Chemotherapy for one type of leukaemia could be improved by giving patients a drug currently used to treat an unrelated condition, new research shows. Acute myeloid leukaemia (AML) is an aggressive cancer that stops healthy blood cell production. Chemotherapy is the standard treatment, but improvements are needed as the five-year survival rate in patients older than 60 is only 5-15 per cent.

Now, by studying how leukaemia cells infiltrate bone marrow, where blood cells are created, researchers led by a team from Imperial College London have made a crucial discovery. Studying mice and human samples, they found that certain areas in the bone marrow support blood stem cells, and when these are overtaken by leukaemia cells, these stem cells are lost and production of healthy blood is significantly reduced. This can cause anaemia, infection, and bleeding in patients, and affects the success of chemotherapy.

Crucially, the team also discovered that a drug already approved to treat a condition known as iron overload can protect these important bone marrow areas and allow blood stem cells to survive. Their results are published today in the journal Cell Stem Cell. The study's lead author, Dr Cristina Lo Celso from the Department of Life Sciences at Imperial, said: "Since the drug is already approved for human use for a different condition, we already know that it is safe. "We still need to test it in the context of leukaemia and chemotherapy, but because it is already in use we can progress to clinical trials much quicker than we could with a brand new drug."

A cancer diagnosis disrupts a person's life in many ways, including sexually. A study led by the University of Houston found that more than half of young cancer patients reported problems with sexual function, with the probability of reporting sexual dysfunction increasing over time.

The study, recently published in the American Cancer Society journal Cancer, discovered that two years after their initial cancer diagnosis, nearly 53 percent of young adults 18 to 39 years old still reported some degree of affected sexual function.

While cancer-related sexual dysfunction has been studied among adolescents and young adults with cancer, the study is the first to establish its prevalence and to identify variables that contribute to reporting sexual problems over time.

"We wanted to increase our understanding of what it's like to adjust to cancer as a young adult but also the complexity of it over time," said Chiara Acquati, lead author and assistant professor at the UH Graduate College of Social Work. "Cancer can put a patient's life on hold, especially among young adults who are just starting their careers or families."

The study also found that for women, being in a relationship increased the probability of reporting sexual problems over time; for men, the probability of reporting sexual problems increased regardless of their relationship status.

"We concluded that sexual functioning is experienced differently among males and females. For a young woman, especially, a cancer diagnosis can disrupt her body image, the intimacy with the partner and the ability to engage in sex," Acquati said.

While more than 60 percent of patients with the brain tumors called malignant gliomas enroll in hospice services, almost a quarter of them do so within a week of death, probably too late for patients and family members to benefit from hospice care. A study by research team from the Massachusetts General Hospital (MGH) Cancer Center also finds that certain groups are more likely than others to receive a week or less of hospice services.

"We know from prior research that patients with terminal illnesses, including incurable cancers, derive numerous benefits from hospice services," says Justin Jordan, MD, MPH, clinical director of the Pappas Center for Neuro-Oncology in the MGH Cancer Center, corresponding author of the report published in the journal Neuro-Oncology. "The magnitude of these benefits is notably reduced with late hospice referral. Even though timely hospice enrollment is an important measure of quality oncology care, we found that 37 percent of malignant glioma patients received no hospice at all prior to death."

Malignant gliomas include the aggressive and invariably fatal glioblastomas and other, slower growing but still incurable tumors. The average survival for glioblastoma patients is 15 months, and only 5 percent survive for as long as five years. Since no previous study has investigated either the proportion of glioma patients who enter hospice care or the length of time they receive hospice services, the MGH team analyzed information from a cancer database that included 12,437 patients with malignant gliomas who were treated and died from 2002 through 2012.

Of those patients, 7,849 were enrolled in hospice before their death, while 4,588 were not. The overall proportions of patients receiving hospice care remained fairly stable during the 10-year study period. While the average length of stay in hospice care was 21 days, 23 percent of patients enrolled less than a week before death, and 11 percent, less than three days. While race, education and household income were not associated with hospice length of stay, patients who were younger, male, and resided in rural areas were more likely to have a short hospice stay.