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Health

Ultraprocessed foods linked to ovarian and other cancer deaths, study finds

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CNN
 — 

Eating more ultraprocessed foods raises the risk of developing and dying from cancer, especially ovarian cancer, according to a new study of over 197,000 people in the United Kingdom, over half of whom were women.

Overly processed foods include prepackaged soups, sauces, frozen pizza and ready-to-eat meals, as well as hot dogs, sausages, french fries, sodas, store-bought cookies, cakes, candies, doughnuts, ice cream and many more.

“Ultra-processed foods are produced with industrially derived ingredients and often use food additives to adjust colour, flavour, consistency, texture, or extend shelf life,” said first author Dr. Kiara Chang, a National Institute for Health and Care Research fellow at Imperial College London’s School of Public Health, in a statement.

“Our bodies may not react the same way to these ultra-processed ingredients and additives as they do to fresh and nutritious minimally processed foods,” Chang said.

However, people who eat more ultra-processed foods also tend to “drink more fizzy drinks and less tea and coffee, as well as less vegetables and other foods associated with a healthy dietary pattern,” said Duane Mellor, a registered dietitian and senior teaching fellow at Aston Medical School in Birmingham, UK, in an email.

“This could mean that it may not be an effect specifically of the ultra-processed foods themselves, but instead reflect the impact of a lower intake of healthier food,” said Mellor, who was not involved in the study.

The study, published Tuesday in the journal eClinicalMedicine, looked at the association between eating ultraprocessed foods and 34 different types of cancer over a 10-year period.

Researchers examined information on the eating habits of 197,426 people who were part of the UK Biobank, a large biomedical database and research resource that followed residents from 2006 to 2010.

The amount of ultraprocessed foods consumed by people in the study ranged from a low of 9.1% to a high of 41.4% of their diet, the study found.

Eating patterns were then compared with medical records that listed both diagnoses and deaths from cancer.

Each 10% increase in ultraprocessed food consumption was associated with a 2% increase in developing any cancer, and a 19% increased risk for being diagnosed with ovarian cancer, according to a statement issued by Imperial College London.

Deaths from cancers also increased, the study found. For each additional 10% increase in ultraprocessed food consumption, the risk of dying from any cancer increased by 6%, while the risk of dying from ovarian cancer rose by 30%, according to the statement.

“These associations persisted after adjustment for a range of socio-demographic, smoking status, physical activity, and key dietary factors,” the authors wrote.

When it comes to death from cancer among women, ovarian cancer is ranked fifth, “accounting for more deaths than any other cancer of the female reproductive system,” noted the American Cancer Society.

“The findings add to previous studies showing an association between a greater proportion of ultra-processed foods (UPFs) in the diet and a higher risk of obesity, heart attacks, stroke, and type 2 diabetes,” said Simon Steenson, a nutrition scientist at the British Nutrition Foundation, a charity partially supported by food producers and manufacturers. Steenson was not involved in the new study.

“However, an important limitation of these previous studies and the new analysis published today is that the findings are observational and so do not provide evidence of a clear causal link between UPFs and cancer, or the risk of other diseases,” Steenson said in an email.

People who ate the most ultraprocessed foods “were younger and less likely to have a family history of cancer,” Chang and her colleagues wrote.

High consumers of ultraprocessed foods were less likely to do physical activity and more likely to be classified as obese. These people were also likely to have lower household incomes and education and live in the most underprivileged communities, the study found.

“This study adds to the growing evidence that ultra-processed foods are likely to negatively impact our health including our risk for cancer,” said Dr. Eszter Vamos, the study’s lead author and a clinical senior lecturer at Imperial College London’s School of Public Health in a statement.

This latest research is not the first to show an association between a high intake of ultraprocessed foods and cancer.

A 2022 study examined the diets of over 200,000 men and women in the United States for up to 28 years and found a link between ultraprocessed foods and colorectal cancer — the third most diagnosed cancer in the United States — in men, but not women.

And there are “literally hundreds of studies (that) link ultraprocessed foods to obesity, cancer, cardiovascular disease, and overall mortality,” Marion Nestle, the Paulette Goddard professor emerita of nutrition, food studies and public health at New York University told CNN previously.

While the new UK-based study cannot prove causation, only an association, “other available evidence shows that reducing ultra-processed foods in our diet could provide important health benefits,” Vamos said.

“Further research is needed to confirm these findings and understand the best public health strategies to reduce the widespread presence and harms of ultra-processed foods in our diet,” she added.

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Health

Many women underestimate breast density as a risk factor for breast cancer, study shows

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CNN
 — 

Dense breast tissue has been associated with up to a four times higher risk of breast cancer. However, a new study suggests few women view breast density as a significant risk factor.

The study, published in JAMA Network Open, surveyed 1,858 women ages 40 to 76 years from 2019 to 2020 who reported having recently undergone mammography, had no history of breast cancer and had heard of breast density.

Women were asked to compare the risk of breast density to five other breast cancer risk factors: having a first-degree relative with breast cancer, being overweight or obese, drinking more than one alcoholic beverage per day, never having children and having a prior breast biopsy.

“When compared to other known and perhaps more well-known breast cancer risks, women did not perceive breast density as significant of a risk,” said Laura Beidler, an author of the study and researcher at the Dartmouth Institute for Health Policy and Clinical Practice.

For example, the authors report that dense breast tissue is associated with a 1.2 to four times higher risk of breast cancer compared with a two times higher risk associated with having a first-degree relative with breast cancer – but 93% of women said breast density was a lesser risk.

Dense breasts tissue refers to breasts that are composed of more glandular and fibrous tissue than fatty tissue. It is a normal and common finding present in about half of women undergoing mammograms.

The researchers also interviewed 61 participants who reported being notified of their breast density and asked what they thought contributes to breast cancer and how they could reduce their risk. While most women correctly noted that breast density could mask tumors on mammograms, few women felt that breast density could be a risk factor for breast cancer.

Roughly one-third of women thought there was nothing they could do to reduce their breast cancer risk, although there are several ways to reduce risk, including maintaining a healthy, active lifestyle and minimizing alcohol consumption.

Breast density changes over a woman’s lifetime, and is generally higher in women who are younger, have a lower body weight, are pregnant or breastfeeding, or are taking hormone replacement therapy.

The level of breast cancer risk increases with the degree of breast density; however, experts aren’t certain why this is true.

“One hypothesis has been that women who have more dense breast tissue also have higher, greater levels of estrogen, circulating estrogen, which contributes to both the breast density and to the risk of developing breast cancer,” said Dr. Harold Burstein, a breast oncologist at the Dana-Farber Cancer Institute who was not involved in the study. “Another hypothesis is that there’s something about the tissue itself, making it more dense, that somehow predisposes to the development of breast cancer. We don’t really know which one explains the observation.”

Thirty-eight states currently mandate that women receive written notification about their breast density and its potential breast cancer risk following mammography; however, studies have shown that many women find this information confusing.

“Even though women are notified usually in writing when they get a report after a mammogram that says, ‘You have increased breast density,’ it’s kind of just tucked in there at the bottom of the report. I’m not sure that anyone is explaining to them, certainly in person or verbally, what that means,” said Dr. Ruth Oratz, a breast oncologist at NYU Langone’s Perlmutter Cancer Center who was not involved in the study.

“I think what we’ve learned from this study is that we have to do a better job of educating not only the general public of women, but the general public of health care providers who are doing the primary care, who are ordering those screening mammograms,” she added.

Current screening guidelines recommend women of average risk of breast cancer undergo breast cancer screening every one to two years between ages 50 to 74 with the option of beginning at age 40.

Because women with dense breast tissue are considered to have higher than average cancer risks, the authors of the study suggest women with high breast density may benefit from supplemental screening like breast MRI or breast ultrasound, which may detect cancers that are missed on mammograms. Currently, coverage of supplemental screening after the initial mammogram varies, depending on the state and insurance policy.

The authors warn that “supplemental screening not only can lead to increased rates of cancer detection but also may result in more false-positive results and recall appointments.” They say clinicians should use risk assessment tools when discussing tradeoffs associated with supplemental screening.

“Usually, it’s a discussion between the patient, the clinical team, and the radiologist. And it’ll be affected by prior history, by whether there’s anything else of concern on the mammogram, by the patient’s family history. So those are the kinds of things we discuss frequently with patients who are in such situations,” Burstein said.

Breast cancer screening recommendations differ between medical organizations, and experts say women at higher risk due to breast density should discuss with their doctor what screening method and frequency are most appropriate.

“I think it’s really, really important that everyone understands – and this is the doctors, the nurses, the women themselves – that screening is not a one size fits all recommendation. We cannot just make one general recommendation to the entire population because individual women have different levels of risks of developing breast cancer,” Oratz said.

For the nearly one-third of women with dense breast tissue that reported there was nothing they could do to prevent breast cancer, experts say there are some steps you can take to reduce your risk.

“Maintaining an active, healthy lifestyle and minimizing alcohol consumption address several modifiable factors. Breastfeeding can decrease the risk. On the other hand, use of hormone replacement therapy increases breast cancer risk,” said Dr. Puneet Singh, a breast surgical oncologist at the MD Anderson Cancer Center who was not involved in the study.

The researchers add that there are approved medications, such as tamoxifen, that can be given for those at significantly increased risk that may reduce the chances of breast cancer by about half.

Finally, breast cancer doctors say that in addition to appropriate screening, knowing your risk factors and advocating for yourself can be powerful tools in preventing and detecting breast cancer.

“At any age, if any woman feels uncomfortable about something that’s going on in her breast, if she has discomfort, notices a change in the breast, bring that to the attention of your doctor and make sure it gets evaluated and don’t let somebody just brush you off,” Oratz said.

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Health

US cancer death rate drops 33% since 1991, partly due to advances in treatment, early detection and less smoking, new report says

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CNN
 — 

The rate of people dying from cancer in the United States has continuously declined over the past three decades, according to a new report from the American Cancer Society.

The US cancer death rate has fallen 33% since 1991, which corresponds to an estimated 3.8 million deaths averted, according to the report, published Thursday in CA: A Cancer Journal for Clinicians. The rate of lives lost to cancer continued to shrink in the most recent year for which data is available, between 2019 and 2020, by 1.5%.

The 33% decline in cancer mortality is “truly formidable,” said Karen Knudsen, chief executive officer of the American Cancer Society.

The report attributes this steady progress to improvements in cancer treatment, drops in smoking and increases in early detection.

“New revelations for prevention, for early detection and for treatment have resulted in true, meaningful gains in many of the 200 diseases that we call cancer,” Knudsen said.

In their report, researchers from the American Cancer Society also pointed to HPV vaccinations as connected to reductions in cancer deaths. HPV, or human papillomavirus, infections can cause cervical cancer and other cancer types, and vaccination has been linked with a decrease in new cervical cancer cases.

Among women in their early 20s, there was a 65% drop in cervical cancer rates from 2012 through 2019, “which totally follows the time when HPV vaccines were put into use,” said Dr. William Dahut, the society’s chief scientific officer.

“There are other cancers that are HPV-related – whether that’s head and neck cancers or anal cancers – so there’s optimism this will have importance beyond this,” he said.

The lifetime probability of being diagnosed with any invasive cancer is estimated to be 40.9% for men and 39.1% for women in the US, according to the new report.

The report also includes projections for 2023, estimating that there could be nearly 2 million new cancer cases – the equivalent of about 5,000 cases a day – and more than 600,000 cancer deaths in the United States this year.

During the early days of the Covid-19 pandemic, many people skipped regular medical exams, and some doctors have seen a rise in advanced cancer cases in the wake of pandemic-delayed screenings and treatment.

The American Cancer Society researchers were not able to track “that reduction in screening that we know we all observed across the country during the pandemic,” Knudsen said. “This time next year, I believe our report will give some initial insight into what the impact was in the pandemic of cancer incidence and cancer mortality.”

The new report includes data from national programs and registries, including those at the National Cancer Institute, the US Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries.

Data showed that the US cancer death rate rose during most of the 20th century, largely due to an increase in lung cancer deaths related to smoking. Then, as smoking rates fell and improvements in early detection and treatments for some cancers increased, there was a decline in the cancer death rate from its peak in 1991.

Since then, the pace of the decline has slowly accelerated.

The new report found that the five-year relative survival rate for all cancers combined has increased from 49% for diagnoses in the mid-1970s to 68% for diagnoses during 2012-18.

The cancer types that now have the highest survival rates are thyroid at 98%, prostate at 97%, testis at 95% and melanoma at 94%, according to the report.

Current survival rates are lowest for cancers of the pancreas, at 12%.

The finding about a decreasing cancer death rate shows “the continuation of good news,” said Dr. Otis Brawley, an oncology professor at Johns Hopkins University who was not involved in the research.

“The biggest reason for the decline that started in 1991 was the prevalence of smoking in the United States started going down in 1965,” said Brawley, a former chief medical officer of the American Cancer Society.

“That’s the reason why we started having a decline in 1991, and that decline has continued because the prevalence of people smoking in the United States has continued to go down,” he said. “Now, in certain diseases, our ability to treat has improved, and there are some people who are not dying because of treatment.”

Although the death rate for cancer has been on a steady decline, the new report also highlights that new cases of breast, uterine and prostate cancer have been “of concern” and rising in the United States.

Incidence rates of breast cancer in women have been increasing by about 0.5% per year since the mid-2000s, according to the report.

Uterine corpus cancer incidence has gone up about 1% per year since the mid-2000s among women 50 and older and nearly 2% per year since at least the mid-1990s in younger women.

The prostate cancer incidence rate rose 3% per year from 2014 through 2019, after two decades of decline.

Knudsen called prostate cancer “an outlier” since its previous decline in incidence has reversed, appearing to be driven by diagnoses of advanced disease.

On Thursday, the American Cancer Society announced the launch of the Impact initiative, geared toward improving prostate cancer incidence and death rates by funding new research programs and expanding support for patients, among other efforts.

“Unfortunately, prostate cancer remains the number one most frequently diagnosed malignancy amongst men in this country, with almost 290,000 men expected to be diagnosed with prostate cancer this year,” Knudsen said. Cancer diagnosed when it is confined to the prostate has a five-year survival rate of “upwards of 99%,” she said, but for metastatic prostate cancer, there is no durable cure.

“Prostate cancer is the second leading cause of cancer death for men in this country,” she said. “What we’re reporting is not only an increase in the incidence of prostate cancer across all demographics but a 5% year-over-year increase in diagnosis of men with more advanced disease. So we are not catching these cancers early when we have an opportunity to cure men of prostate cancer.”

Breast, uterine and prostate cancers also have a wide racial disparity, in which communities of color have higher death rates and lower survival rates.

In 2020, the risk of overall cancer death was 12% higher in Black people compared with White people, according to the new report.

“Not every individual or every family is affected equally,” Knudsen said.

For instance, “Black men unfortunately have a 70% increase in incidence of prostate cancer compared to White men and a two- to four-fold increase in prostate cancer mortality as related to any other ethnic and racial group in the United States,” she said.

The data in the new report demonstrates “important and consistent” advances against cancer, Dr. Ernest Hawk, vice president of cancer prevention and population sciences at the University of Texas MD Anderson Cancer Center, said in an email.

“Cancer is preventable in many instances and detectable at an early stage with better outcomes in many others. When necessary, treatments are improving in both their efficacy and safety. That’s all great news,” Hawk wrote.

“However, it’s well past time for us to take health inequities seriously and make them a much greater national priority. Inequities in cancer risks, cancer care and cancer outcomes are intolerable, and we should not be complacent with these regular reminders of avoidable inequities,” he said. “With deliberate and devoted effort, I believe we can eliminate these disparities and make even greater progress to end cancer.”

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Health

Colonoscopies may not reduce cancer deaths, study finds — but experts say you should still get one

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CNN
 — 

Colonoscopy may reduce the risk of dying of colorectal cancer by as much as 50%, but there’s a catch: It only works if you get the scan.

That’s the big takeaway message from the first randomized trial of colonoscopy, published Sunday in The New England Journal of Medicine.

Colonoscopy has been recommended as a screening test for adults age 50 and over since the mid-1990s, and some 15 million colonoscopies are performed in the United States each year. This recommendation has been based on evidence from observational studies that looked back in time to compare how often colorectal cancer is diagnosed in people who received colonoscopies versus those who did not. These studies can be subject to bias, however, so scientists look to randomized trials that blindly sort people into two groups: those who are assigned to get an intervention, and those who are not. These studies then follow both groups forward in time to see if there are differences. Those studies have been difficult to do for colon cancer, which can be slow growing and may take years to be diagnosed.

The NordICC study, which stands for Northern-European Initiative on Colon Cancer, included more 84,000 men and women ages 55 to 64 from Poland, Norway and Sweden. None had gotten a colonoscopy before. The participants were randomly invited to have a screening colonoscopy between June 2009 and June 2014, or they were followed for the study without getting screened.

In the 10 years after enrollment, the group invited to get colonoscopies had an 18% lower risk of colorectal cancers than the group that wasn’t screened. Overall, the group invited to screening also had a small reduction in their risk of death from colorectal cancer, but that difference was not statistically significant – meaning it could be simple due to chance.

The researchers say they’re going to continue to follow participants for another five years. It could be that because colon cancers can be slow-growing, more time will help refine their results and may show bigger benefits for colonoscopy screening.

Normally, those kinds of disappointing results from such a large, strong study would be considered definitive enough to change medical practice.

But there’s a big caveat in this study that limits how the results should be applied: Only 42% of the participants who were invited to get a colonoscopy went through with it.

“I think it’s just hard to know the value of a screening test when the majority of people in the screening didn’t get it done,” said Dr. William Dahut, chief scientific officer at the American Cancer Society, who was not involved in the study.

When the study authors restricted the results to the people who actually received colonoscopies – about 12,000 out of the more than 28,000 who were invited to do so – the procedure was found to be more effective. It reduced the risk of colorectal cancer by 31% and cut the risk of dying of that cancer by 50%.

Experts say it’s difficult to rely just on the results from this subgroup, however, because they can be subject to bias.

For example, in clinical trials, researchers often worry about the “healthy volunteer effect”: People who volunteer for testing may be more likely to take care of themselves by eating a healthy diet or doing other things that can’t be measured by the study that might reduce their risk.

Dr. Michael Bretthauer, a researcher on the study who leads the clinical effectiveness group at the University of Oslo in Norway, says that as a gastroenterologist, he found the results disappointing.

But as a researcher, he has to follow the science, “so I think we have to embrace it,” he said.

“And we may have oversold the message for the last 10 years or so, and we have to wind it back a little,” he said.

Bretthauer thinks of the full set of study results – including the people who didn’t get a colonoscopy – to be the minimal amount of benefit a person could expect to get, while the more narrow results – limited to the subset of people who did get colonoscopies – are the largest benefits people could expect.

Based on his results, then, he expects that screening colonoscopy probably reduces a person’s chances of colorectal cancer by 18% to 31%, and their risk of death from 0% to as much as 50%, “which is on the low end what what I think everybody thought it would be.”

Other studies have estimated larger benefits for colonoscopies, reporting that these procedures could reduce the risk of dying of colorectal cancer by as much as 68%.

There are other caveats that may limit the applicability of the study’s results.

First, says Dr. Douglas Corley, a gastroenterologist who directs delivery science and applied research at Kaiser Permanente Northern California, it’s not clear how much followup people got after their colonoscopies. Part of the value of the screening comes from close followup if abnormalities are detected, he said.

Corley, who was not involved in the study, also says colonoscopies have gotten better since the research was conducted. The technology is better, and so is the training doctors get to perform them, so the findings may not be a reflection of the performance of screening tests available today.

The question of the most effective way to screen for colon cancer is an important one.

Colorectal cancer was the fourth most common cause of cancer in the United States in 2022 and the second most common cause of cancer death, according to the National Cancer Institute.

Several other studies now in the works may help settle the question of how effectively colonoscopies catch cancer. One, Colonprev, is being conducted in Spain; another is based in the United States and called Confirm. The Spanish study finished its followup of patients in late 2021. he US trial is following patients until 2027.

Dr. Jason Dominitz is the national director of gastroenterology for the Veterans Health Administration. He’s running the Confirm study, which is comparing colonoscopy to the fecal immunochemical test, or FIT, which looks for problems by detecting blood in stool.

Dominitz co-authored an editorial that was published alongside the new study Sunday in The New England Journal of Medicine and says no one should cancel their colonoscopy based on these results.

“We know that colon cancer screening works,” he told CNN. Previous studies of FIT and a test called sigmoidoscopy, which looks only at the lower part of the colon, have been shown to reduce both cancer incidence and colorectal cancer deaths.

“Those other tests work through colonoscopy,” Dominitz said. “They identify people at high risk who would benefit from colonoscopy, then the colonoscopy is done and removes polyps, for example, that prevents the individual from getting colon cancer in the first place, or it identifies colon cancer at a treatable stage.”

Polyps are benign growths that can turn into cancers. They are typically removed when identified during a screening colonoscopy, which can lower a person’s risk of colorectal cancer in the future.

Dominitz said this randomized controlled trial was a test of advice as much as it was a test of the value of colonoscopy.

“If you ask the population to do something, how much of an impact will it have?” he said.

Overall, the study found that just inviting people to get a colonoscopy didn’t have a large beneficial impact across these countries, partly because so many people didn’t do it.

Dominitz thinks the low participation can be partly explained by the study’s setting. Colonoscopies are not as common in the countries involved in the study as they are in the United States. In Norway, he says, official colorectal cancer screening recommendations didn’t come until this past year.

“They don’t see the public service announcements. They don’t hear Katie Couric talking about getting screened for colon cancer. They don’t see the billboards in the airport and whatnot,” he said. “So an invitation to be screened in Europe is, I think, likely to be somewhat different than an invitation to be screened in the US.”

In the US, according to data from the US Centers for Disease Control and Prevention, about 1 in 5 adults between the ages of 50 and 75 have never been screened for colorectal cancer.

The US Preventive Services Task Force says a variety of methods and regimens work to detect colorectal cancer. It recommends screening with tests that check for blood and/or cancer cells in stool every one to three years, a CT scan of the colon every five years, a flexible sigmoidoscopy every five years, a flexible sigmoidoscopy every 10 years paired with stool tests to check for blood annually, or a colonoscopy every 10 years.

In 2021, the task force lowered the recommended age to start routine screening for colorectal cancer from 50 to 45 because the cancer is becoming more common in younger adults.

In considering which screening test might be best for his patients, Dominitz says, he remembers the advice from a mentor who said, “The best test is the one that gets done.”

As proof, he points to early results from a large randomized trial from Sweden that’s testing colonoscopy, FIT testing and no screening at all.

Results collected from more than 278,000 people enrolled between March 2014 and the end of 2020 found that 35% of the group assigned to get a colonoscopy actually got one, compared with 55% who were assigned to the FIT stool test group.

To date, slightly more cancers have been detected in the group assigned to stool testing than in the group assigned to get a colonoscopy – “so participation with screening really is key!” Dominitz said.

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Entertainment

Katie Couric reveals she was diagnosed with breast cancer

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CNN
 — 

Veteran journalist Katie Couric reported some personal news on Wednesday.

In a post on her website, Couric shared she was diagnosed with breast cancer a few months ago.

“Why Not Me,” she titled the post. “June 21, 2022, was the first day of summer, my 8th wedding anniversary, and the day I found out I had breast cancer.”

“I felt sick and the room started to spin,” Couric wrote. “I was in the middle of an open office, so I walked to a corner and spoke quietly, my mouth unable to keep up with the questions swirling in my head.”

She explained that her gynecologist had reminded her she was due for a mammogram since her last one was in December 2020.

Couric, who lost her first husband Jay Monahan to colon cancer in 1998, said she planned on filming the test to share with her audience, much like when she underwent colon cancer screening while working for the morning show “Today.”

Because she has dense breast tissue, she explained, she routinely undergoes a breast sonogram in addition to a mammogram since dense breasts can make it more difficult for mammograms to detect abnormalities.

The sonogram detected something and a followup biopsy determined that she had cancer.

“The heart-stopping, suspended animation feeling I remember all too well came flooding back: Jay’s colon cancer diagnosis at 41 and the terrifying, gutting nine months that followed,” she wrote. “My sister Emily’s pancreatic cancer, which would later kill her at 54, just as her political career was really taking off. My mother-in-law Carol’s ovarian cancer, which she was fighting as she buried her son, a year and nine months before she herself was laid to rest.”

Her family has had better outcomes with cancer, she wrote, including her mother being “diagnosed with mantle cell non-Hodgkin’s lymphoma, which was kept at bay for a decade,” her father’s prostate cancer, and her now husband, John, having “a tumor the size of a coconut on his liver,” which was surgically removed a few months before their wedding.

Couric had surgery in July to remove a tumor from her breast that she wrote was “2.5 centimeters, roughly the size of an olive” and underwent radiation, which, she wrote, ended Tuesday.

She went public with her experience, she wrote, as a teachable moment she hopes will save lives.

“Please get your annual mammogram. I was six months late this time,” Couric wrote. “I shudder to think what might have happened if I had put it off longer. But just as importantly, please find out if you need additional screening.”

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Health

Cancer death rates fall steadily in the US, with more survivors than ever

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CNN
 — 

More people are surviving cancer than ever before in the United States, according to a new report from the American Association for Cancer Research.

In the past three years, the number of cancer survivors in the US – defined as living people who have had a cancer diagnosis – increased by more than a million. There are 18 million survivors in the US as of January, with that number expected to increase to 26 million by 2040, the association said. The report notes that there were only 3 million US cancer survivors in 1971.

For all cancers combined, the five-year overall survival rate has increased from 49% in the mid-1970s to nearly 70% from 2011 to 2017, the most recent years for which data is available.

The overall cancer death rate, adjusted for age, continues to drop, with reductions between 1991 and 2019 translating into nearly 3.5 million deaths avoided, the association said.

Declines in smoking and improvements in catching and treating cancer early are driving the change, according to the AACR Cancer Progress Report 2022, released Wednesday.

Dr. Lisa Coussens, president of the association, said in a statement that part of the credit goes to an investment in research – both for treatments and for understanding the disease.

“Targeted therapies, immunotherapy, and other new therapeutic approaches being applied clinically all stem from fundamental discoveries in basic science,” she said. “Investment in cancer science, as well as support for science education at all levels, is absolutely essential to drive the next wave of discoveries and accelerate progress.”

For example, between August 1 and July 31, the US Food and Drug Administration approved eight anticancer therapeutics, expanded the use of 10 previously approved medications to treat new cancer types, and approved two diagnostic imaging agents, Coussens said at a news conference Wednesday.

Increased funding for cancer research is a cornerstone of President Joe Biden’s relaunched Cancer Moonshot initiative.

Biden – who lost a son to brain cancer – said this month that his goal is to cut cancer death rates in the United States by at least half in the next 25 years.

“Cancer does not discriminate red and blue. It doesn’t care if you’re Republican or Democrat. Beating cancer is something we can do together,” said Biden, who initially helmed the initiative when he was vice president under Obama.

The new report urges Congress to fully fund and support Biden’s goal to “end cancer as we know it.”

“The reignited Cancer Moonshot will provide an important framework to improve cancer prevention strategies; increase cancer screenings and early detection; reduce cancer disparities; and propel new lifesaving cures for patients with cancer,” the report says, adding that the “actions will transform cancer care, increase survivorship, and bring lifesaving cures to the millions of people whose lives are touched by cancer.”

Although nearly 3.5 million cancer deaths were avoided between 1991 and 2019, more than 600,000 people in the US are still expected to die from cancer this year, according to the association.

“In the United States alone, the number of new cancer cases diagnosed each year is expected to reach nearly 2.3 million by 2040,” the report says.

About 40% of cancer cases in the US are attributable to preventable risk factors, such as smoking, drinking too much alcohol, eating a poor diet, not exercising enough and being obese, according to the report.

But there are also ongoing challenges such as health disparities that affect racial and ethnic minorities and barriers to health care such as limited health insurance coverage and living in rural areas.

In a recorded statement played at the news conference, US Rep. Nikema Williams said she learned after her mother died of cancer that “health care in America is not a human right yet.”

“We have two health care systems in this country: one for people who can afford preventative services and quality treatment and one for everyone else,” said Williams, a Democrat from Georgia.

The reversal of Roe v. Wade is also expected to affect cancer care by limiting health care options for pregnant women with cancer, the report said.

“With the recent Supreme Court decision to overturn Roe v. Wade, which ends the constitutional right to an abortion, there is uncertainty surrounding how a particular cancer treatment may lead to the termination of a pregnancy. Such uncertainty may prohibit some physicians from prescribing a drug or performing other health services in a timely manner due to the potential legal consequences for both physician and mother,” according to the report.

The Covid-19 pandemic had an effect on cancer in the US, with nearly 10 million breast, colorectal and prostate cancer screenings missed in 2020.

The report offers recommendations to build on the progress and regain momentum.

“Making progress to end cancer means more birthdays, more Christmases, more graduations and everyday moments for families everywhere,” Williams said.

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Business

Top Specialized Hospitals – Oncology

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1 MD Anderson Cancer Center Houston, TX United States 2 Memorial Sloan Kettering Cancer Center New York, NY United States 3 Institut Gustave Roussy Villejuif France 4 Dana-Farber Cancer Institute Dana Farber Cancer Institute Boston, MA United States 5 Mayo Clinic – Rochester Mayo Clinic Oncology Rochester, MN United States 6 Samsung Medical Center Samsung Comprehensive Cancer Center Seoul South Korea 7 Asan Medical Center Asan Cancer Institute Seoul South Korea 8 The Johns Hopkins Hospital The Sidney Kimmel Comprehensive Cancer Center Baltimore, MD United States 9 The Princess Margaret Cancer Centre Toronto Canada 10 National Cancer Center Hospital Tokyo Japan 11 The Royal Marsden Hospital – London London United Kingdom 12 IEO – Istituto Europeo di Oncologia Milan Italy 13 Charité – Universitätsmedizin Berlin Charité Comprehensive Cancer Center Berlin Germany 14 Massachusetts General Hospital Mass General Cancer Center Boston, MA United States 15 Seoul National University Hospital SNU Cancer Hospital Seoul South Korea 16 Hospital Israelita Albert Einstein Centro de Oncologia e Hematologia Einstein Família Dayan Sao Paulo Brazil 17 Istituto Nazionale dei Tumori Milan Italy 18 Institut Curie Paris France 19 Peter MacCallum Cancer Centre Melbourne Australia 20 Universitätsklinikum Heidelberg Nationales Centrum für Tumorerkrankungen (NCT) Heidelberg Germany 21 The Catholic University Of Korea – Seoul St. Mary’s Hospital Department of Oncology Seoul South Korea 22 Johns Hopkins Bayview Medical Center The Sidney Kimmel Comprehensive Cancer Center Baltimore, MD United States 23 Hospital Universitario La Paz Department of Oncology Madrid Spain 24 Cleveland Clinic Cleveland Clinic Cancer Center Cleveland, OH United States 25 Istituto Clinico Humanitas Unitá Medica ed Ematologia Milan Italy 26 Mayo Clinic – Phoenix Department of Oncology Phoenix, AZ United States 27 Severance Hospital – Yonsei University Yonsei Cancer Hospital Seoul South Korea 28 Universitätsklinikum Köln Onkologisches Zentrum im CIO Köln Cologne Germany 29 The Mount Sinai Hospital Tisch Cancer Center New York, NY United States 30 Hospital Universitari Vall d’Hebron Medical Oncology Barcelona Spain 31 Hospital Sirio Libanes Centro de Oncologia Sao Paulo Brazil 32 Universitätsklinikum Hamburg-Eppendorf Zentrum für Onkologie Hamburg Germany 33 Stanford Health Care – Stanford Hospital Cancer Center Stanford, CA United States 34 Cancer Research Ariake Hospital Tokyo Japan 35 National Cancer Center Goyang South Korea 36 New York-Presbyterian Hospital-Columbia and Cornell Cancer Care New York, NY United States 37 The Christie The Christie NHS Foundation Trust Manchester United Kingdom 38 Policlinico Universitario A. Gemelli Comprehensive Cancer Center Rome Italy 39 Clinica Universidad de Navarra Departamento de Oncología Médica Pamplona Spain x 40 UCSF Medical Center UCSF Hermatology and Oncology San Francisco, CA United States 41 Grande Ospedale Metropolitano Niguarda Department of Hematology and Oncology Milan Italy 42 City of Hope Comprehensive Cancer Center Duarte, CA United States 43 A.C. Camargo Cancer Center Sao Paulo Brazil 44 UCLA Health – Santa Monica Medical Center Oncology Unit Santa Monica, CA United States 45 Antoni van Leeuwenhoek Hospital Amsterdam Netherlands 46 Istituto Nazionale Tumori di Napoli – Fondazione G. Pascale Naples Italy 47 National Cancer Center Hospital East Kashiwa Japan 48 University of Washington Medical Center Fred Hutchinson Cancer Center Seattle, WA United States 49 Hospital Universitario 12 de Octubre Oncología Médica Madrid Spain 50 Northwestern Memorial Hospital Division of Hematology and Oncology Chicago, IL United States 51 Keio University Hospital Cancer Center Tokyo Japan 52 Hospital of the University of Pennsylvania – Penn Presbyterian Abramson Cancer Center Penn Presbyterian Philadelphia, PA United States 53 Hospital General Universitario Gregorio Marañón Oncología Médica Madrid Spain 54 The University of Tokyo Hospital Department of Hematology and Oncology Tokyo Japan 55 Cedars-Sinai Medical Center Department of Radiation Oncology Los Angeles, CA United States 56 Karolinska Universitetssjukhuset Cancer Theme Solna Sweden 57 Jefferson Health – Thomas Jefferson University Hospitals Sidney Kimmel Cancer Center Philadelphia, PA United States 58 National Cancer Centre Singapore (NCCS) National Cancer Centre Singapore Singapore Singapore 59 AP-HP – Hôpital Universitaire Pitié Salpêtrière Centre Intégré de Cancérologie Paris France 60 Presidio Ospedaliero Molinette – A.O.U. Città della Salute e della Scienza C.A.S. Presidio Molinette Turin Italy 61 Fundación Instituto Valenciano de Oncología Valencia Spain 62 St Jude Children’s Research Hospital Childhood Cancer Memphis, TN United states 63 LMU Klinikum Medizinische Klinik und Poliklinik III Munich Germany x 64 Azienda Ospedaliera di Padova Reparto di Oncologia Medica Padova Italy 65 Beth Israel Deaconess Medical Center Cancer Center Boston, MA United States 66 Hokkaido University Hospital Medical Oncology Hokkaido Japan 67 Universitätsklinikum Düsseldorf Klinik für Hämatologie, Onkologie und Klinische Immunologie Düsseldorf Germany 68 Universitätsklinikum Essen Das Westdeutsche Tumorzentrum Essen Germany 69 Thoraxklinik Heidelberg Thoraxonkologie Heidelberg Germany 70 University of Chicago Medical Center Comprehensive Cancer Center Chicago, IL United States 71 MD Anderson Cancer Center – Madrid Madrid Spain 72 Seoul National University – Bundang Hospital Division of Hematology & Medical Oncology Seongnam South Korea 73 Kyoto University Hospital Department for Hematology and Oncology Kyoto Japan 74 Centre Léon-Bérard Lyon France 75 Keck Hospital of USC USC Norris Comprehensive Cancer Center Los Angeles, CA United States 76 Duke University Hospital Duke Cancer Center Durham, NC United States 77 Hospital Clínico San Carlos Oncología médica Madrid Spain 78 Ospedale San Raffaele – Gruppo San Donato Unità Clinica Oncologia medica Milan Italy 79 AP-HP – Hôpital Européen Georges Pompidou Cancérologie Paris France 80 BP – A Beneficência Portuguesa de São Paulo Centro de Oncologia e Hematologia Sao Paulo Brazil 81 Mayo Clinic – Jacksonville Mayo Clinic Cancer Center Jacksonville, FL United States 82 University of Michigan Hospitals – Michigan Medicine Rogel Cancer Center Ann Arbor, MI United States 83 Shizuoka Cancer Center Nagaizumi Japan 84 Addenbrooke’s Department of Oncology Cambridge United Kingdom 85 Universitätsklinikum Münster Medizinische Klinik A Münster Germany 86 Mount Sinai Hospital Christopher Sharp Cancer Centre Toronto Canada 87 UPMC Presbyterian & Shadyside UPMC Hillman Cancer Center Pittsburgh, PA United States 88 Baylor University Medical Center Sammons Cancer Center Dallas, TX United States 89 Vanderbilt University Medical Center Division of Hematology and Oncology Nashville, TN United States 90 Hospital Clínic de Barcelona Instituto Clínic de Enfermedades Hematológicas y Oncológicas Barcelona Spain 91 Roswell Park Cancer Institute Rosewell Park Comprehensive Cancer Center Buffalo, NY United States 92 AP-HP – Hôpital Saint-Louis Oncologie médicale Paris France 93 Fondazione del Piemonte per l’Oncologia – IRCCS Istituto di Candiolo Candiolo Italy 94 Guy’s Hospital Cancer Centre London United Kingdom 95 Policlinico Sant’Orsola-Malpighi Dipartimento Malattie oncologiche ed ematologiche Bologna Italy 96 Brigham And Women’s Hospital Dana-Farber Brigham Cancer Center Boston, MA United States 97 Barnes-Jewish Hospital Siteman Cancer Center Saint Louis, MO United States 98 Universitätsspital Zürich Comprehensive Cancer Center Zürich Zurich Switzerland 99 Institut de Cancerologie de Lorraine Nancy France 100 Emory University Hospital Emory’s Winship Cancer Institute, an NCI-Designated Comprehensive Cancer Center Atlanta, GA United States 101 Helios Klinikum Berlin-Buch Onkologie und Palliativmedizin Berlin Germany 102 Universitätsklinikum Regensburg Comprehensive Cancer Center Ostbayern (CCCO) Regensburg Germany 103 Martini-Klinik am UKE Prostatakrebszentrum Hamburg Germany 104 University of Maryland Medical Center Cancer Services Baltimore, MD United States 105 Universitätsklinikum Tübingen Innere Medizin II Tübingen Germany 106 Moffitt Cancer Center Moffitt Cancer Center Tampa, FL United States 107 Abbott Northwestern Hospital Allina Health Cancer Institute Minneapolis, MN United States 108 Universitätsklinikum Freiburg Tumorzentrum Freiburg – CCCF Freiburg Germany 109 Osaka University Hospital Department of Hematology and Oncology Osaka Japan 110 NYU Langone Hospitals Perlmutter Cancer Center New York, NY United States 111 Toronto General – University Health Network Princess Margaret Cancer Centre Toronto Canada 112 St. Luke’s International Hospital Medical Oncology Department Tokyo Japan 113 Hammersmith Hospital Cancer Centre London United Kingdom 114 Hospital Ramón y Cajal Servicio de Oncología Médica Madrid Spain 115 Policlinico Umberto I Ematologia, Oncologia e Dermatologia Rome Italy 116 Medizinische Hochschule Hannover Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation Hanover Germany 117 Royal Brisbane & Women’s Hospital Cancer care services Brisbane Australia 118 Institut Bergonié Comprehensive Cancer Center Bordeaux France 119 Erasmus MC Erasmus MC Kanker Instituut Rotterdam Netherlands 120 University of Wisconsin Hospitals UW Carbone Cancer Center Madison, WI United States 121 Klinikum rechts der Isar der Technischen Universität München Innere Medizin III: Hämatologie und Onkologie Munich Germany 122 Universitätsklinikum Ulm Comprehensive Cancer Center Ulm (CCCU) Ulm Germany 123 Hospital de la Santa Creu i Sant Pau Medical Oncology Service Barcelona Spain 124 The Royal Marsden Hospital – Surrey Sutton United Kingdom 125 Centre Antoine Lacassagne Nice France 126 King’s College Hospital Cancer care London United Kingdom 127 Ospedale Policlinico San Matteo Oncologia Medica Pavia Italy 128 I.R.C.C.S. Istituto Oncologico Veneto Istituto Oncologico Veneto Padova Italy 129 Institut Paoli-Calmettes Marseille France 130 Universitätsklinikum Frankfurt Hämatologie/Medizinische Onkologie Frankfurt am Main Germany 131 Tohoku University Hospital Cancer Center Sendai Japan 132 Universitätsklinikum Carl Gustav Carus Dresden Nationales Centrum für Tumorerkrankungen Dresden Dresden Germany 133 Royal Prince Alfred Hospital Cancer Services Sydney Australia 134 Universitätsklinikum Würzburg Comprehensive Cancer Center Mainfranken Würzburg Germany 135 Centres de Lutte contre le Cancer Oncologie Médicale Clermont Ferrand France 136 Chonnam National University – Hwasun Hospital Cancer Clinic Hwasun South Korea 137 Boston Children’s Hospital Dana-Farber/Boston Children’s Cancer and Blood Disorders Center Boston, MA United States 138 Children’s Hospital of Philadelphia Cancer Center Philadelphia, PA United States 139 Universitätsmedizin der Johannes Gutenberg-Universität Mainz Universitäres Centrum für Tumorerkrankungen (UCT Mainz) Mainz Germany 140 MedStar Georgetown University Hospital Cancer Care Washington, DC United States 141 Sunnybrook Health Sciences Centre Odette Cancer Program Toronto Canada 142 Hospital das Clinicas da Universidade de Sao Paulo Instituto do Câncer Sao Paulo Brazil 143 Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta UOC NEUROCHIRURGIA 1 – NEUROCHIRURGIA ONCOLOGICA Milan Italy 144 Universitätsklinikum Bonn Medizinische Klinik und Poliklinik III Bonn Germany x 145 University of Colorado Hospital UCHealth Cancer Care Aurora, CO United States 146 Strong Memorial Hospital – University of Rochester Wilmot Cancer Institute Rochester, NY United States 147 Tata Memorial Hospital Department of Medical Oncology Mumbai India 148 Kyushu University Hospital Hematology, Oncology & Cardiovascular medicine Fukuoka Japan 149 St George’s Hospital Cancer Services London United Kingdom 150 Istituto Giannina Gaslini Oncologia Genova Italy 151 University Hospital Of Wales Cancer services Cardiff United Kingdom 152 Changi General Hospital NCCS Oncology Clinic @ CGH Singapore Singapore 153 Instituto do Cancer do Estado de Sao Paulo Sao Paulo Brazil 154 National Hospital Organization Kyushu Cancer Center Fukuoka Japan 155 Universitätsklinikum Leipzig Universitäres Krebszentrum Leipzig Leipzig Germany 156 Montreal General Hospital – McGill University Health Centre Cedars Cancer Centre Montreal Canada 157 Korea Cancer Center Hospital Cancer Center Seoul South Korea 158 Hospital for Sick Children Haematology and Oncology Division Toronto Canada 159 Okayama University Hospital Department of Hematology and Oncology Okayama Japan 160 Ohio State University – Wexner Medical Center The James Comprehensive Cancer Center Columbus, OH United States 161 Centro Médico Teknon Instituto Oncológico Teknon (IOT) Barcelona Spain 162 Queen Elizabeth Hospital Birmingham Cancer Services Birmingham United Kingdom 163 John Radcliffe Hospital Oxford Cancer and Haematology Centre Oxford United Kingdom 164 Austin Hospital – Heidelberg Olivia Newton-John Cancer Wellness & Research Centre Melbourne Australia 165 Hôpital Saint-Antoine Service d’oncologie Paris France 166 Tufts Medical Center Cancer Center Boston, MA United States 167 Hospital Ruber Internacional Oncología Médica Madrid Spain 168 UCLA Health – Ronald Reagan Medical Center Beverly Hills Cancer Care Los Angeles, CA United States 169 Chiba University Hospital Oncology Chiba Japan 170 AP-HP – Hôpital Bichat-Claude-Bernard Service de Cancérologie Paris France 171 Azienda Ospedaliera Universitaria Sant’Andrea U.O.C. Oncologia Rome Italy 172 Duke Regional Hospital Cancer Center Durham Durham, NC United States 173 Nagoya University Hospital Department of Clinical Oncology and Chemotherapy Nagoya Japan 174 Johns Hopkins All Children’s Hospital Cancer & Blood Disorders Institute Saint Petersburg, FL United States 175 Brigham And Women’s Faulkner Hospital Department of Oncology Boston, MA United States 176 OHSU Hospital OHSU Knight Cancer Institute Portland, OR United States 177 Hospital Universitari de Bellvitge Institut Català d’Oncologia Barcelona Spain 178 Aalborg Universitetshospital Onkologisk Afdeling Aalborg Denmark 179 Universitätsklinikum Jena Abteilung für Hämatologie und Internistische Onkologie Jena Germany 180 UPMC Children’s Hospital of Pittsburgh Division of Pediatric Hematology/Oncology Pittsburgh, PA United States 181 Korea University – Guro Hospital Department of Oncology Seoul South Korea 182 St. Bartholomew’s Hospital Barts Health cancer services London United Kingdom 183 Mount Sinai Beth Israel Mount Sinai Tisch Cancer Center New York, NY United States 184 University of Iowa Hospitals and Clinics Holden Comprehensive Cancer Center Iowa City, IA United States 185 Juntendo University Hospital Department of Medical Oncology Tokyo Japan 186 University of Kentucky – Albert B. Chandler Hospital Markey Cancer Center Lexington, KY United States 187 Westmead Hospital The Crown Princess Mary Cancer Centre Sydney Australia 188 Swedish Medical Center Swedish Cancer Institute Seattle, WA United States 189 Gangnam Severance Hospital – Yonsei University Mediz Seoul South Korea 190 Yale New Haven Hospital Smilow Cancer Hospital New Haven, CT United States 191 Houston Methodist Hospital Houston Methodist Neal Cancer Center Houston, TX United States 192 The National Cancer Center Tokyo Japan 193 Alberta Children’s Hospital Pediatric Oncology Clinic Calgary Canada 194 Amsterdam UMC Medische Oncologie Amsterdam Netherlands 195 Universitätsmedizin Göttingen Klinik für Hämatologie und Medizinische Onkologie Göttingen Germany 196 Franciscan Children’s Hospital & Rehab Center Cancer and Blood Disorders Center Boston, MA United States 197 Alfried Krupp Krankenhaus Rüttenscheid Klinik für Onkologie, Gastroenterologie und Hämatologie Essen Germany 198 St Mary’s Hospital Cancer Services London United Kingdom 199 University College Hospital Macmillan Cancer Centre London United Kingdom 200 Universitätsklinikum Erlangen Onkologisches Zentrum Erlangen Germany 201 Nuffield Health – Cambridge Hospital Cancer Care Cambridge United Kingdom 202 Kaiser Permanente Los Angeles Medical Center Cancer Care Los Angeles, CA United States 203 VU Medisch Centrum Kanker & Cancer Center Amsterdam Amsterdam Netherlands 204 Osaka City University Hospital Department of Radiation Oncology Osaka Japan 205 Konkuk University Medical Center Department of Hematology and Oncology Seoul South Korea 206 The Royal London Hospital Haematology Oncology and General Paediatrics London United Kingdom 207 University of North Carolina Hospitals Lineberger Comprehensive Cancer Center Chapel Hill, NC United States 208 Fred Hutchinson Cancer Research Center Fred Hutchinson Cancer Research Center Seattle, WA United States 209 The Clatterbridge Cancer Center Cancer Department Wirral United Kingdom 210 Apollo Speciality Cancer Hospital Apollo Cancer Centre Chennai India 211 University of Virginia Medical Center Cancer Center Charlottesville, VA United States 212 St. Michael’s Hospital Oncology and Endoscopy Toronto Canada 213 IWK Children’s Health Department of Oncology Halifax Canada 214 Akademiska Sjukhuset Onkologmottagningen Uppsala Sweden 215 The Children’s Hospital at Westmead Cancer Centre for Children Westmead Australia 216 Kindai University Hospital Medical Oncology Osaka Japan 217 All India Institute of Medical Sciences – Delhi Department of Medical Oncology New Delhi India 218 California Pacific Medical Center CPMC Cancer Center San Francisco, CA United States 219 CHUL – CHU de Québec-Université Laval Cancérologie Quebec City Canada 220 AP-HP – Hôpital Lariboisière Chirurgie Viscérale, Cancérologique et Endocrinienne Paris France 221 Virginia Mason Medical Center Seattle Cancer Care Seattle, WA United States 222 Hôpital Paris Saint-Joseph Oncologie Paris France 223 Hôpitaux Universitaires de Marseille Conception Unité d’hématologie Marseille France 224 Hadassah Medical Center Mount Scopus Sharett Institute of Oncology Jerusalem Israel 225 Klinikum Chemnitz gGmbH Onkologisches Centrum Chemnitz Chemnitz Germany 226 CHU Strasbourg Oncologie thoracique Strasbourg France 227 Inselspital Bern Medizinische Onkologie Bern Switzerland 228 University of California – Davis Medical Center UC Davis Comprehensive Cancer Center Sacramento, CA United States 229 Hôpital Saint-Joseph Oncologie Médicale Marseille France 230 Flinders Medical Centre Flinders Cancer Clinic Bedford Park Australia 231 Ajou University Hospital Hematology and Oncology Department Suwon South Korea x 232 National Cancer Institute National Cancer Institute Bethesda, ML United States 233 Complejo Asistencial Universitario de Salamanca Oncología médica Salamanca Spain 234 Case Western Reserve University Case Comprehensive Cancer Center Cleveland, OH United States 235 Universitätsklinikum des Saarlandes Klinik für Innere Medizin I – Therapie von Tumor-, Blut-, immunologischen & rheumatologischen Erkrankungen Homburg Germany 236 Apollo Hospital – Chennai Apollo Cancer Centre Chennai India 237 Institut de Cancérologie de l’Ouest Paul Papin Angers France 238 Institut Mutualiste Montsouris Cancérologie/oncologie Paris France 239 Evangelisches Waldkrankenhaus Spandau Onkologisches Zentrum Berlin Germany 240 Hôpital Lyon Sud (HCL) Institut de cancérologie Pierre Benite France 241 Universitätsklinikum Schleswig-Holstein – Campus Kiel Onkologisches Zentrum am Karl-Lennert-Krebscentrum Kiel Germany 242 Aichi Medical University Hospital Cancer Center Nagakute Japan 243 Sydney Adventist Hospital San Cancer Services Wahroonga Australia 244 Carolina East Medical Center Cancer Center New Bern, NC United States 245 Hôpitaux Universitaires de Marseille Timone Pédiatrie et oncologie pédiatrique Marseile France 246 Hospital Universitario Reina Sofía Oncología Médica Córdoba Spain 247 Universitätsklinikum Schleswig-Holstein – Campus Lübeck Universitäres Cancer Center Lübeck (UCCL) Lübeck Germany 248 Centre Hospitalier Universitaire Vaudois Départment d’oncologie Lausanne Switzerland 249 University Hospitals Cleveland Medical Center Cancer Services & Oncology Cleveland, OH United States 250 Hospital Universitario de Basurto Oncología Médica Bilbao Spain 251 Hospital Universitario Fundación Jiménez Díaz Oncohealth Institute Madrid Spain 252 Vancouver General Hospital BC Cancer – Vancouver Vancouver Canada 253 University of California at Irvine Division of Hematology & Oncology Irvine, CA United States 254 Bristol Royal Hospital For Children Bristol Haematology and Oncology Centre Bristol United Kingdom 255 LWL-Universitätsklinikum Bochum Hämatologie und Onkologie mit Palliativmedizin Bochum Germany 256 Centrastate Medical Center Cancer Care Freehold, NJ United States 257 Hospital Universitario de la Princesa Oncología Médica Madrid Spain 258 Robert-Bosch-Krankenhaus Abteilung für Hämatologie, Onkologie und Palliativmedizin Stuttgart Germany 259 Klinik Hirslanden Zürich Onkologie Zürich Switzerland 260 The James Cook University Hospital James Cook Cancer Institute Middlesbrough United Kingdom 261 Centre hospitalier de l’Université de Montréal Oncologie Medicale Montreal Canada 262 Les Hôpitaux Universitaires de Genève (HUG) – Cluse-Roseraie Service d’oncologie Genève Switzerland 263 Glasgow Royal Infirmary Department of Oncology Glasgow United Kingdom 264 London Bridge Hospital Private Care at Guy’s London United Kingdom 265 National University Cancer Institute, Singapore (NCIS) Singapore Singapore 266 Royal Brompton Hospital Department of Oncology London United Kingdom 267 Royal Papworth Hospital Thoracic Oncology Cambridge United Kingdom 268 Ospedale Luigi Sacco Oncologia Sacco Milano Italy 269 Oxford University Hospitals Oncology Oxford United Kingdom 270 Luzerner Kantonsspital Medizinische Onkologie Luzern Switzerland 271 Royal Free Hospital Cancer services London United Kingdom 272 Institute of Clinical Medicine – University of Oslo Comprehensive Cancer Centre (OUS-CCC) Oslo Norway 273 Salford Royal Endocrinology and Metabolic Medicine Salford United Kingdom 274 Wythenshawe Hospital Cancer Services Manchester United Kingdom 275 Singapore General Hospital (SGH) Cancer Singapore Singapore 276 Aarhus Universitetshospital Kræftafdelingen Aarhus Denmark 277 Manchester Royal Infirmary Department of Oncology Manchester United Kingdom 278 The Christian Medical College Medical Oncology Vellore India 279 Baylor St. Luke’s Medical Center Dan L Duncan Comprehensive Cancer Center (DLDCCC) Houston, TX United States 280 Hospital Universitario Puerta de Hierro Oncología Médica Majadahonda Spain 281 Leeds General Infirmary Leeds Cancer Centre Leeds United Kingdom 282 Helsinki University Hospital Comprehensive Cancer Center Helsinki Finnland 283 The Catholic University Of Korea – Yeouido St. Mary’s Hospital Department of Radiation Oncology Seoul South Korea 284 Hirslanden Klinik Beau-Site Onkologie Bern Bern Switzerland 285 Cleveland Clinic Fairview Hospital Cancer Center Cleveland, OH United States 286 Universitätsklinikum Knappschaftskrankenhaus Bochum Onkologisches Zentrum (RUCCC) Bochum Germany 287 Churchill Hospital Department of Oncology Oxford United Kingdom 288 Royal Orthopaedic Hospital Orthopaedic Oncology Birmingham United Kingdom 289 Osaka International Cancer Institute Cancer Control Center Osaka Japan 290 University of California at San Diego Cancer Services La Jolla, CA United States 291 Lindenhofspital Bern Onkologiezentrum Bern Bern Switzerland 292 Clinique Générale-Beaulieu Oncologie (cancérologie) Geneve Switzerland 293 Mount Elizabeth Hospital – Orchard Cancer (Oncology) Singapore Singapore 294 Hospital Universitario Virgen del Rocío Oncología Médica, Radioterápica y Radiofísica Sevilla Spain 295 Hospital Moinhos de Vento Centro de Oncologia Lygia Wong Ling Porto Alegre Brazil 296 Tokyo Metropolitan Komagome Hospital Department of Oncology Tokyo Japan 297 University of Illinois Hospital Cancer services Chicago, IL United States 298 Cliniques universitaires Saint-Luc Institut Roi Albert II Brussels Belgium 299 Leicester Royal Infirmary Oncology Service Leicester United Kingdom 300 Great Ormond Street Hospital Haematology and Oncology Department London United Kingdom

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Business

Tumor-infiltrating lymphocytes therapy treats cancers at a large scale

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A novel treatment strategy with personalized cell therapy significantly improves progression-free survival compared to standard immunotherapy in patients with advanced melanoma, according to ground-breaking results reported at the ESMO Congress 2022 from the phase 3 M14TIL trial.

“This study shows for the first time in a randomized, controlled trial that cell therapy can be efficacious and beneficial for patients with solid cancers,” said lead author John Haanen, Netherlands Cancer Institute, Amsterdam, Netherlands. “For patients with melanoma, we see a 50% reduction in the chance of progression of the disease or dying from the disease, which is absolutely practice changing. This is the first time that a TIL-based approach has been compared directly to standard-of-care treatment, in this case ipilimumab. So we are now able to position TIL treatment much better in the management landscape for patients with metastatic melanoma.”

“TIL therapy is an extraordinary therapy,” commented George Coukos, Lausanne University Hospital and the Ludwig Institute for Cancer Research, Lausanne, Switzerland, who was not involved in the study. “TIL is a new paradigm for treating cancers and, as these results clearly demonstrate, it’s efficacious and feasible at large scale. The findings raise hopes for the management and potential cure of metastatic solid tumors.”

The treatment essentially involves taking a small sample from a patient’s resected tumor, growing immune T cells from the tumor in the laboratory and then infusing the personalized TIL therapy back into the patient following chemotherapy. TILs recognize tumor cells as abnormal, penetrate them and then work to kill them.

The phase 3 M14TIL trial randomized 168 patients with unresectable stage IIIC-IV melanoma to immunotherapy with the anti-CTLA-4 antibody ipilimumab or to TIL treatment; most patients had failed prior anti-PD-1 treatment. Results reported for the first time at the ESMO Congress 2022 showed that patients treated with TIL therapy had significantly longer median progression-free survival of 7.2 months compared to 3.1 months in those receiving ipilimumab; the overall response rate to TILs was 49% versus 21% for ipilimumab; median overall survival was 25.8 months versus 18.9 months. Patients are still being followed up for overall survival.

Treatment options for patients with metastatic melanoma have changed considerably over the last 10 years with the development of checkpoint inhibitors, including the PD-1 inhibitors nivolumab and pembrolizumab and the CTLA-4 inhibitor ipilimumab. These drugs release a natural brake on the immune system so that the body’s own immune cells can recognize and attack tumor cells. “They have a very good safety profile and quite high efficacy and are now often given as first-line therapy. But if patients fail first-line treatments then the options become very scarce, particularly for patients failing anti-PD-1 drugs so there is a real unmet need,” explained Haanen. He added: “In our study, 89% of patients had failed anti-PD-1 treatment.” The remaining patients joined the trial before anti-PD-1 therapies were licensed.

Exploring the possible mechanism by which TIL therapy is effective in patients who have failed anti-PD-1 treatment, Haanen suggested: “We think that the mechanism of resistance to anti-PD-1 treatment is mostly delivered by the tumor microenvironment. So when we take these cells out of their natural environment, reactivate them in the laboratory, grow them up to very large numbers and give them back to the patients we can overcome some of the escape mechanisms. And that’s what we are seeing – otherwise TILs wouldn’t work in this setting.”

Even though grade 3 or higher adverse events occurred in all patients treated with TIL therapy and 57% of those randomized to ipilimumab, Haanen specified: “The side-effects are well manageable and most resolve by the time patients leave the hospital after their TIL therapy”. He also added that most side-effects are related to the other therapies, including chemotherapy and interleukin-2, that patients receive as part of the TIL regimen. About the impact of TIL therapy, Haanen concluded: “TIL has the potential to benefit patients with a wide range of solid tumors and trials are currently underway in many cancer types, including lung, cervical and head and neck cancers.”

Haanen explained that the trial was run by academics in the Netherlands and Denmark, with no industry involvement. The researchers are now working to obtain EMA approval for their TIL therapy to try to ensure that it remains affordable, free from commercial pressures.

“The results from this phase 3 study could potentially lead to regulatory approval that would be practice changing,” said Coukos. “It would enable countries that would consider this path to establish centers that can deliver TIL therapy for patients and establish this a potential second-line treatment in advanced melanoma.”

Source:

European Society for Medical Oncology

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Health

Woman’s Advanced Pancreatic Cancer Shrinks After Gene Treatment

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Photo: Shutterstock (Shutterstock)

In new research this week, an experimental treatment seems to have helped beat back a woman’s advanced pancreatic cancer. The woman’s tumors have since substantially shrunk in size and she has remained in stable health a year after the treatment—results that hold promise for a new approach to these kinds of often fatal cancers.

The treatment is a form of immunotherapy, a recently developed method of fighting cancer. The premise is simple enough: teach the immune system to kill cancer cells that it normally wouldn’t. Often, this is done by genetically altering T-cells to carry new receptors on their surface, receptors that allow the cells to now recognize a protein, or antigen, found in certain cancer cells.

Immunotherapy treatments have succeeded in improving many people’s odds of survival against advanced blood cancers like leukemia. But it’s proven harder to train the immune system to go after solid tumors, which can form anywhere in the body. Researchers at the Providence Cancer Institute, however, believe that they may have found a way around these hurdles, at least for some patients.

Their earlier research has shown that some T-cells can naturally identify a particular mutant version of an antigen found in some solid tumors, known as KRAS G12D. They theorized that the T-cells of people with the right genetic compatibility could be reprogrammed to target tumors that contain this mutant KRAS. The patient in this new study, identified as Kathy Wilkes by the Associated Press, turned out to have just such a cancer, and she was genetically compatible to boot.

Last June, Wilkes received a single infusion of her T-cells, which were altered to carry two receptors important for recognizing the mutant antigen in the lab and then grown en masse. Six months later, her metastatic tumors had seemingly shrunk by 72% percent, while the altered T-cells continued to linger, accounting for 2% of circulating peripheral T-cells in her system. And recent check-ups haven’t found any signs of her condition worsening. The team’s findings were published Wednesday in the New England Journal of Medicine.

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“It’s really exciting. It’s the first time this sort of treatment has worked in a very difficult-to-treat cancer type,” Josh Veatch of the Fred Hutchinson Cancer Research Center, who is not affiliated with the research, told the AP.

This improvement is obviously not a full remission. But following conventional treatment with chemotherapy, radiation, and surgery, Wilkes’ cancer began to spread outside her pancreas, leaving her with few options and little chance of long-term survival. Reportedly, she herself sought out doctors at the Providence Cancer Institute after hearing about their research. And the team was able to perform the procedure with approval from the Food and Drug Administration.

Encouraging as these results are, they come from a sample size of one. And an earlier patient of the institute failed to show any improvement following treatment. So it will take more clinical research to confirm that this method really can help compatible patients. Elsewhere, other research teams are working on their own ways to boost the potential of immunotherapy for solid tumor cancers, such as by using cancer-killing viruses in conjunction.

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