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.

Alterations in four main genes are responsible for how long patients survive with pancreatic cancer, according to a new study in JAMA Oncology. Before now, the presence and patterns between the genes and disease progression was not clearly established. One key difference in this study is the relatively large size: it involved 356 patients who all had pancreatic adenocarcinoma that could be surgically removed.

Adenocarcinoma is by far the most common type of pancreas  tumor. Ninety of the patients were treated at the University of Rochester Medical Center's Wilmot Cancer Institute; the others at Dana Farber/Brigham and Women's Cancer Center in Boston and Stanford Cancer Institute. In all cases after the tumors were removed, scientists extracted DNA from the cancerous tissue and nearby normal tissue, and conducted next-generation DNA sequencing on the specimens.
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The analysis centered on the activity of the KRAS, CDKN2A, SMAD4, and TP53 genes. Results showed that patients who had three or four of the altered genes had worse disease-free survival (the time between surgery and when the cancer returns), and overall survival (from surgery to death), compared to patients with a single or two altered genes. A more detailed breakdown of survival and specific gene activity is available in the full study.

Cancer cells rely on the healthy cells that surround them for sustenance. Tumors reroute blood vessels to nourish themselves, secrete chemicals that scramble immune responses, and, according to recent studies, even recruit and manipulate neurons for their own gain. This pattern holds true not just for brain cancers, but also for prostate cancer, skin cancer, pancreatic cancer, and stomach cancer. Stanford neuroscientists review how tumors exploit neuronal signals in Trends in Cancer.

"There is no part of the body that isn't well innervated," says Michelle Monje of the Stanford University School of Medicine, who co-authored the article with PhD candidate Humsa Venkatesh. "The nervous system is an extremely arborized tree that reaches every aspect of every tissue and contributes importantly to tissue development. Those growth signals are already there, so why shouldn't cancer cells co-opt them?"

Cancer treatments often target tumors by cutting off blood vessels and other nutrient supply routes, so Monje and others are interested to learn whether it may be possible to target nerves via analogous therapies or by simply blocking secreted neural growth factors. The challenge is that growth-promoting signals vary by neuron and cancer type. Furthermore, blocking neural activity can be dangerous.

"In the brain, modulating neuronal activity isn't a great option because we don't want to silence the brain. Brains need to be active and functioning," says Monje. "But we can interrupt the specific molecular pathways that are being co-opted by the tumor."
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Monje first became interested in neurons' role supporting tumors while working on childhood glioma, a cancer that strikes in the precursors to glial cells in the developing brain. In 2015, her lab published a paper in Cell (DOI: 10.1016/j.cell.2015.04.012) that found that both adult and pediatric glioma cells grew faster when adjacent to highly active neurons.

A team of investigators from Cedars-Sinai and UCLA is using a new blood-analysis technique and tiny experimental device to help physicians predict which cancers are likely to spread by identifying and characterizing tumor cells circulating through the blood.

The investigators are conducting "liquid biopsies" by running blood through a postage-stamp-sized chip with nanowires 1,000 times thinner than a human hair and coated with antibodies, or proteins, that recognize circulating tumor cells. The device, the NanoVelcro Chip, works by "grabbing" circulating tumor cells, which break away from tumors and travel through the bloodstream, looking for places in the body to spread.

Use of the chip in liquid biopsies could allow doctors to regularly and easily monitor cancer-related changes in patients, such as how well they're responding to treatment. The research earned the lead investigators a place on the U.S. Cancer Moonshot program, an initiative led by former Vice President Joe Biden to make available more therapies to more patients and to prevent cancer.

"It's far better to draw a tube of blood once a month to monitor cancer than to make patients undergo repeated surgical procedures," said Edwin Posadas, MD. "The power of this technology lies in its capacity to provide information that is equal to or even superior to traditional tumor sampling by invasive procedures."

Although some forms of prostate cancer are so slow-growing that they pose little risk to patients, other forms of the disease are lethal. Identifying which patients have which type of disease has become a crucial area of study because prostate cancer is one of the leading causes of cancer death among men in the U.S. Nearly 27,000 U.S. men are expected to die from the disease in 2017, according to the American Cancer Society.

A woman's risk of dying of cervical cancer is higher than long believed, particularly among older and black women, new Johns Hopkins Bloomberg School of Public Health-led research suggests.

The researchers found that black women in the United States are dying from cervical cancer at a rate 77 percent higher than previously thought while white women are dying at a rate 47 percent higher. The new figures reflect a change in how mortality rates are calculated. By excluding women who have had hysterectomies, which typically involves the removal of the cervix and therefore reduces the risk of developing cervical cancer to zero, the researchers say these data paint a more accurate picture of who is getting cervical cancer - and can be used to better understand how to prevent it.

Meanwhile, many of those who are dying are over the age of 65, a cutoff point where guidelines no longer recommend women with cervixes be regularly screened for cervical cancer. With routine screening, cervical cancer is preventable. In the United States, there are 12,000 cases of cervical cancer each year and around 4,000 deaths.

The findings, published Jan. 23 in the journal Cancer, highlight the need to understand the risks associated with cervical cancer in older and black women and determine both the best screening and treatment options for these women.

"This is a preventable disease and women should not be getting it, let alone dying from it," says study leader Anne F. Rositch, PhD, MSPH, an assistant professor in the Department of Epidemiology at the Bloomberg School. "Since the goal of a screening program is to ultimately reduce mortality from cervical cancer, then you must have accurate estimates within the population targeted by those programs -- adult women with a cervix. These findings motivate us to better understand why, despite the wide availability of screening and treatment, older and black women are still dying from cervical cancer at such high rates in the United States."

Excluding women with a history of a hysterectomy, something that has not been done in previous calculations, makes a sizable difference since one in five women in the United States have had a hysterectomy, with the number slightly higher in black women than white women. Current guidelines do not recommend cervical cancer screening after the age of 65, since it was believed that older women were at much less risk. These new findings suggest the risk remains - and even increases - in older women.

Accurate mediastinal nodal staging is crucial in the management of non-small cell lung cancer (NSCLC) because it directs therapy and has prognostic value. Now researchers have examined five-year survival after endosonography vs mediastinoscopy for mediastinal nodal staging of lung cancer.

Accurate mediastinal nodal staging is crucial in the management of non-small cell lung cancer (NSCLC) because it directs therapy and has prognostic value. The Assessment of Surgical Staging vs Endosonographic Ultrasound in Lung Cancer (ASTER) trial compared mediastinoscopy (surgical staging) with an endosonographic staging strategy (which combined the use of endobronchial and transesophageal ultrasound followed by mediastinoscopy if negative). The endosonographic strategy was significantly more sensitive for diagnosing mediastinal nodal metastases than surgical staging (94 percent endosonographic strategy vs 79 percent surgical strategy). If mediastinal staging is improved, more patients should receive optimal treatment and might survive longer.
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This analysis evaluated survival in ASTER. Of 241 patients with potentially resectable NSCLC, 123 were randomized to endosonographic staging and 118 to surgical staging in 4 tertiary referral centers. Survival data were obtained through patient records, death registers, or contact with general practitioners. Survival data at 5 years were obtained for 237 of 241 patients. The prevalence of mediastinal nodal metastases was 54 percent in the endosonographic strategy group and 44 percent in the surgical strategy group. Survival at 5 years was 35 percent for the endosonographic strategy vs 35 percent for the surgical strategy. The estimated median survival was 31 months for the endosonographic strategy vs 33 months for the surgical strategy.

Scientists at Florida Atlantic University's Harbor Branch Oceanographic Institute found that a deep-water marine sponge collected off of Fort Lauderdale's coast contains leiodermatolide, a natural product that has the ability to inhibit the growth of cancer cells as well as block cancer cells from dividing using extremely low concentrations of the compound. This work resulted in the award of a patent from the U.S. Patent and Trademark Office protecting the use of the compound against various forms of cancer.

​Sea sponges are an ancient group of animals that appeared more than 600 million years ago that have many of the same genes as humans. These scientists are taking advantage of this similarity in human and sponge genomes to isolate marine natural compounds from these organisms to develop medicines useful in the treatment of human diseases such as cancer. The researchers are expanding on their original findings, recently showing that leiodermatolide can reduce pancreatic tumor size in vivo, publishing the results of this study in the International Journal of Cancer (IJC).
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Pancreatic cancer is the fourth leading cause of cancer death in the United States. Pancreatic cancer patients have less than a seven percent survival rate within five years of diagnosis, and 74 percent of patients die within the first year of diagnosis. In recent years, pancreatic cancer has received considerable attention because many well-known individuals have died from the disease. September marks seven years since the passing of actor Patrick Swayze, and October will be five years since the death of Apple Inc. co-founder Steve Jobs. The great tenor Luciano Pavarotti also died from this disease almost a decade ago.

​In the article in IJC titled, "Leiodermatolide, a Novel Marine Natural Product, Has Potent Cytotoxic and Antimitotic Activity Against Cancer Cells, Appears to Affect Microtubule Dynamics, and Exhibits Antitumor Activity," the researchers more fully define how this marine compound kills the cancer cells, and show that its effects occur not only against cells but that it also has the ability to reduce pancreatic cancer tumor weight.

Lead author Esther Guzmán, Ph.D., associate research professor at FAU Harbor Branch, along with colleagues and co-authors Amy Wright, Ph.D., research professor; Tara Pitts, biological scientist; and Priscilla Winder, Ph.D., research associate; as well as collaborators from Eisai Pharmaceuticals and the University of Central Florida, have been able to show that leiodermatolide induces programmed cell death in pancreatic cancer cells, and inhibits the growth of other cancer cells such as metastatic melanoma, colon cancer, lymphoma, and glioblastoma, a rare and deadly form of brain cancer.

We've all heard of laughter being the best medicine, but what about music?

A systematic review published by the Cochrane Library found that there is significant evidence that music interventions help alleviate symptoms of anxiety, pain and fatigue in cancer patients, while also boosting their quality of life.

Led by Joke Bradt, PhD, associate professor in Drexel University's College of Nursing and Health Professions, a team looked into studies that examined the impact of music therapy (a personalized music experience offered by trained music therapists) and music medicine (listening to pre-recorded music provided by a doctor or nurse) on psychological and physical outcomes in people with cancer.
"We found that music therapy interventions specifically help improve patients' quality of life," explained Bradt. "These are important findings as these outcomes play an important role in patients' overall well-being."

A total of 52 trials were examined in the review, constituting of 3,731 participants with cancer. Twenty-three of the trials were categorised as music therapy and the remaining 29 were classified as music medicine interventions. Overall, one of the most impactful findings was that music interventions of all kinds resulted in a moderate-to-strong effect in reducing patients' anxiety.

A recent study by researchers at Johns Hopkins concludes that a substantial number of people with a history of the most frequent kind of nonmelanoma skin cancers still get sunburned at the same rate as those without previous history, probably because they are not using sun-protective methods the right way or in the right amounts.

The findings, which were based on self-reporting of sunburn and sun protection practices gathered from the National Health Interview Survey, urge skin doctors and other health care providers to better educate their patients about protective skin care practices, especially for those with history of nonmelanoma skin cancer. The findings are published in the Journal of the American Academy of Dermatology.
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"It is important to look at how patients are currently practicing sun protection and what they are doing that is not very effective," says Anna Chien, M.D., co-director of the Cutaneous Translational Research Program in the Department of Dermatology at the Johns Hopkins University School of Medicine. "Only then can we make strides in helping patients improve their sun protective practices by ensuring they do them the correct way." Sun exposure is the leading cause of nonmelanoma skin cancers, and treatment is estimated to cost $4.8 billion in the U.S. annually.

In the United States, Chien says, approximately 13 million white non-Hispanic individuals have a history of at least one type of nonmelanoma skin cancer, including basal cell and squamous cell cancers, putting them at a well-documented higher risk for subsequent nonmelanoma skin cancer. For example, studies show that 40 percent of those with a history of basal cell carcinoma are diagnosed with another lesion within five years.

For the new study, investigators analyzed self-reported survey results about sun protective practices from 758 people with previous nonmelanoma skin cancer and from 34,161 people without a history of skin cancer. The study focused on non-Hispanic whites, the population most affected by nonmelanoma skin cancer. Of the people without history, 18,933 were female and 15,228 were male, and of those with history, 390 were female and 368 were male.