Latest & greatest articles for cancer

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Top results for cancer

21. New evidence confirms three-yearly surveillance interval for people at intermediate risk of bowel cancer

New evidence confirms three-yearly surveillance interval for people at intermediate risk of bowel cancer Signal - New evidence confirms three-yearly surveillance interval for people at intermediate risk of bowel cancer Dissemination Centre Discover Portal NIHR DC Discover New evidence confirms three-yearly surveillance interval for people at intermediate risk of bowel cancer Published on 3 October 2017 People with benign growths (adenomas), who are at intermediate risk of bowel cancer, benefit (...) from follow-up colonoscopy. However, some of the patients at the lower end of risk in this intermediate category may not benefit from more than one follow-up. This NIHR-funded cohort study reviewed data for 11,944 intermediate-risk patients from UK hospitals. Within this group, particular features were identified which placed them at higher risk, such as the presence of larger or highly abnormal adenomas or incomplete colonoscopy. These patients had half the risk of developing cancer

NIHR Dissemination Centre2018

22. Blood tests alone are not sufficient for detecting recurrent bowel cancer

Blood tests alone are not sufficient for detecting recurrent bowel cancer Signal - Blood tests alone are not sufficient for detecting recurrent bowel cancer Dissemination Centre Discover Portal NIHR DC Discover Blood tests alone are not sufficient for detecting recurrent bowel cancer Published on 1 March 2016 The carcinoembryonic antigen (CEA) blood test – part of the usual approach for monitoring for bowel cancer– is not sensitive or specific enough to depend on alone for detecting recurrence (...) . This new Cochrane review added more detail to existing evidence about the low sensitivity and specificity of CEA, a test which has been available in the UK for many years. The review clarifies that no threshold level for CEA testing gives sufficient sensitivity and specificity to allow it to be used alone to detect recurrence. Instead, it is more reliable to consider the results of blood and imaging tests together for detecting recurrence of bowel cancer. The findings confirm NICE guidance from 2011

NIHR Dissemination Centre2018

23. Large ten-year trial on treatment of localised prostate cancer will aid management decisions

Large ten-year trial on treatment of localised prostate cancer will aid management decisions Signal - Large ten-year trial on treatment of localised prostate cancer will aid management decisions Dissemination Centre Discover Portal NIHR DC Discover Large ten-year trial on treatment of localised prostate cancer will aid management decisions Published on 15 September 2016 New, long-term research indicates that active monitoring, with prompt treatment if needed, may be a better option than radical (...) surgery or radiotherapy for many men who have prostate cancer if it’s confined to the prostate gland. In the ProtecT trial, after an average of ten years, few men died of prostate cancer and there was no difference in survival between men receiving active monitoring and those who had radical treatments (which caused unpleasant side effects). But active monitoring did increase the risk of cancer progressing or spreading to other parts of the body. Longer follow-up will help to fully understand

NIHR Dissemination Centre2018

24. Bone-targeting drugs improve quality of life, but not survival in prostate cancer that has spread to bone

Bone-targeting drugs improve quality of life, but not survival in prostate cancer that has spread to bone Signal - Bone-targeting drugs improve quality of life, but not survival in prostate cancer that has spread to bone Dissemination Centre Discover Portal NIHR DC Discover Bone-targeting drugs improve quality of life, but not survival in prostate cancer that has spread to bone Published on 27 September 2016 The drug zoledronic acid delayed the onset of bone complications by two months in men (...) with prostate cancer that had spread to the bone. Though it did not increase overall survival, it improved quality of life by reducing important complications such as fractures and spinal cord compression. The radioactive drug strontium-89 was also tested and delayed the combined outcome of bone-related complications, pain or death by about one month. It also had no effect on overall survival or the number of bone complications. Both treatments were compared with chemotherapy alone. Current NICE guidance

NIHR Dissemination Centre2018

25. Common osteoporosis drugs may prevent breast cancer spreading to bone

Common osteoporosis drugs may prevent breast cancer spreading to bone Signal - Common osteoporosis drugs may prevent breast cancer spreading to bone Dissemination Centre Discover Portal NIHR DC Discover Common osteoporosis drugs may prevent breast cancer spreading to bone Published on 13 March 2018 Drugs commonly prescribed to prevent bone thinning probably help prevent the spread of early breast cancer to the bones in a few women, when taken in addition to standard cancer therapies. However (...) , the overall benefits may be small, for example preventing spread to bone or death in about one extra woman in every 100 treated for about five years. This is a complex area because many of the treatments for breast cancer are known to worsen bone thinning, but there are other bone strengthening benefits to these drugs. This large review of 44 studies with more than 37,000 participants looked at women with either early breast cancer or advanced breast cancer with or without bone involvement. The reviewers

NIHR Dissemination Centre2018

26. Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment.

Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment. BACKGROUND: Surgery is an important part of the management of oral cavity cancer with regard to both the removal of the primary tumour and removal of lymph nodes in the neck. Surgery is less frequently used in oropharyngeal cancer. Surgery alone may be treatment for early-stage disease or surgery may be used in combination with radiotherapy, chemotherapy and immunotherapy/biotherapy. There is variation (...) in the recommended timing and extent of surgery in the overall treatment regimens of people with these cancers. This is an update of a review originally published in 2007 and first updated in 2011. OBJECTIVES: To determine which surgical treatment modalities for oral and oropharyngeal cancers result in increased overall survival, disease-free survival and locoregional control and reduced recurrence. To determine the implication of treatment modalities in terms of morbidity, quality of life, costs, hospital days

Cochrane2018

27. FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer.

FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer. BACKGROUND: Among patients with metastatic pancreatic cancer, combination chemotherapy with fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) leads to longer overall survival than gemcitabine therapy. We compared the efficacy and safety of a modified FOLFIRINOX regimen with gemcitabine as adjuvant therapy in patients with resected pancreatic cancer. METHODS: We randomly assigned 493 patients with resected (...) included overall survival and safety. RESULTS: At a median follow-up of 33.6 months, the median disease-free survival was 21.6 months in the modified-FOLFIRINOX group and 12.8 months in the gemcitabine group (stratified hazard ratio for cancer-related event, second cancer, or death, 0.58; 95% confidence interval [CI], 0.46 to 0.73; P<0.001). The disease-free survival rate at 3 years was 39.7% in the modified-FOLFIRINOX group and 21.4% in the gemcitabine group. The median overall survival was 54.4

NEJM2018

28. Radical Prostatectomy or Watchful Waiting in Prostate Cancer - 29-Year Follow-up.

Radical Prostatectomy or Watchful Waiting in Prostate Cancer - 29-Year Follow-up. BACKGROUND: Radical prostatectomy reduces mortality among men with clinically detected localized prostate cancer, but evidence from randomized trials with long-term follow-up is sparse. METHODS: We randomly assigned 695 men with localized prostate cancer to watchful waiting or radical prostatectomy from October 1989 through February 1999 and collected follow-up data through 2017. Cumulative incidence and relative (...) risks with 95% confidence intervals for death from any cause, death from prostate cancer, and metastasis were estimated in intention-to-treat and per-protocol analyses, and numbers of years of life gained were estimated. We evaluated the prognostic value of histopathological measures with a Cox proportional-hazards model. RESULTS: By December 31, 2017, a total of 261 of the 347 men in the radical-prostatectomy group and 292 of the 348 men in the watchful-waiting group had died; 71 deaths

NEJM2018

29. Breast Cancer Risk After Recent Childbirth: A Pooled Analysis of 15 Prospective Studies.

Breast Cancer Risk After Recent Childbirth: A Pooled Analysis of 15 Prospective Studies. Background: Parity is widely recognized as protective for breast cancer, but breast cancer risk may be increased shortly after childbirth. Whether this risk varies with breastfeeding, family history of breast cancer, or specific tumor subtype has rarely been evaluated. Objective: To characterize breast cancer risk in relation to recent childbirth. Design: Pooled analysis of individual-level data from 15 (...) prospective cohort studies. Setting: The international Premenopausal Breast Cancer Collaborative Group. Participants: Women younger than 55 years. Measurements: During 9.6 million person-years of follow-up, 18 826 incident cases of breast cancer were diagnosed. Hazard ratios (HRs) and 95% CIs for breast cancer were calculated using Cox proportional hazards regression. Results: Compared with nulliparous women, parous women had an HR for breast cancer that peaked about 5 years after birth (HR, 1.80 [95% CI

Annals of Internal Medicine2018

30. Exercise interventions for people undergoing multimodal cancer treatment that includes surgery.

Exercise interventions for people undergoing multimodal cancer treatment that includes surgery. BACKGROUND: People undergoing multimodal cancer treatment are at an increased risk of adverse events. Physical fitness significantly reduces following cancer treatment, which is related to poor postoperative outcome. Exercise training can stimulate skeletal muscle adaptations, such as increased mitochondrial content and improved oxygen uptake capacity may contribute to improved physical fitness (...) . OBJECTIVES: To determine the effects of exercise interventions for people undergoing multimodal treatment for cancer, including surgery, on physical fitness, safety, health-related quality of life (HRQoL), fatigue, and postoperative outcomes. SEARCH METHODS: We searched electronic databases of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, SPORTDiscus, and trial registries up to October 2018. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that compared

Cochrane2018

31. Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer.

Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer. BACKGROUND: Patients who have residual invasive breast cancer after receiving neoadjuvant chemotherapy plus human epidermal growth factor receptor 2 (HER2)-targeted therapy have a worse prognosis than those who have no residual cancer. Trastuzumab emtansine (T-DM1), an antibody-drug conjugate of trastuzumab and the cytotoxic agent emtansine (DM1), a maytansine derivative and microtubule inhibitor, provides benefit (...) in patients with metastatic breast cancer that was previously treated with chemotherapy plus HER2-targeted therapy. METHODS: We conducted a phase 3, open-label trial involving patients with HER2-positive early breast cancer who were found to have residual invasive disease in the breast or axilla at surgery after receiving neoadjuvant therapy containing a taxane (with or without anthracycline) and trastuzumab. Patients were randomly assigned to receive adjuvant T-DM1 or trastuzumab for 14 cycles

NEJM2018

32. Apixaban to Prevent Venous Thromboembolism in Patients with Cancer.

Apixaban to Prevent Venous Thromboembolism in Patients with Cancer. BACKGROUND: Patients with active cancer have an increased risk of venous thromboembolism, which results in substantial morbidity, mortality, and health care expenditures. The Khorana score (range, 0 to 6, with higher scores indicating a higher risk of venous thromboembolism) has been validated to identify patients with cancer at elevated risk for this complication and may help select those who could benefit from (...) thromboprophylaxis. METHODS: We conducted a randomized, placebo-controlled, double-blind clinical trial assessing the efficacy and safety of apixaban (2.5 mg twice daily) for thromboprophylaxis in ambulatory patients with cancer who were at intermediate-to-high risk for venous thromboembolism (Khorana score, ≥2) and were initiating chemotherapy. The primary efficacy outcome was objectively documented venous thromboembolism over a follow-up period of 180 days. The main safety outcome was a major bleeding episode

NEJM2018

33. Stomach cancer

Stomach cancer Stomach cancer - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Stomach cancer Last reviewed: November 2018 Last updated: December 2018 Summary Presenting symptoms can include weight loss and abdominal pain, although patients with proximal or gastro-oesophageal junction tumours may present with dysphagia. Upper gastrointestinal endoscopy with biopsy demonstrating carcinoma is required to confirm (...) the diagnosis. Staging based on imaging is required. Early-stage disease is treated with surgery alone. Locally advanced disease is treated with multimodality approach that includes surgery followed by postoperative chemoradiation, or chemotherapy before and after surgery. Metastatic disease is treated with chemotherapy or chemoradiation and supportive care measures. Common complications are gastric bleeding and gastric outlet obstruction. Definition Stomach cancer is a neoplasm that can develop in any

BMJ Best Practice2018

34. Exfoliative cytology for diagnosing basal cell carcinoma and other skin cancers in adults.

Exfoliative cytology for diagnosing basal cell carcinoma and other skin cancers in adults. BACKGROUND: Early accurate detection of all skin cancer types is essential to guide appropriate management, reduce morbidity and improve survival. Basal cell carcinoma (BCC) is usually localised to the skin but has potential to infiltrate and damage surrounding tissue, while cutaneous squamous cell carcinoma (cSCC) and melanoma have a much higher potential to metastasise and ultimately lead to death (...) cytology scrape can never give the same information as a skin biopsy, however, so it is important to better understand in which skin cancer situations it may be helpful. OBJECTIVES: To determine the diagnostic accuracy of exfoliative cytology for detecting basal cell carcinoma (BCC) in adults, and to compare its accuracy with that of standard diagnostic practice (visual inspection with or without dermoscopy). Secondary objectives were: to determine the diagnostic accuracy of exfoliative cytology

Cochrane2018

35. Computer-assisted diagnosis techniques (dermoscopy and spectroscopy-based) for diagnosing skin cancer in adults.

Computer-assisted diagnosis techniques (dermoscopy and spectroscopy-based) for diagnosing skin cancer in adults. BACKGROUND: Early accurate detection of all skin cancer types is essential to guide appropriate management and to improve morbidity and survival. Melanoma and cutaneous squamous cell carcinoma (cSCC) are high-risk skin cancers which have the potential to metastasise and ultimately lead to death, whereas basal cell carcinoma (BCC) is usually localised with potential to infiltrate (...) and damage surrounding tissue. Anxiety around missing early curable cases needs to be balanced against inappropriate referral and unnecessary excision of benign lesions. Computer-assisted diagnosis (CAD) systems use artificial intelligence to analyse lesion data and arrive at a diagnosis of skin cancer. When used in unreferred settings ('primary care'), CAD may assist general practitioners (GPs) or other clinicians to more appropriately triage high-risk lesions to secondary care. Used alongside clinical

Cochrane2018

36. Visual inspection and dermoscopy, alone or in combination, for diagnosing keratinocyte skin cancers in adults.

Visual inspection and dermoscopy, alone or in combination, for diagnosing keratinocyte skin cancers in adults. BACKGROUND: Early accurate detection of all skin cancer types is important to guide appropriate management, to reduce morbidity and to improve survival. Basal cell carcinoma (BCC) is almost always a localised skin cancer with potential to infiltrate and damage surrounding tissue, whereas a minority of cutaneous squamous cell carcinomas (cSCCs) and invasive melanomas are higher-risk (...) skin cancers with the potential to metastasise and cause death. Dermoscopy has become an important tool to assist specialist clinicians in the diagnosis of melanoma, and is increasingly used in primary-care settings. Dermoscopy is a precision-built handheld illuminated magnifier that allows more detailed examination of the skin down to the level of the superficial dermis. Establishing the value of dermoscopy over and above visual inspection for the diagnosis of BCC or cSCC in primary- and secondary

Cochrane2018

37. Optical coherence tomography for diagnosing skin cancer in adults.

Optical coherence tomography for diagnosing skin cancer in adults. BACKGROUND: Early accurate detection of all skin cancer types is essential to guide appropriate management and to improve morbidity and survival. Melanoma and squamous cell carcinoma (SCC) are high-risk skin cancers, which have the potential to metastasise and ultimately lead to death, whereas basal cell carcinoma (BCC) is usually localised, with potential to infiltrate and damage surrounding tissue. Anxiety around missing early (...) cases needs to be balanced against inappropriate referral and unnecessary excision of benign lesions. Optical coherence tomography (OCT) is a microscopic imaging technique, which magnifies the surface of a skin lesion using near-infrared light. Used in conjunction with clinical or dermoscopic examination of suspected skin cancer, or both, OCT may offer additional diagnostic information compared to other technologies. OBJECTIVES: To determine the diagnostic accuracy of OCT for the detection

Cochrane2018

38. High-frequency ultrasound for diagnosing skin cancer in adults.

High-frequency ultrasound for diagnosing skin cancer in adults. BACKGROUND: Early, accurate detection of all skin cancer types is essential to guide appropriate management and to improve morbidity and survival. Melanoma and squamous cell carcinoma (SCC) are high-risk skin cancers with the potential to metastasise and ultimately lead to death, whereas basal cell carcinoma (BCC) is usually localised, with potential to infiltrate and damage surrounding tissue. Anxiety around missing early curable (...) image of tissues and structures closer to the skin surface. Used in conjunction with clinical and/or dermoscopic examination of suspected skin cancer, HFUS may offer additional diagnostic information compared to other technologies. OBJECTIVES: To assess the diagnostic accuracy of HFUS to assist in the diagnosis of a) cutaneous invasive melanoma and atypical intraepidermal melanocytic variants, b) cutaneous squamous cell carcinoma (cSCC), and c) basal cell carcinoma (BCC) in adults. SEARCH METHODS

Cochrane2018

39. Teledermatology for diagnosing skin cancer in adults.

Teledermatology for diagnosing skin cancer in adults. BACKGROUND: Early accurate detection of all skin cancer types is essential to guide appropriate management and to improve morbidity and survival. Melanoma and squamous cell carcinoma (SCC) are high-risk skin cancers which have the potential to metastasise and ultimately lead to death, whereas basal cell carcinoma (BCC) is usually localised with potential to infiltrate and damage surrounding tissue. Anxiety around missing early curable cases (...) and interactive consultations using videoconferencing to connect the patient, referrer and dermatologist in real time. OBJECTIVES: To determine the diagnostic accuracy of teledermatology for the detection of any skin cancer (melanoma, BCC or cutaneous squamous cell carcinoma (cSCC)) in adults, and to compare its accuracy with that of in-person diagnosis. SEARCH METHODS: We undertook a comprehensive search of the following databases from inception up to August 2016: Cochrane Central Register of Controlled

Cochrane2018

40. Reflectance confocal microscopy for diagnosing keratinocyte skin cancers in adults.

Reflectance confocal microscopy for diagnosing keratinocyte skin cancers in adults. BACKGROUND: Early accurate detection of all skin cancer types is important to guide appropriate management and improve morbidity and survival. Basal cell carcinoma (BCC) is usually a localised skin cancer but with potential to infiltrate and damage surrounding tissue, whereas cutaneous squamous cell carcinoma (cSCC) and melanoma are higher risk skin cancers with the potential to metastasise and ultimately lead (...) to death. When used in conjunction with clinical or dermoscopic suspicion of malignancy, or both, reflectance confocal microscopy (RCM) may help to identify cancers eligible for non-surgical treatment without the need for a diagnostic biopsy, particularly in people with suspected BCC. Any potential benefit must be balanced against the risk of any misdiagnoses. OBJECTIVES: To determine the diagnostic accuracy of RCM for the detection of BCC, cSCC, or any skin cancer in adults with any suspicious lesion

Cochrane2018