faulty copies of this gene raise ovarian cancer risk.

But Prof Rahman said: “There is also real hope on the horizon that drugs specifically targeted to the gene will be available.”

The study was based on comparing the DNA of women from 911 families with ovarian and breast cancer, to that from 1,060 people in the general population.

Cancer Research UK, which helped fund the study, described it as “the most significant ovarian cancer gene discovery for more than a decade”.

Prof Nic Jones, the charity’s chief scientist, said: “It’s incredibly exciting to discover this high risk gene for ovarian cancer.

“It’s further evidence that a range of different high risk genes are causing the development of breast and ovarian cancer and we hope there are more waiting to be discovered in different cancers.

“We believe the results of this research will help inform personalised treatment approaches and give doctors better information about risks of cancer to tell patients.”

About 10 per cent of the 6,500 new cases of ovarian cancer every year are estimated to be in those with “a strong family history” of the disease, said Annwen Jones, chief executive of the charity Target Ovarian Cancer.

She said: “This new information, in the future, could help more women with a family history understand their personal risk of developing this disease.”

Survival rates for ovarian cancer remain poor compared to other types. While 92 per cent of breast cancer patients now survive for at least five year from diagnosis, for ovarian cancer only about four in 10 do.

From: http://www.telegraph.co.uk/Ovarian-cancer-gene-raises-risk-six-fold

Rising cancer rates mean four in 10 people in the UK get the disease at some point in their lives, a health charity says.Macmillan Cancer Support says the figure has risen significantly in the past decade.

The charity says the rise poses a “massive challenge” for the NHS.

Ministers in England say they are working to improve cancer survival rates and the quality of life after diagnosis and treatment.

Macmillan Cancer Support says a decade ago about a third of people, or 33%, developed cancer at some point in their lives. The charity says that figure has risen to more than 40%.

The estimates are drawn from projections published two years ago in the British Journal of Cancer, which concluded that at the end of 2008 there were two million cancer survivors in the UK and that the figure was rising every year.

Macmillan also looked at recent cancer incidence and mortality statistics for the UK, indicating that 310,000 people were diagnosed with cancer in 2008.

About 157,000 people died from the disease, and 89,000 who had been diagnosed with cancer died from other causes, making a total of 246,000 who died “with” cancer.

The charity says this accounted for 42% of total deaths in the UK – which stood at 580,000.

Macmillan says the increase is partly down to an ageing population – older people are more likely to develop cancer. It says lifestyle factors, such as diet and exercise, and improved diagnosis have also contributed to the rise.

The chief executive of Macmillan Cancer Support, Ciaran Devane, said the calculations had important implications for the health service.

“It is really alarming that the number of people who will get cancer is now well past one in three and that there are so many more people with cancer today than even 10 years ago,” he said.

“There are currently two million people living with cancer in the UK and that number is doubling to four million over the next 20 years. Yet no-one thinks the country can afford to double its spending on cancer. We’ve therefore got to become twice as effective in how we spend that money.”

The charity says there is growing evidence of the long-term health problems many cancer patients are experiencing long after initial diagnosis and treatment. It says there is a need for more services to help people stay well at home, rather than waiting until they require emergency hospital treatment.

The Care Services Minister for England, Paul Burstow, said it was absolutely right for Macmillan to raise this as a major issue.

“We agree with Macmillan. That’s why we are working to deliver more personalised care and more help to keep people well in their own homes. We are investing more than £750m over four years to improve cancer outcomes,” he said.

The chair of the Royal College of GPs, Dr Clare Gerada, said the figures highlighted the increasing impact of cancer on many people’s lives.

“What is clear from this study is that cancer survival is not the whole picture. All healthcare professionals have a duty to see that patients receive the best possible care, and aftercare, following a diagnosis of cancer, and to ensure their patients are not just living, but living well,” she said.

From: http://www.bbc.co.uk/news/health-14140424

Only 56% of the government’s £50 million interim Cancer Drugs Fund – or just under £27.5 million – was spent by Strategic Health Authorities (SHAs) in England during the time the Fund was available from October 2010 to March 31, 2011, new figures show.
This spending rises to just over £32.5 million (65%) if anticipated future costs are included for patients whose treatment was initiated before March 31, says leading charity the Rarer Cancers Foundation (RCF), in a new report evaluating the impact of policies to improve access to cancer treatments.

The study shows that 2,880 applications were made to the interim Cancer Drugs Fund during October 2010-March 31, 2011 (773 applications in March alone) and that, overall, 2,506 cancer patients gained access to treatment as a result of the Fund, although applications for 187 patients were denied.

It also reveals a dramatic postcode lottery with a northsouth divide in approvals, as SHAs in the south of England approved a lower number of applications than those in the north.

For example, NHS South Central approved around 75% of applications during the period whereas NHS North East approved every application it received, and while NHS South West used less than a quarter of its allocated funds, NHS Yorkshire and the Humber spent slightly more than its allocated budget.

Most SHAs have taken steps to expedite the application process for the Fund, with one – NHS East of England – removing the requirement for clinicians to submit exceptional-case applications before they can access the Fund.

Also, six out of 10 SHA operate lists of drugs which will be routinely reimbursed through the Fund. “This approach reduces bureaucracy, enables rapid decision-making and provides greater certainty to clinicians and patients,” says the RCF.

However, NHS North West’s operation of a negative list of drugs which will only be funded in exceptional circumstances breaches the spirit of the Cancer Drugs Fund policy, says the RCF, adding that, despite guidance instructing SHAs to cease using negative lists, NHS North West’s list was still operational on June 3, 2011.

The Fund could potentially benefit more than 30,000 patients, enabling them to access 34 treatments which would not have been routinely available on the NHS, and patients with bowel, kidney and blood cancers have been among the greatest beneficiaries, the report finds.

The most-requested drug – by far – has been Roche’s Avastin (bevacizumab), followed by Merck & Co’s Erbitux (cetuximab), Novartis’ Afinitor (everolimus), GlaxoSmithKline’s Tyverb (lapatinib) and Roche’s MabThera (rituximab).

Commenting on these findings, RCF chief executive Andrew Wilson said that while it was “great news” that thousands of patients have benefited from the Fund, it was concerning that 187 patients had been denied life-extending treatment “despite money going unspent and the emergence of significant regional variations in approval rates.”

The report also looks at progress with Primary Care Trust (PCT) exceptional-case processes. It estimates that 7,743 applications were submitted between April 2007 and December 2010, and suggests that the substantial increase in application rates during October-December last year reflects the fact that many SHAs required clinicians to submit exceptional-case applications to PCTs before a treatment could be considered for reimbursement from the Cancer Drugs Fund.

October-December 2010 (the period in which the interim Fund was introduced) also saw a dramatic drop in the exceptional-case approval rate.

This is likely due to more clinicians being encouraged to apply for treatments which would have stood little chance of being approved before the Fund was introduced, the Foundation suggests, although it adds that this requires further investigation.

Older people with cancer are more likely to die in England than in other leading countries because of “age bias” in the NHS according to new research.The study from the King’s Fund found that pensioners tended to be diagnosed with the disease later and were less likely to receive surgery.

Some 15,000 people over 75 in Britain die prematurely from cancer each year compared with better performing countries, according to estimates.

The report said there was “substantial evidence” that older patients were under treated on the NHS and that their chances of survival were “poorer as a result”.

It found the elderly were less likely to receive proper tests or surgery and more likely to be seen when their cancers were advanced and so beyond treatment.

The study identified “age bias” in the NHS as a factor behind this.

Catherine Foot, Senior Fellow at the King’s Fund, said: “England still has a way to go to reach cancer survival rates that are ranked with the best international performers. The evidence points to early diagnosis as being key to improving outcomes.

“We hope urgent priority is given to closing the gap in survival rates between different groups in society. We found that older people are particularly burdened by this, being more likely to have cancer, to be diagnosed later, to be under-treated and to experience worse outcomes.”

Ministers have repeatedly cited England’s relatively poor performance in cancer survival as justification for their unprecedented reform of the NHS, repeatedly claiming that 5,000 lives could be saved a year if standards were raised although some health experts have queried this figure.

The new report by the King’s Fund think-tank acknowledges that overall cancer survival rates are improving, but agrees with the Government that England’s performance is still worse than that of several other developed countries.

One important factor behind the generally lower survival rates in England is late diagnosis, the study found.

For example, the difference between England and the Nordic countries for all cancers is 10.8 per cent.

But, if patients who have been diagnosed late and have died after a year are excluded, this falls to 3.6 per cent. This suggests that late diagnosis causes a large chunk of the difference.

Chances of surviving colorectal, breast, lung and ovarian cancer are “persistently lower” in parts of Britain and Denmark than areas of Australia, Canada, Sweden and Norway, with the gap having “widened slightly” for lung cancer, according to the report.

It said there was “strong evidence” that delays in diagnosis by GP and in accessing care partly explained the difference.

In addition, some studies have suggested that patients in some parts of Britain are far less likely to likely to have surgery on tumours than others, while more people should receive radiotherapy.

Ciaran Devane, Chief Executive at Macmillan Cancer Support, said: “There is strong evidence to show that age, not their health, is the main consideration when choosing the most appropriate cancer treatment for older people. It is absolutely vital that we look at new assessment methods in order to improve survival rates and the experience of older people with cancer.”

From: http://www.telegraph.co.uk/Older-people-receive-worse-NHS-cancer-care

Women over 50 who persistently feel bloated or have lower abdominal pain should be offered a £20 blood test to check for ovarian cancer, a panel of experts has recommended.
Campaigners say hundreds of lives could be saved a year if GPs were quicker to spot symptoms of the disease – dubbed a “silent killer” because it is hard to diagnose early enough.

Ovarian cancer kills almost 4,400 women in Britain every year – one every two hours – making it the fourth most common cancer in females.

While almost three times as many die from breast cancer, those diagnosed with ovarian cancer are far more likely to die earlier.

Figures published in The Lancet show that about 82 per cent of British women with breast cancer survive to at least five years after diagnosis. For ovarian cancer the figure is just 36 per cent. The key reason for the difference is late diagnosis.

Consequently, the National Institute for Curbing Expenditure (Nice) is publishing its first guidelines to help doctors identify and manage the disease.

These include checking the level of a blood protein called CA125, if a women tells her GP she has been persistently experiencing symptoms which could be ovarian cancer.

The test, which costs around £20, is already available on the NHS but offering it sooner could give women a greater chance of survival by speeding up diagnosis and treatment.

Dr Fergus Macbeth, director of Nice’s Centre for Clinical Practice, said older women were often misdiagnosed with irritable bowel syndrome (IBS) when they actually had early stage ovarian cancer. Other possible symptoms include feeling full quickly and the need to urinate urgently or quickly.

He said: “While the symptoms are nonspecific, their persistence can be an important indicator of the disease.”

Women who experienced them 12 or more times a month should see a doctor, the guidelines say.

Although the CA125 test is a useful indicator, they cautioned that it only picked up around 50 per cent of early stage ovarian cancers. Sometimes women with tumours had no raised level of the protein, while others with raised levels sometimes did not have ovarian cancer.

Frances Reid, of the charity Target Ovarian Cancer, said: “This guidance tackles for the first time critical issues facing women who develop ovarian cancer, and could save hundreds of lives. British women must no longer die from delayed diagnosis”, she said.

From: http://www.telegraph.co.uk/GPs-should-offer-20-ovarian-cancer-blood-test

A British man has been sentenced to eight years in prison for his role in what law enforcers describe as the “most serious known breach” of the regulated UK medicines supply chain.
Following a four month trial in Croydon Crown Court, 64-year old Peter Gillespie was found guilty for working with an international network of criminals to introduce fake drugs into the UK’s legitimate supply chain during a five month period in 2007.

The case, known as Operation Singapore, centred on the importation of more than two million doses of counterfeit life saving medicines into the country.

More than half of these were captured by the Medicines and Healthcare products Regulatory Agency, but a huge amount – almost 900,000 doses – initially reached pharmacies and patients.

Despite an immediate recall of Eli Lilly’s antipsychotic Zyprexa (olanzapine), Bristol-Myers Squibb’s bloodthinner Plavix (clopidogrel) and AstraZeneca’s prostate cancer drug Casodex (bicalutamide), 700,000 doses were left unaccounted for, putting the health of many Britons in jeopardy.

Mick Deats, the MHRA’s head of enforcement, also revealed that plans to bring in three other counterfeit drugs – Pfizer/Eisai’s Alzheimer’s drug Aricept (donepezil), UCB’s antiepileptic Keppra (levetiracetam) and Johnson & Johnson’s antipsychotic Risperdal (risperidone) – had been foiled.

“They didn’t get to bring them in but they were definitely well on the way to being prepared to receive them,” he told the media, according to Reuters.

“This is serious criminal activity and puts people’s lives at risk,” Deats said, and stressed that the Agency would not hesitate “to take all appropriate action to eliminate the risks posed by counterfeit medicines and take action against those engaged in their supply”.

However, he also noted current evidence suggests that medicines supplied through the UK legitimate supply chain are genuine and safe to take.

Since 2004 there have been just 15 known instances of counterfeit medicines in the UK regulated supply chain, and given that 850 million prescriptions are dispensed every year in the UK, the likelihood of receiving a counterfeit medicine remains extremely rare, the MHRA said.

From: http://www.pharmatimes.com/Man_jailed_for_worst_ever_breach_of_medicines_supply_chain

The National Health Service could save around £200 million a year through more efficient prescribing by GPs, a report by the think tank The King’s Fund has found.
While its extensive inquiry into general practice in England praised the majority of care, it found significant variation in prescribing across the country, and that substantial savings could be made if family doctors were more efficient in prescribing certain drugs, particularly statins.

The extensive review also other widespread variations in the quality of care and performance throughout primary care.

For example, one-third of patients with stomach or oesophageal cancer who needed an urgent referral to hospital were actually given a non-urgent referral by GPs.

In fact, overall, an eight-fold variation at which practices urgently refer patients with suspected symptoms of cancer on to specialists in secondary care was found.

Continuity of care continues to be an issue, as only just over a quarter of patients are able to see the doctor of their choice in the lowest performing practices.

Crucially, there were also wide variations in admission rates for patients that could actually be treated outside hospital, which is particularly important as the effective management of patients within the community could also save the NHS hundreds of millions of pounds a year, The King’s Fund said.

On a more general note, the inquiry’s report strongly backs the position of GPs as generalists rather than specialists, but also notes that the profession must embrace the radical changes laid out in the government’s reform of the health system – particularly new commissioning powers -  in order to “maintain its international reputation for excellence”.

In addition, in order to help meet the growing challenges in healthcare, such as the ageing population and increasing demand on service, by building on the changes already taking place within the system.

It calls on GPs to accelerate the trend for multi-professional teams that work closely alongside specialists outside the practice, move away from being ‘gatekeepers’ to ‘navigators’ who essentially co-ordinate care for people with complex needs, and place a greater emphasis on prevention of ill health.

There must also be a much stronger focus on improving the quality of care, the report notes, and also calls on GPs to take responsibility for driving forward progress through a stronger commitment to transparency, particularly on performance data, peer review and benchmarking, and better data capture and use of information.

“Although general practice in this country remains the envy of the world, there is no room for complacency,” warned The King’s Fund’s chief executive Chris Ham.

“While many practices have been at the vanguard of innovation and quality improvement, too many GPs remain unaware of significant variations in performance and do not give priority to improving quality,” he noted.

NHS Confederation acting chief executive Nigel Edwards said improving primary care and GP services is one of the biggest challenges facing the NHS, and that the report “highlights the need to address the major variations in the standards of care patients are receiving”.

He calls for the introduction of a national process to compare general practice standards which, he claims, would not only empower patients to compare the standard of care, but would also help “drive down variation in diagnosis, referrals and prescriptions, all of which are central to saving lives”.

According to the British Medical Association a “culture of self-scrutiny has existed for many years but now more than ever, given the increased intensity and complexity of general practice work nowadays, GPs need time off the treadmill so they can look critically at what they do and make improvements”.

“A reduction in bureaucracy would help them to do this, as would stopping the constant reorganisations within the NHS”, it stressed.

From: http://www.pharmatimes.com/NHS_could_save_millions_of_pounds_with_better_prescribing

It is looking increasingly likely that PharmaMar’s Yondelis will not be available on the National Health Service for patients with ovarian cancer, after cost regulators again rejected the drug on questions over efficacy.
The National Institute for Curbing Expenditure (NICE) has republished draft guidance turning down the use of Yondelis (trabectedin), in combination with pegylated liposomal doxorubicin (PLDH), as a treatment for ovarian cancer that has returned six months or more after initial treatment with chemotherapy, including platinum for platinum-sensitive disease.

Ovarian cancer is the fifth most common cancer in women in the UK, with more than 6,500 patients diagnosed every year.

In around 80% of cases the cancer will return following first-line treatment, and it is estimated that just over two fifths of these could be eligible for treatment with Yondelis, a marine-based anticancer drug derived from the sea-squirt that attacks cancer cell DNA to prevent cell growth and spread.

But the Institute’s Appraisal Committee said it has serious concerns over how Yondelis’ effectiveness compares to that of other treatments available on the NHS. Crucially, PharmaMar did not submit any evidence comparing its drug to platinum-based chemotherapy regimens in treating relapsed disease, despite the latter being the gold standard therapy in such cases.

“This means that we cannot be sure that [Yondelis] extends patients’ lives for longer than the most routinely used treatments,” explained NICE chief executive Andrew Dillon.

Evidence ‘not robust’

New evidence considered did suggest that Yondelis might be most effective in women with ‘partially platinum-sensitive’ ovarian cancer, i.e. when the disease comes back between six and 12 months after initial platinum chemotherapy.

However, the Committee said it was not sure that the effectiveness of the drug in this subset of patients was “genuinely different from that seen in the wider group of patients for which the drug is licensed”, and so concluded that the data were not robust enough.

Taking all the uncertainties into account, the Committee calculated that the incremental cost-effectiveness ratio (ICER) for Yondelis could be higher than £95,000 per QALY gained for the entire eligible population, and £68,000 for the partially platinum-sensitive subgroup, despite a proposed patient access scheme under which PharmaMar offered to pick up the tag for treatment with its drug following the fifth cycle of treatment.

“Even when taking into consideration the Patient Access Scheme, through which the manufacturer limited the total cost of the drug, the committee concluded that the cost of trabectedin was too high relative to the uncertain benefits it may provide patients,” Dillon said.

Meanwhile, the Institute has announced that Sir Professor Sir Michael Rawlins has been reappointed as its chair for another year’s term, until March 31, 2012.

Professor Rawlins has held the position since NICE was created by the then Labour government in 1999 to curb the NHS’s expenditure on drugs.

From: http://www.pharmatimes.com/Another_NICE_no_for_PharmaMar_s_Yondelis