Analysis of one week's worth of tweets about breast cancer paints mixed picture of the network's use by individuals and institutions.

Twitter is a place where many cancer patients go to share and discuss their experiences of the disease. This is the main finding of a recent exploratory study, to be presented at the ESMO 2018 Congress in Munich, which analysed the contents of over 6,000 tweets and retweets about breast cancer.

Social media today have become an echo chamber in which every societal issue is reverberated many times over - including cancer. Study author Dr. Rodrigo Sanchez-Bayona of Clinica Universidad de Navarra in Pamplona, Spain, said: "Many of the patients we see in daily practice use social media to search for information about their disease, so, as care providers, we wanted to know what kind of content they find there. At the same time, the sheer volume of posts on Twitter represents a rich pool of data we can use to assess attitudes and discourses surrounding cancer."

For this analysis, all tweets posted with the hashtag #BreastCancer over a seven-day period were collected and categorised according to their content, aim, user information and whether they displayed a stigmatising attitude towards breast cancer. The tweets were also grouped into four subthemes: diagnosis, treatment, prognosis and prevention. "This study was part of a larger, multidisciplinary project to observe the presence of different diseases on social media. In 2014, we found that cancer was the most mentioned pathology on Twitter globally. We decided to look more closely at breast cancer first, because it is one of the three most common tumours worldwide and the primary cause of cancer deaths in women."

The data collected included 3,703 original tweets and 2,638 retweets. "When examining the original tweets, we found that only one in three had medical content," said Sanchez-Bayona. "However, 90% of this medical information was appropriate, which is likely owed to the fact that 40% of tweets came from institutions and public accounts." The categorisation of tweets by aim showed that the most frequent motive was patients sharing their experiences, followed closely by patient advocacy. The most common subtheme by far was prevention (44.5% of tweets).

A recent achievement in the field of protein research allows for better tailored pharmaceuticals with fewer side effects; the method was developed by two University of Copenhagen researchers.

Protein research is one of the hottest areas in medical research because proteins make it possible to develop far more effective pharmaceuticals for the treatment of diabetes, cancer and other illnesses.

However, while proteins have great potential, they also present great challenges for scientists. Proteins have incredibly complex chemical structures that make them difficult to modify. As a result, researchers have been looking for a tool to modify them more precisely, without increasing a drug's side-effects.

"We often run the risk of not being approved by health authorities because protein-based drugs lack precision and may have side-effects. Among other things, this is because of the serious limitations with the tools that have been used up until now," according to Professor Knud J. Jensen of the University of Copenhagen's Department of Chemistry.
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Together with his research colleague, Sanne Schoffelen, he has developed a new protein-modifying method that promises fewer side-effects and could be pivotal in furthering the development of protein-based pharmaceuticals. Their work has been published in the distinguished journal, Nature Communications.

The world’s first clinical trial (SURGUVANT) evaluating anti-inflammatory use at the time of surgery in colon cancer patients to improve their cancer outcome has been published in the scientific journal, BMC Cancer.

The research successfully tested an anti-inflammatory agent with anti-cancer properties known as ‘Taurolidine’ in the SURGUVANT trial which was funded by a grant from Geistlich Pharma AG, Wolhusen, Switzerland.  The research was undertaken by researchers at RCSI in Dublin in collaboration with the Cork University Hospital group, University College Cork, Mercy University Hospital and the Bon Secours Hospital, Cork led by Professor Paul Redmond, RCSI Council member and Chair of Surgery at Cork University Hospital and Mr Peter O’Leary, CUH Department of Surgery. 

The Surguvant trial examined a link between surgical inflammation and the recurrence of cancer. The trial randomised patients undergoing surgery for colon cancer to either a placebo or 2% Taurolidine solution. The trial reported that important components of the inflammatory response to surgery that have been shown to propagate tumour cell growth, can be attenuated successfully without compromising patient safety. 
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“We are delighted that this important clinical trial could be performed in Ireland. The Surguvant trial is the first of its kind to be performed worldwide showing that it is safe to use Taurolidine in this critical period of time for cancer patients where they are exposed to an inflammatory response necessary for wound healing but which can be potentially detrimental to their cancer outcome,” said Professor Redmond. “Now that we have proven the safety of this treatment strategy, it remains to be demonstrated if targeting the inflammatory response to surgery will lead to improved outcomes for cancer patients. We hope to do this in much larger future trials.” 

Redmond et al. RandomiSed clinical trial assessing Use of an anti-inflammatoRy aGent in attenUating peri-operatiVe inflAmmatioN in non-meTastatic colon cancer – the S.U.R.G.U.V.A.N.T. trial. BMC Cancer2018;18:794 https://doi.org/10.1186/s12885-018-4641-x [Article]

Stephanie Linder and colleagues at Sleep Help are devoted to increasing sleep health awareness and wellness. They  have  been working on a useful resource all about how patients in cancer treatment and remission can deal with the sleep-disrupting side effects of chemotherapy, steroids, and other treatments.

It can be found here:

https://www.sleephelp.org/cancer-sleep/

Biological markers responsible for extreme exhaustion in patients with cancer have now been linked to fatigue in those with Parkinson's disease, according to new research from Rice University.
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"Inflammation and fatigue in early, untreated Parkinson's disease" will appear in an upcoming edition of Acta NeurologicaScandinavica. It is one of the first studies to link the biomarkers responsible for fatigue in patients with cancer and patients with Parkinson's.

The researchers examined blood samples from 47 patients with Parkinson's disease, half of whom experienced high levels of fatigue, which is characterized by feeling severely tired and unable to engage in usual activities and is disruptive to one's work and social life and daily routines.

Chris Fagundes, an assistant professor of psychology at Rice and one of the study's lead authors, said that although Parkinson's disease is not fatal, patients often complain that fatigue is one of the most common and disabling side effects and a contributor to reduced quality of life.

"The No. 1 complaint among Parkinson's disease sufferers is chronic fatigue," Fagundes said.

The researchers found that individuals with Parkinson's disease who suffered from fatigue had elevated levels of the interleukin-1 receptor antagonist (IL-1RA) and vascular cell adhesion molecule 1 (VCAM-1) inflammatory biomarkers. Interestingly, elevated levels of inflammatory markers such as these are also linked to fatigue in patients with cancer.
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This is the one of the first times these biomarkers has been linked to fatigue in patients with Parkinson's, Fagundes said. His previous research has focused on the link between specific biomarkers and cancer-related fatigue, and he said this study was a great opportunity to take work from one area and help a separate population.

Of 509,179 patients studied, 16% received preoperative oral care from a dentist. When a surgeon requested that a dentist provide preoperative oral care to a patient with cancer, the dentist checked the patient's oral condition, provided professional tooth cleaning, taught the patient self-cleaning methods for the teeth, and provided any treatment needed.

In the study, 15,724 patients (3.09%) developed postoperative pneumonia and 1734 (0.34%) died within 30 days of surgery. After adjustments, preoperative oral care by a dentist was linked with a decrease in postoperative pneumonia (3.28% versus 3.76%) and death within 30 days (0.30% versus 0.42%).
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"The findings could help improve strategies for the prevention of postoperative complications," the authors wrote.
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Ishimaru et al. Preoperative oral care and effect on postoperative complications after major cancer surgery. Br J Surg. 2018; doi:10.1002/bjs.10915 [Article]

A review of more than 200 studies reveals that olfactory receptors--proteins that bind to odors that aid the sense of smell--perform a wide range of mostly unknown functions outside the nose. The function of extra-nasal olfactory receptors has the potential to be used in the diagnosis and treatment of health conditions such as cancer. The article is published in the July issue of Physiological Reviews.

Olfactory, or smell, receptors were originally thought to be only in the sensory nerve cells (neurons) of nasal cavity tissues. However, more recent and extensive study suggests that the receptors "occur in nearly the entire human body, [and] they appear to be substantially more functionally important than previously suggested," researchers from Ruhr-University Bochum in Germany wrote. In addition to the receptors playing a major role in the sense of smell, "several essential physiological and pathophysiological processes have been described as targeted by human [olfactory receptors], including path finding, cell growth, [cell death], migration and secretion."

The research team summarized the location and purpose of certain types of olfactory receptors, including those that may be beneficial to general health:

• Receptors present in heart muscle cells may be a metabolic regulator of heart function.
• Receptors activated in the immune system have been seen to promote the death of certain types of leukemia cells.
• Smell receptors in the liver reduce the spread of liver cancer cells.
• Receptors in the skin increase the regeneration of skin cells and help speed wound healing.

Many cancer patients suffer from a loss of body mass known as cachexia. Approximately 20 percent of cancer related deaths are attributed to the syndrome of cachexia, which in cancer patients is often characterized by a rapid or severe loss of fat and skeletal muscle. Dr. Melinda Sheffield-Moore, professor and head of the Department of Health and Kinesiology, along with researchers at University of Texas Medical Branch, recently published research in the Journal of Cachexia, Sarcopenia and Muscle showing that the hormone testosterone is effective at combatting cachexia in cancer patients and improving quality of life.

These findings are important, as there are currently no established therapies targeting this loss of skeletal muscle, and without an intervention, patients lose muscle function and become fatigued and weakened.
"We hoped to demonstrate these patients would go from not feeling well enough to even get out of bed to at least being able to have some basic quality of life that allows them to take care of themselves and receive therapy," Dr. Sheffield-Moore said.

Dr. Sheffield-Moore said doctors sought her expertise in nutrition and metabolism when patients were losing tremendous amounts of weight from cancer cachexia. She said that previous nutrition-focused treatment failed to combat this severe loss of body mass, which led her team to investigate the hormone testosterone as an option to combat the often debilitating consequences of cancer cachexia.
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"We already know that testosterone builds skeletal muscle in healthy individuals, so we tried using it in a population at a high risk of muscle loss, so these patients could maintain their strength and performance status to be able to receive standard cancer therapies." Dr. Sheffield-Moore said.

Giving radiation therapy to the lymph nodes located behind the breast bone and above the collar bone to patients with early stage breast cancer improves overall survival without increasing side effects, and this effect continues for 15 years, researchers have found. Professor Philip Poortmans, head of the department of radiation oncology at the Institut Curie, Paris, France, will tell participants at the annual American Society for Clinical Oncology (ASCO) congress that these findings settle once and for all the question as to whether radiation therapy is beneficial for these patients.

Results from the international randomised trial, carried out by the European Organisation for the Research and Treatment of Cancer (EORTC) and which involved 4004 patients with stage I to III breast cancer from 43 centres, are convincing, he says. "Our results make it clear that irradiating these lymph nodes gives a better patient outcome than giving radiation therapy to the breast/thoracic wall alone. Not only have we shown that such treatment has a beneficial effect on disease control, but it also improves breast-cancer related survival," he will tell the meeting.

Lymphatic drainage from breast cancer to the regional lymph nodes means that the cancer is more likely to spread to other parts of the body. This drainage follows two pathways. The best known is to the axilla (armpit), and these lymph nodes are usually treated by surgery and/or radiation therapy. The second pathway drains to the internal mammary (IM) lymph nodes behind the breast bone, and probably from there to those just above the collar bone, the medial supraclavicular (MS) nodes. Because of uncertainty about the effects of treatment in this area, and particularly concerns about the increased toxicity that might be caused by the irradiation of a larger area, until recently only about half of radiation oncology centres treated the IM-MS lymph nodes.
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After a median follow-up of 15.7 years, the researchers found a significant reduction in deaths from breast cancer (16.0% in the treatment group vs. 19.8% in the control group), and in the return of breast cancer in patients who had received radiation to the IM-MS nodes (24.5% vs. 27.1%). A total of 1117 patients had died during the time. Overall survival was 73.2% in the IM-MS group and 70.8% in the control group. There was no increase in non-breast cancer related mortality in the first group and to date there has been no increased level of serious complications related to the treatment. There was no difference in the incidence of second cancers, cancer in the other breast, or deaths from cardiovascular disease between the two groups.

Wearable fitness trackers, such as the popular Fitbit, have the potential to help doctors predict which patients will do well on a course of chemotherapy, and be able to intervene before unexpected admissions to the hospital, experts believe.

Researchers said that in the future doctors might be able to use the technology in a number of ways, such as to predict which patients would not perform well in clinical trials. The study was presented at the American Society of Clinical Oncologists conference in Chicago.

“What we’ve learned is that we can get an objective metric of patient performance with the use of these modern technological tools,” stated Jorge Nieva, one of many authors of the analysis from the University of Southern California. He stated the expertise may in impact plug sufferers into the “internet of things”, referring to house items or gadgets which have a web-based connection.

“We’ve all got our home sprinkler systems and our thermostats, all connected to the internet – there’s no reason that our patients shouldn’t also be connected to the internet and have the potential to have monitoring and smart interventions, based on their performance and functioning,” Nieva stated.

Cancer researchers specifically have gravitated towards health trackers as a approach to objectively measure sufferers’ high quality of life. As of December 2015, almost 300 medical trials integrated health trackers to gather private knowledge, in keeping with Bloomberg.