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."

Many physicians are not telling cancer patients about the cardiotoxicity risks of treatments and may not be fully aware of the dangers themselves. A new study reveals an urgent need to look after the hearts of these patients. 

"There was no mention that it could lead to heart disease. Would have been nice to know."

The growing number of cancer survivors and increasing number of over-65s needing chronic cancer therapy mean that the need for cardio-oncology services is rising. Heart failure caused by cancer therapy can occur up to 20 years after treatment. In 2012 over 32 million people worldwide were living with cancer.

"Depending on the type of chemotherapy and radiotherapy, between 1% and 25% cancer patients may develop heart failure due to cancer treatment," said study author Professor Robyn Clark, of Flinders University, Adelaide, Australia. "Risk also depends on cardiovascular risk factors such as smoking and obesity. Better monitoring of the heart and intervention before, during and after treatment can prevent or lessen the impact of this cardiotoxicity."

The researchers reviewed medical records of 46 randomly selected cancer patients with cardiotoxicity who attended one of three hospitals between 1979 and 2015. Just 11% were referred to a cardiologist before chemotherapy and less than half (48%) were referred to a heart failure clinic after cancer treatment. Almost 40% were overweight or obese, 41% were current or ex-smokers, 24% were regular consumers of alcohol, 48% had hypertension, and 26% had diabetes.
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In a subset of patients, practice was compared before (1994-2011) and after (2012-2015) the 2012 European Society for Medical Oncology guidelines were published.3 Referral to a cardiologist before chemotherapy rose from 0 to 23% and conducting a baseline echocardiogram of the heart increased from 57% to 77%.

Researchers examined if a mouth rinse to detect human papillomavirus (HPV) DNA might be associated with helping to predict risk of recurrence of head and neck squamous cell cancer and death.

This study included 396 adults with head and neck squamous cell cancer of the mouth or throat, of which 202 patients had HPV-positive cancers. The adults were tested for the presence of HPV DNA with an oral rinse at various times. After completing cancer treatment, the repeated detection of HPV DNA identical to their tumor type in oral rinses was associated with a higher risk of cancer recurrence and death. The typical follow-up time of about two years in this study may have underestimated the associations between the persistence of HPV and cancer recurrence. More research is needed but these findings suggest HPV DNA may be a promising biomarker to understand cancer treatment response and future risk of progression.

Fakhry et al. Association of oral human papillomavirus DNA persistence with cancer progression after primary treatment for oral cavity and oropharyngeal squamous cell carcinoma. JAMA Oncol. 2019. doi:10.1001/jamaoncol.2019.0439  [Abstract]

Leukemia treatments often leave girls infertile, but a procedure developed by researchers at the University of Michigan working with mice is a step toward restoring their ability to be biological mothers.
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Ovarian follicles are the "nests" that carry eggs and support them to grow and become viable. The researchers demonstrated that they could dramatically improve the rate at which follicles develop mature eggs by surrounding the follicles with adipose-derived adult stem cells in a 3D scaffold that mimics the environment of the ovary.

Adipose-derived stem cells can be obtained from readily available fat tissue in adults.
The researchers point out that utilizing this approach in women is a ways off, but it could offer hope for many.

"Once a patient is cancer-free and they want biologically related children, we hope we'll be able to take their ovarian follicles, grow them in vitro and obtain healthy eggs for these young, otherwise healthy women," said Ariella Shikanov, U-M associate professor of biomedical engineering.

The described approach increased follicle survival from less than 5 percent to between 42 percent and 86 percent depending on the size of the follicle. The research was recently published in Stem Cell Research & Therapy Journal.

"This is a huge step toward being able to preserve the fertility of women and girls undergoing chemotherapy and radiation for cancer since those treatments are toxic to the follicles," said Claire Tomaszewski, a U-M doctoral student in biomedical engineering and member of the research team.
At this time, a young female leukemia patient's hope for carrying and delivering a biologically related child is freezing ovarian tissue prior to treatment, and hoping technology can eventually make follicle growth and maturation a viable procedure.
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And historically, attempts to grow human follicles into eggs in two-dimensional petri dishes have failed.
"A follicle is a three-dimensional structure, which becomes a pancake, not the spherical structure surrounded by supportive cells, when placed on a flat surface in a dish," Shikanov said. "As a result, it loses the contact between the supportive cells and the germs cells and then it fails to grow."

Denmark has one of highest incidences of cervical cancer in the Western world. But once a person has turned 65, they are no longer automatically screened - even though older women are in fact those who have the highest mortality. This is shown by new research from Aarhus University and Aarhus University Hospital.

"Cervical cancer has become known as 'a young women's disease'. But it's a myth that it only affects young people. In fact, the mortality rate among women above the age of 65 is 25-30 per cent higher than previously thought," says medical doctor and postdoc Anne Hammer from the Department of Clinical Medicine, Aarhus University and Aarhus University Hospital.

Anne Hammer is behind the new study which has just been published in the scientific journal Acta Obstetricia et Gynecologica Scandinavia. The researchers looked at cervical cancer mortality rates in Denmark between 2002-2015 and found that the over 65s stood out here. For example, the mortality rate was five times higher among woman aged 75-79 compared to those aged 40-45.

Advanced cancer
The research results support a study from November 2018 in which Anne Hammer and her research colleagues found that older women were very often diagnosed so late that the cancer was already too big to be surgically removed. In such cases patients are instead treated with radiotherapy and chemotherapy - a treatment that is associated with side effects such as pain and urination and defecation discomfort.
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More than half of the older women with cervical cancer who had followed the screening programme on a regular basis until it expired are diagnosed with cancer that is so advanced that surgery is no longer possible.

"When people are screened, the cancer can be discovered in its initial stages or at such an early stage that surgical treatment is still possible. This significantly reduces the risk of dying," says Anne Hammer.