During spaceflight, astronauts experience similar physical stress as cancer patients undergoing treatments such as chemotherapy, immunotherapy, and targeted therapy. In a commentary published November 14 in the journal Cell, researchers suggest that by mimicking a NASA astronaut's schedule of exercising before, during, and after a mission, cancer patients could reduce the long-term impact their treatments often have on their bodies.
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"It was surprising when we looked at similarities between astronauts during spaceflight and cancer patients during treatment. Both have a decrease in muscle mass, and they have bone demineralization and changes in heart function," says senior author Jessica Scott, an exercise physiology researcher at the Memorial Sloan Kettering Cancer Center's Exercise Oncology Service. The similarities also extend to brain function: "Astronauts may get something called space fog, where they have trouble focusing or get a little forgetful. That's very similar to what some cancer patients experience, which is called chemo brain."

Despite similar symptoms, astronauts and cancer patients often receive very different advice on how to take care of their bodies. Astronauts are required to exercise prior to their mission while physicians monitor their cardiorespiratory fitness and other systems to develop a baseline level. The astronauts are then required to exercise during their mission utilizing special equipment made for working out in space. When they return to Earth, physicians continue to monitor the astronauts until their cardiorespiratory fitness and other systems return to their pre-mission baseline levels.

"That's completely backwards to how it is on Earth, where cancer patients may still be advised to rest in preparation for and during treatment and may have to ask permission to exercise from their physicians," says Scott.

But Scott and her team of researchers suggest that basic exercise such as walking on a treadmill could benefit cancer patients in the long term. Like astronauts preparing for spaceflight, cancer patients that are monitored using similar tests such as cardiorespiratory fitness could develop their own baseline levels prior to receiving treatment. Exercising during and after treatment could then potentially reduce the negative side effects of treatments such as heart problems.

With the advent of new therapies, cancer patients are surviving longer than ever before -- but the incidence of side-effect chemotherapy-induced cardiomyopathy (CHIC), or weakness of the heart muscle, is increasing. Research published in JAMA has shown that treating CHIC with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.
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"Chemotherapies are systemic toxins," said lead author Jagmeet P. Singh, MD, DPhil, associate chief of cardiology at Massachusetts General Hospital (MGH). "Patients take them to kill the cancer cells but they can also affect different organs and tissues in the body."

Anthracyclines and other drugs used to treat breast cancer and lymphomas are particularly likely to have a negative effect on the heart muscle and result in reduced heart function in approximately 9 percent of patients treated with them. Sometimes, along with the negative effect on the heart muscle, the chemotherapy may also impact the electrical system in the heart, resulting in an abnormal contraction pattern. When contractions in the heart's right and left sides aren't synchronized, said Singh, "the heart begins to progressively fail because it becomes less and less efficient."

While using cardiac resynchronization therapy is "pretty standard therapy for conventional patients with reduced heart function and abnormal electrical activation within the heart," according to Singh, to his knowledge their use in former cancer patients has never before been evaluated in a systematic way. "It's an orphaned cohort of patients. Nobody knows who they 'belong' to -- oncologists, cardiologists, internists?" Added to that, he said, CHIC is associated with decreased quality of life and poor clinical outcomes and is rarely treated aggressively. "There may be some unconscious physician bias because the prognosis isn't good to start with," he added.

Hypertension with ibrutinib more common than previously reported; this study is first to show association between cancer drug-related hypertension and other heart problems.

Over half of the people prescribed the targeted blood cancer-fighting drug ibrutinib developed new or worsened high blood pressure within six months of starting the medication, according to a new study published online today in Blood. The analysis is also the first to tie ibrutinib-related hypertension to a heightened risk of heart problems, particularly atrial fibrillation. Moreover, the association of ibrutinib with cardiovascular complications remained regardless of the prescribed dose.

“This study provides a more clear picture of the extent of hypertension development among patients taking ibrutinib, while allowing us to tease out what ibrutinib-related hypertension means in the long run for other cardiovascular events and survival,” said Daniel Addison, MD, of the Ohio State University Comprehensive Cancer Center Cancer Control Research Program, and the study’s senior author. “Overall, both the magnitude and level of hypertension that developed was higher than previously thought and appears to portend a higher risk of other cardiac events.”

In fact, after controlling for traditional risk factors, people treated with ibrutinib who developed new or worsened hypertension were more than twice as likely to develop other heart problems, including arrhythmias, compared with people who did not develop hypertension while taking the cancer drug. The good news: Addison and his team found that the initiation of blood pressure-lowering medications among ibrutinib patients with new or worsened high blood pressure was associated with a 60 percent reduction in major adverse cardiovascular events.

New estimates suggest strategies to reduce the risk of cardiovascular disease are needed for the growing population of cancer survivors. In one of the largest studies of its kind, the research team, led by the London School of Hygiene & Tropical Medicine, analysed the medical records of more than 630,000 people in the UK, including over 100,000 survivors of a range of cancers.

They found raised risks of blood clots forming in the veins among survivors of most cancers, ranging from approximately a two- to ten-fold increase in risk for different cancer sites. Risks decreased over time but were still elevated for more than five years after the cancer diagnosis. Survivors of half of the 20 cancers studied also faced increased risks of heart muscle damage, known as cardiomyopathy, and heart failure.

For example, survivors of blood, oesophagus, lung, kidney and ovarian cancers were more than one and a half times more likely to experience cardiomyopathy or heart failure than people with no prior cancer.
An increased risk of coronary artery disease and stroke was found in some cancer survivors, including those with prior blood cancers.

The researchers stress that for many people the overall risks will still be low, particularly for younger cancer survivors, but say the findings highlight the need for new strategies to prevent and manage heart and circulation problems in cancer survivors, including a need to raise awareness among GPs of the raised risks.

While the researchers could not definitively identify the causes of the increased risks, the team's analysis suggests that exposure to cancer treatments such as chemotherapy is likely to play a key role.

Lead author Helen Strongman from the London School of Hygiene & Tropical Medicine said: "Over recent decades cancer treatment and management have improved substantially, resulting in a large and growing population of long-term cancer survivors. Around half of those diagnosed with cancer in developed countries are now expected to survive for more than 10 years. However, there are concerns that there may be increased long-term risks of cardiovascular disease following cancer diagnosis, driven by treatment side-effect effects and the potential impact of the cancer itself."

While previous studies have demonstrated the short- to medium-term increased risk of cardiovascular disease from some specific cancer treatments, there have been limited data on the overall and long-term differences in cardiovascular risk between cancer survivors and those who have never had cancer.
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To address this, the team brought together anonymised data from primary care, hospitals, cancer registries, and death certificates, to quantify the absolute and relative risks of a comprehensive range of cardiovascular diseases in survivors of the 20 most common adult cancers compared with cancer-free general population controls. The research also accounted for other risk factors for cardiovascular disease, such as older age, smoking and body mass index.

Many of the deadliest or most common cancers get the least amount of nonprofit research funding, according to a new Northwestern Medicine study that examined the distribution of nonprofit research funding in 2015 across cancer types.

Colon, endometrial, liver and bile duct, cervical, ovarian, pancreatic and lung cancers were all poorly funded compared to how common they are and how many deaths they cause, the study found. In contrast, breast cancer, leukemia, lymphoma and pediatric cancers were all well-funded, respective to their impact on society.

The study is the first to compare nonprofit funding distribution in the United States across cancer types. It will be published  in the Journal of the National Comprehensive Cancer Network.

"The goal of this study is not to divert funds away from cancers that are well-supported, but rather expand funding for other cancers that aren't getting enough support currently," said corresponding author Dr. Suneel Kamath, who was the chief fellow in the department of hematology and oncology at Northwestern University Feinberg School of Medicine when he conducted the study. "These are all deadly and life-altering diseases that deserve our attention and support."

Cancer-related nonprofit organizations play an important role in funding medical research, supporting the education of patients and their families and influencing health policy. Underfunding of these common cancers could negatively impact research, drug development and the number of FDA drug approvals for poorly funded cancers.
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"Well-funded patient advocacy organizations should be applauded for their successes," said co-author Dr. Sheetal Kircher, assistant professor of hematology and oncology at Feinberg and a Northwestern Medicine oncologist. "We hope to bring awareness to the organizations with less relative funding so we can collaborate to improve funding and outcomes for all patients with cancer."

Researchers at the University of Sussex have identified how differences in the genetic sequence of the two main strains of the cancer-associated Epstein-Barr virus (EBV) can alter the way the virus behaves when it infects white blood cells.

When EBV enters white blood cells it drives them to grow rapidly and continuously, making them 'immortal'. In some cases this can lead to the development of lymphoma, a type of blood cancer.
There are two main strains of the virus worldwide and although they can both cause cancer, in the laboratory, one strain (type 1) is able to drive white blood cells to become immortal better than the other (type 2).
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While scientists already knew that the different properties of the two strains were caused by a protein called EBNA2, which is produced by EBV, until now they didn't know how it could cause the viruses to act so differently.

A combination of chemotherapy drugs during brain cancer surgery using a biodegradable paste, leads to long-term survival, researchers at the University of Nottingham have discovered.

In a new study published in Clinical Cancer Research, scientists found a significant survival benefit in rat models with brain tumours when a combination of two chemotherapy drugs, (etoposide and temozolomide), were delivered using a biodegradable polymer called PLGA/PEG.

The research was carried out by experts from the Children's Brain Tumour Research Centre (CBTRC) at the University of Nottingham, in partnership with researchers from Johns Hopkins University in the USA.
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Glioblastoma multiforme (GBM) is the most aggressive and common brain tumour with a dismal average survival of 15 months from diagnosis, killing 3500 UK people annually. This is despite treatment comprising surgery, radiotherapy and chemotherapy.
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The polymer formulation, which was originally designed to help mend broken bones, is made from two types of micro-particles called PLGA and PEG and has been developed and patented by leading tissue engineer Professor Kevin Shakesheff, based in the University's School of Pharmacy. A powder at room temperature, it can be mixed to a toothpaste-like consistency with the addition of water.

The paste can be applied to the brain cancer cavity created after removal of the bulk tumour during surgery. The paste then releases chemotherapy drugs into the brain, in so doing targeting the remaining cancer cells which cannot be safely removed by surgery and which cause the cancer to return.

More than 5 million cancer survivors in the United States experience chronic pain, almost twice the rate in the general population, according to a study published by Mount Sinai researchers in JAMA Oncology.

Researchers used the National Health Interview Survey, a large national representative dataset from the U.S. Centers for Disease Control and Prevention, to estimate the prevalence of chronic pain among cancer survivors. They found that about 35 percent of cancer survivors have chronic pain, representing 5.39 million patients in the United States.

"This study provided the first comprehensive estimate of chronic pain prevalence among cancer survivors," said corresponding author Changchuan Jiang, MD, MPH, a medical resident at Mount Sinai St. Luke's and Mount Sinai West. "These results highlight the important unmet needs of pain management in the large, and growing cancer survivorship community."

The researchers, including Susmita Bose, Herman and Brita Lindholm Endowed Chair Professor in the School of Mechanical and Materials Engineering, and graduate student Naboneeta Sarkar, report on their work in the journal, ACS Applied Materials and Interfaces.

Young patients with bone cancer are often treated with high doses of chemotherapy before and after surgery, many of which have harmful side effects. Researchers would like to develop gentler treatment options, especially after surgery when patients are trying to recover from bone damage at the same time that they are taking harsh drugs to suppress tumor growth.

Turmeric has been used in cooking and as medicine for centuries in Asian countries, and its active ingredient, curcumin has been shown to have anti-oxidant, anti-inflammatory and bone-building capabilities. It has also been shown to prevent various forms of cancers.

"I want people to know the beneficial effects of these natural compounds," said Bose. "Natural biomolecules derived from these plant-based products are inexpensive and a safer alternative to synthetic drugs."