A London hospital’s trial of a prostate cancer drug has been stopped early because it was so successful doctors felt it would be “unethical” to deny the treatment to other patients.Medics halted tests of the life-extending drug because it would have been “unethical” not to offer the treatment to all 922 cancer sufferers taking part in the trial.

Patients who were given the drug found that it eased pain and caused only minor side effects.

The new drug accurately targets tumours using alpha radiation, which doctors conducting the study said is the most effective form of radiation to eliminate cancer because it limits damage to surrounding tissue.

Dr Chris Parker, lead researcher on the project at the Royal Marsden Hospital, said: “It’s more damaging. It takes one, two, three hits to kill a cancer cell compared with thousands of hits for beta particles.”

The drug, Radium-223 Chloride – known as Alpharadin TM – will also do less damage to surrounding tissue because it accurately targets calls, the doctors said.

Speaking at an international gathering of cancer experts, Dr Parker, a consultant clinical oncologist, said: “They have such a tiny range, a few millionths of a metre. So we can be sure that the damage is being done where it should be.”

Patients taking the drug has a 30 per cent lower rate of death compared top patients taking a placebo pill.

“It would have been unethical not to offer the active treatment to those taking placebo,” Dr. Parker said.

Radium-223 has “a completely different safety profile” to chemotherapy, he added.

The trial’s results were presented this week at the 2011 European Multidisciplinary Cancer Congress in Stockholm.

The researchers, who have pointed out the urgent need for an effective treatment for prostate cancer, will now submit their findings for approval by regulators.

Prof Gillies McKenna, Cancer Research UK’s radiotherapy expert said: “This appears to be an important study using a highly targeted form of radiation to treat prostate cancer that has spread to the bones.”

“This research looks very promising and could be an important addition to approaches available to treat secondary tumours – and should be investigated further.”

From:  http://www.telegraph.co.uk/Early-success-in-cancer-drug-trial-gives-patients-promising-future

All patients getting cancer treatment should be told to do two and a half hours of physical exercise every week, says a report by Macmillan Cancer Support.
Being advised to rest and take it easy after treatment is an outdated view the charity says.

Research shows that exercise can reduce the risk of dying from cancer and minimise the side effects of treatment.

The Department of Health says local initiatives can get people moving.

Macmillan’s report, Move More, says that of the two million cancer survivors in the UK, around 1.6 million are not physically active enough.

Adult cancer patients and cancer survivors should undertake 150 minutes of moderate intensity physical activity per week, the reports says, which is what the Department of Health guidelines recommend.

In the report, the American College of Sports Medicine also recommends that exercise is safe during and after most types of cancer treatment and says survivors should avoid inactivity.

Getting active, the report says, can help people overcome the effects of cancer and its treatments, such as fatigue and weight gain.

“The evidence review shows that physical exercise does not increase fatigue during treatment, and can in fact boost energy after treatment. It can also lower their chances of getting heart disease and osteoporosis.”

“Also, doing recommended levels of physical activity may reduce the chance of dying from the disease. It may also help reduce the risk of the cancer coming back.”

Previous research shows that exercising to the recommended levels can reduce the risk of breast cancer recurring by 40%. For prostate cancer the risk of dying from the disease is reduced by up to 30%.

Bowel cancer patients’ risk of dying from the disease can be cut by around 50% by doing around six hours of moderate physical activity a week.

Ciaran Devane, chief executive of Macmillan Cancer Support, said physical activity was very important to the survival and recovery process.
Woman jogging Keeping active after treatment for cancer is now recommended by cancer experts

“Cancer patients would be shocked if they knew just how much of a benefit physical activity could have on their recovery and long term health, in some cases reducing their chances of having to go through the gruelling ordeal of treatment all over again.

“It doesn’t need to be anything too strenuous, doing the gardening, going for a brisk walk or a swim, all count.”

Traditionally cancer patients were told to rest after their cancer treatment, but the report says this approach could put cancer patients at risk.

Jane Maher, chief medical officer of Macmillan Cancer Support and a leading clinical oncologist said: “The advice that I would have previously given to one of my patients would have been to ‘take it easy’.

“This has now changed significantly because of the recognition that if physical exercise were a drug, it would be hitting the headlines.”

Martin Ledwick, head information nurse at Cancer Research UK, was a little more cautious.

“Anything that improves wellbeing and reduces treatment side effects for cancer survivors has to be a good thing.

“But the evidence that exercise has a bearing on survival is not conclusive. It is important to remember that no two cancer patients are the same, so rehabilitation programmes that include physical activity will need to be tailored to the individual.”

From: http://www.bbc.co.uk/news/health-14417084

Drinking six or more cups of coffee a day could cut the risk of prostate cancer by 20 per cent new US research has found.Coffee has been linked to a reduced risk of dying from prostate cancer in a study of nearly 50,000 US men.

Those who drank six or more cups a day were found to be 20% less likely to develop any form of the disease – which is the most common cancer in men.

They were also 60% less likely to develop an aggressive form which can spread to other parts of the body.

But charities say the evidence, reported in the Journal of the National Cancer Institute, is still unclear. They do not recommend that men take up coffee drinking in the hope of preventing prostate cancer.

The study looked at about 48,000 men in the US who work as health professionals. Every four years between 1986 and 2006, they were asked to report their average daily intake of coffee.

During this 20-year period, 5,035 of the men were diagnosed with prostate cancer, including 642 fatal cases.

Each year about 37,000 men are diagnosed with prostate cancer in the UK. Some 10,000 die from the disease.

No difference was seen between caffeinated and decaffeinated coffee, suggesting caffeine itself was not the cause.

But even relatively small amounts of coffee – one to three cups per day – were found to lower the risk of lethal prostate cancer by 30%.

The researchers think there may be unknown compounds in coffee that protect against the disease.

Lead researcher Dr Kathryn Wilson, from the Harvard School of Public Health in Boston, said: “At present we lack an understanding of risk factors that can be changed or controlled to lower the risk of lethal prostate cancer.

“If our findings are validated, coffee could represent one modifiable factor that may lower the risk of developing the most harmful form of prostate cancer.”

Commenting on the study, Dr Helen Rippon of The Prostate Cancer Charity, said other studies had not shown the link and the research evidence was still unclear.

She added: “Although this study is a welcome addition to our knowledge, it is far from definitive and we would not recommend men who are not already habitual coffee drinkers to become so in the hope of preventing prostate cancer.

From: http://www.bbc.co.uk/news/health-13430219

Here is a cancer rates league table of the countries with the highest overall rates of cancer, for men, for women and for breast cancer in women, according to the World Cancer Research Fund.

In total there were 12.7 million new cases of cancer worldwide in 2008The latest global figures show that in 2008, there were 12.7 million cases of cancer diagnosed worldwide.

The highest rates of cancer were found in Australia/New Zealand and North America, and the lowest rate was in Africa.

The cancer rate in Australia and New Zealand was nearly three times that in Africa.

Of the total number of cases 48% are in Asia and 25% in Europe. Only 14% of cancers diagnosed worldwide are from regions with the highest rates i.e. Australia, New Zealand and North America. This apparent disparity is likely due to the large population size in Asia.

The most common cancer in men is prostate cancer except for Asia where it is lung cancer. In all regions the most common cancer in women is breast cancer.

Age standardised incidence rates for cancer (excluding non-melanoma skin cancer) in 2008

The tables show the countries with the top ten cancer rates – how many people in every 100,000 develop cancer every year – in four different categories.

Overall cancer rates
1. Denmark (rate: 326.1)
2. Ireland (317)
3. Australia (314.1)
4. New Zealand (309.2)
5. Belgium (306.8)
6. France (Metropolitan) (300.4)
7. USA (300.2)
8. Norway (299.1)
9. Canada (296.6)
10. Czech Republic (295)
[22. United Kingdom (266.9)]

Cancer in men
1. France (Metropolitan) (360.6)
2. Australia (360.5)
3. Ireland (355.9)
4. Uruguay (354.4)
5. Hungary (352.3)
6. Belgium (351.3)
7. Czech Republic (348.8)
8. Norway (338.4)
9. New Zealand (337.6)
10. USA (335)
[33. United Kingdom (280)]

Cancer in women
1. Denmark (325.3)
2. New Zealand (287.1)
3. Ireland (285.1)
4. Israel (280.4)
5. The Netherlands (276.5)
6. Belgium (275.7)
7. Canada (275)
8. Australia (274.4)
9. USA (274.4)
10. Norway (270.3)
[12. United Kingdom (260.5)]

Breast cancer (women)
1. Belgium (109.2)
2. Denmark (101.1)
3. France (Metropolitan) (99.7)
4. The Netherlands (98.5)
5. Israel (96.8)
6. Iceland (95.5)
7. Ireland (93.9)
8. Uruguay (90.7)
9. Switzerland (89.4)
10. New Zealand (89.4)
[11. United Kingdom (89.1)]

From: http://www.wcrf.org/cancer_facts/millions_new_cancer_worldwide.php and GLOBOCAN 2008 http://globocan.iarc.fr

Men with prostate cancer are five times more likely to die in some parts of the country than others, highlighting a “postcode lottery” in NHS care, campaigners claim.Experts warned that inequalities in care across the country were “getting worse”.

The disease is one of the most common forms of cancer in men. About 35,000 men are diagnosed with prostate cancer in Britain every year and about 10,000 die from the disease.

Figures show that men diagnosed with the condition in south east Cambridgeshire are almost five times less likely to die from the disease than those in Tottenham, north London.

The statistics, collated by the Prostate Cancer Charter for Action, also show that 96 of England’s 529 parliamentary constituencies have a death rate 25 per cent higher than the England average.

The figures show that in Tottenham, 57 men per 100,000 died from the disease, 131 per cent higher than the national average.

In south east Cambridgeshire the figure was 12 per 100,000.

An earlier report found that areas of the country which had failed to implement NHS guidelines on improving care had a mortality rate 4 per cent higher than those areas were the guidance had been taken up.

Dr Frank Chinegwundoh, a consultant urologist, said: “It is not enough that prostate cancer services are improving as a whole, if patients face such a lottery in the care they receive.”

“We need better services for all patients across the country, not just a lucky few.”

David Smith, of the Prostate Cancer Support Federation, said: “All men with prostate cancer should benefit from better services, yet these figures suggest that the inequalities in prostate cancer are getting worse.

“There can be no excuse for services in some areas of the country to be performing so much worse than in others.

“This situation cannot be allowed to continue.”

Mark Simmonds, the Tory shadow health minister, said: “We have been warning for some time about the inequalities in access to treatment for cancer.

“We want an NHS focused around the needs or patients and the outcomes they want to see.

“And the way funding is allocated to local NHS organisations needs to reflect the burden of disease across the country better.”

Professor Mike Richards, the NHS’s national clinical director for cancer, said: “The Department of Health recognises the importance of implementing the Improving Outcomes Guidance published by NICE and we have asked Strategic Health Authorities to submit action plans to demonstrate how they will implement this.

“Raising the public awareness of prostate cancer is one of the key challenges for the future. We want men to know what their prostate is, what it does, and what can go wrong with it and we are tackling this through the National Awareness and Early Detection Initiative.

“Also for the first time, as a result of the work of the Prostate Cancer Advisory Group, we now have a definitive set of consistent key messages for the general public about the prostate, including prostate cancer. These clear messages provide men and their families with information about the prostate that they need to be aware of and are designed in such a way as not to cause unnecessary anxiety.”

From: http://www.telegraph.co.uk/health/healthnews/5531954/Postcode-lottery-in-protate-cancer-treatment.html

Three senior NHS staff in London claim they have been suspended for whistle blowing after raising concerns about the hospitals they work in.As NHS staff they are entitled to protection under the Public Disclosure Act 1998 from dismissal or victimisation if they have concerns about misconduct and malpractice.

But the three health trusts concerned have denied suspending them for speaking out.

The trio became whistle-blowers because of fears about standards of care, they told BBC London’s Inside Out programme.

Ramon Niekrash, a surgeon at Queen Elizabeth Hospital in Woolwich, south London, said he complained to his manager because he did not believe local health services were “adequate” or “safe”.

“The concerns related to staffing levels” and the number of clinical nurse specialists for cancer, he said.

He also said a patient who had a biopsy on his prostate which was positive for cancer had to wait six months to be seen by a consultant.

Mr Niekrash subsequently won a legal battle to be reinstated but had to pay a £140,000 legal bill.

Radiologist Sharmila Chowdhury was the imaging services manager in charge of 60 staff when she was “marched off the premises” at Ealing Hospital in west London.

She claimed to have discovered what she believed were “anomalies” in her department’s budget.

“My main role was to manage the budget, day in, day out. I was concerned because I wasn’t sure I hadn’t got it wrong. When I found anomalies I did raise the issues with the line manager and senior managers.”

She said she was “stunned and humiliated” by her treatment.

Henry Fernandez, a nurse with the Kent and Medway NHS Trust, received a £70,000 settlement before a tribunal was due to take place, after he made complaints about his department.

He said he was told “to go back to my office, clear my desk and get off the premises”.

In Mr Fernandez’s case the Trust did not accept he was penalised for whistle-blowing and said that “an out-of-court settlement was discussed with Henry Fernandez for unfair dismissal but no agreement was reached”.

Inside Out has spoken to other NHS staff who said they had been suspended for highlighting concerns at work.

They said they were still being paid by their employers but had not been allowed to return to work.

A Freedom of Information (FoI) request by the programme discovered nearly 600 NHS staff in London were suspended in 2009/10.

A total of 56 of London’s 71 hospitals responded to the FoI request asking how many staff were suspended last year.

There were 514 staff, plus 84 doctors and dentists who are being were paid to stay away from work.

The cost of their wages reached a figure of £3m.

However these figures cover suspensions for reasons which include illness, “gardening leave” between jobs and those who have been suspended but claim the action taken against them was for whistle-blowing.

From: http://www.bbc.co.uk/news/uk-england-london-11578078

Cholesterol lowering drugs used to prevent heart problems can reduce the risk of bowel cancer by 12%, a study has suggested.
The beneficial effect of statins emerged from an analysis of 22 studies involving more than 2.5 million participants.

“Statin use was associated with a statistically significant reduction in colorectal cancer,” said lead research Dr Jewel Samadder, from the University of Michigan at Ann Arbor in the US.

The most common type of statins, known as lipophilic, had the greatest impact.

Statins block the production of cholesterol in the liver and help prevent the build up of hard deposits on the walls of arteries.

They are normally taken by people with diabetes, at risk of heart attacks or with abnormally high cholesterol levels.

But long-term statin use has been associated with a reduced risk of several cancers, including breast, prostate, lung, pancreas and liver – and now bowel.

“Our findings suggest that randomised controlled trials designed to test the hypothesis that statins reduce the risk of colorectal cancer are warranted,” said Dr Samadder.

The findings were presented today at the annual scientific meeting of the American College of Gastroenterology in San Antonio, Texas.

Bowel cancer is the third most common cancer in the UK, affecting around 38,600 people a year.

About 16,260 people in the UK die from the disease each year, though death rates are falling.

From: http://www.independent.co.uk/statins-cut-bowel-cancer-risk-by-12-per-cent

A single blood test for every man aged 60 could save tens of thousands of lives by pinpointing those most at risk from prostate cancer, scientists claim.

The national screening programme would rule out the risk in half of the male population and also identify those most in danger of dying from the disease, the second most deadly cancer in men.

The procedure, which costs just £10, would allow doctors to concentrate their scarce resources on those most susceptible to developing and dying from the condition.

Controversy currently surrounds the tests, which are already available, as there has been debate over when is the optimum time to administer it.

The fear is many men could be “overdiagnosed” and be so worried they will undergo unnecessary and risky surgery.

But the new report suggests that 60 is a watershed age and having one then can definitely eliminate the risk of the disease becoming life-threatening in up to 50 per cent of men, eliminating the need for them to be screened in future, experts said.

It would also help doctors predict which men may be susceptible to death from the cancer or to metastasis – where the disease spreads to other organs – and monitor their health accordingly.

Professor Mark Emberton, a leading prostate cancer expert at University College, London said the test could help get thousands of men off the “diagnostic conveyor belt”.

“It may be that PSA is actually a much better prediction of long-term outcome than we thought,” he said.

“The key question is not ‘do you have prostate cancer’ because most men are going to get it. The key thing is ‘do you have clinically important prostate cancer, cancer that will have an adverse effect on your life.

“I think this is a potential route out of the diagnostic conveyor belt from which there has been no exit before.”

The simple tests works because it highlights levels in the blood of prostate specific antigen (PSA), a protein that can leak from the prostate gland and tumour cells.

Some 90 per cent of deaths from prostate cancer occur in men with the highest levels of PSA.

Because it is generally slow to develop, taking up to 15 years to spread to other parts of the body, scientists believe that men with below-average PSA levels at the age of 60 need not worry about the threat.

Doctors would then be able to focus their attention and resources on those at risk from the disease, while patients with low PSA would not need to be exposed to potentially dangerous screening and treatment later on in life.

Prostate cancer is the most prevalent cancer among British men, affecting a third of men over the age of 50 and accounting for about 10,000 deaths every year in England and Wales.

It is second only to lung cancer in terms of loss of life.

Charities last year called for national PSA screening to be introduced in Britain after a study indicated that such a programme could save 2,000 lives a year.

But doctors disagree over how valuable the testing is because more than 65 per cent of men with high PSA do not have cancer, raising the risk of misdiagnosis.

Earlier this year it was reported that one fifth of men in at-risk age groups who asked their GP for a PSA test had their request turned down.

But the latest study raises the possibility of men with low PSA being excluded from any further prostate cancer testing such as biopsies, which can cause impotence and incontinence, at a later date.

Dr Hans Lilja, who led the study, said it “adds to the arguments” for the introduction of national screening programmes.

He added: “With screening there is a balance of benefits and harms and obviously if we can be more clever in how we sift the benefits from the harms and identify that a man at the age of 60 would not benefit substantially from any further testing then I think we are shifting that balance.”

John Anderson, Vice President of the British Association of Urological Surgeons, said the “exciting” study showed that a targeted approach to testing was preferable to a screening programme, which could see men tested at regular intervals over several years.

He said: “What we have got so far is a debate as to whether we should have screening or not. “The study does a snapshot at the age of 60 and the evidence is that that is where we need to focus our energies on.”

The research, published in the British Medical Journal, was based on research by doctors at the Memorial Sloan-Kettering Cancer Center in New York and Lund University in Malmo, Sweden.

Experts took blood samples from 1,167 men aged 60 in 1981 and followed their health up to the age of 85.

The team, led by Professor Lilja, wrote: “Our findings suggest that 60 year old men with low concentrations can be reassured that even if they do harbour cancer, it is unlikely to become apparent during their lifetime and even less likely to become life threatening.

“None the less, a raised PSA is far from being an inevitable harbinger of advanced prostate cancer … while a concentration below the median can probably ‘rule out’ subsequent death or metastasis from prostate cancer, higher concentrations indicate only that careful monitoring might be warranted.”

According to the study, the quarter of men with the highest PSA at age 60 have a 26 times greater chance of dying from prostate cancer than those in the lowest quarter.

However, having a high PSA does not make advanced prostate cancer inevitable.

Of the five per cent of men with the highest levels of PSA, only one in six will die of prostate cancer by the age of 85, the study said.

Dr Sarah Cant, Head of Policy and Campaigns at The Prostate Cancer Charity, said the study presented an “interesting proposition which takes the ongoing PSA debate in a new direction”.

She added: “However, this is an early study, involving only 1,000 men in Sweden, and long-term research in a greater number and range of men would be needed before we can say whether this approach would work.”

The UK National Screening Committee is currently reviewing its policy on PSA screening for over-50s, and is expected to publish its results next spring.

From: http://www.telegraph.co.uk/Single-prostate-cancer-test-could-save-tens-of-thousands-of-lives

Doctors’ leaders are demanding curbs on the boom in private screening clinics offering services ranging from simple blood pressure checks to full body scans costing more than £1,000.
Patients are being exploited by “irresponsible” marketing of private health screening tests, the British Medical Association and the Academy of Royal Medical Colleges say in a letter to health secretary Andrew Lansely.

Screening tests can harm in two ways. First, there’s the positive result that triggers further investigation and treatment but which turns out to be a false alarm, thus subjecting the individual to unnecessary anxiety and pain. And second, there’s the negative result that lulls the individual into a false sense of security – until the disease that has been lurking undetected strikes.

In a joint statement, Hamish Meldrum, chairman of the BMA and Professor Sir Neil Douglas, chairman of the Academy, warn that there are “significant risks” with direct-to-consumer tests. They say private companies are highlighting the benefits of screening while ignoring or playing down the risks.

“Many are unreliable and inaccurate. Patients may be falsely reassured, or undergo unnecessary and sometimes invasive follow-up tests and treatments. Unnecessary procedures may have long-term or permanent complications. These problems often create unnecessary burdens for mainstream NHS services.”

The statement does not mention specific tests but one that is widely promoted is a blood test for prostate cancer which measures the level of prostate specific antigen (PSA).

Research shows that seven in 10 men with a high reading will not have cancer. Worse, two in 100 with a low reading will have significant cancer. So a lot of men will get treatment they don’t need, and some will not get treatment they do.

For those with a high reading, the next stage is a biopsy. This is a painful procedure in which a hollow needle is inserted into the gland close to the rectum and a sample of tissue removed to be examined for the presence of malignant cells.

As the PSA level is a poor predictor of prostate cancer, there is no NHS screening programme. Men are advised to be tested only if they have symptoms, such as difficulty urinating, or a family history of the cancer.

If cancer is found, it may lead to surgery – with its risks – followed by radiotherapy and chemotherapy, which have side effects. But the cancer may not need treating. Prostate cancer is often slow-growing, and many men die with it rather than from it. For them, screening and treating the cancer brings pain and anxiety – and no health benefit.

In the case of whole body scans, sometimes marketed as the “ultimate health check” or “health MOT” for a milestone birthday at 40, 50 or 60, the promise is that it can offer more accurate checks than are usually carried out by old-fashioned family doctors.

The problem is that most scans throw up abnormalities – and if the patient is paying £1,000-plus they are unlikely to feel satisfied with a report that says simple “all’s well”. The clinic may feel under pressure to highlight any abnormalities.

But distinguishing those that are benign from those that indicate serious disease is often difficult. The risk is instead of bringing extra years of life the scans will bring years of anxiety.

In their letter Dr Meldrum and Professor Douglas call on the government to introduce tougher regulations on the marketing of private screening tests to ensure it is factual and balanced. They say clinics must include information on the risks and limitations of the tests, the implications of the results, the procedures not included in the price and the evidence of health benefit.

Dr Meldrum said: “Some private companies are taking advantage of vulnerable people by claiming the health screening they offer will detect diseases early or reduce an individual’s risk of developing specific illnesses.

“However, the NHS has safeguards in place to ensure the public can be confident the tests are supported by sound research evidence. This ensures that anyone having a test is aware of the benefits, risks and limitations involved.

“Such safeguards often do not exist in the private sector which makes it impossible for people to distinguish between private testing services that may do some good, and those that are of no value or potentially harmful.”

Professor Douglas said: “There are significant risks with direct-to-consumer tests. Many are unreliable and inaccurate. Patients may be falsely reassured, or undergo avoidable and invasive follow-up tests and treatments.

“Unnecessary procedures may have long-term or permanent complications which can place a burden on the NHS.”

From: http://www.independent.co.uk/the-1631000-body-scans-that-ought-to-come-with-a-health-warning