Tag Archive for: Cancer Treatments

June 2023 Notable News

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June brings many challenges for cancer patients and new knowledge can help fight the disease. Insurance companies have taken the fight to the supreme court to try to avoid paying for cancer screening tests. A shortage of two cancer drugs is having a significant impact on cancer patients in the U.S. Obesity has been found to be a rising risk factor for cancer, affecting men and women differently.

Survey Finds Majority of Cancer Patients and Survivors Would be Less Likely to Get Recommended Screenings if Costs Were Added

Thanks to a provision in the Affordable Care Act (ACA) that requires evidence-based prevention and early detection at no cost to patients with private insurance, we’ve seen improved access to recommended services that detect disease when it is less costly to treat, and chances of survival are greater reports American Cancer Society. A new ruling in the case Braidwood v Becerra, in the US District Court in Texas, is threatening that access for patients. Patients surveyed said that a cost between $100 to $200 for preventative tests would be a burden to them financially and would be a barrier to getting those lifesaving tests. The cost increase incurred can either be from annual screening or lifesaving treatments. Cancer patients already face challenges in finding a provider due to cost. A patient navigator is also a beneficial service for cancer patients and has been shown to help influence better outcomes. The cost of the navigator can be prohibitive for patients. Insurance cutbacks are a matter of life and death for many cancer patients. Click here for more information.

Carboplatin, Cisplatin Chemotherapy Drug Shortages Delaying Some Cancer Treatments in New York

We’re really in an unprecedented situation in the cancer field, said Dr Richard Carvajal, a medical oncologist who helps run Northwell Health Cancer Institute. Carboplatin and cisplatin shortages are delaying treatment, forcing doctors and patients to make tough choices, according to Carvajal reports CBS News. These two drugs are used in 10 to 20% of cancer patient treatment in New York. Doctors are having to give lower doses or fewer doses of this chemotherapy to patients. The National Comprehensive Cancer Network released a study that found 93% of cancer centers in the U.S. are experiencing this shortage reports CBS News. In January, a large plant in India had quality control problems with much of its supply causing this shortage. Doctors must choose who gets treatment and who does not. The FDA is trying to get the cancer drugs sent from China to help correct the shortage. Patients should talk with their physician about their best option. Click here for more information.

Women and Men Face Different Cancers- Depending on Where Fat Falls

To investigate the links between cancer and obesity among men and women, Rask- Anderson and other researchers turned to the UK Biobank, a biomedical database with genetic and health information from more than half a million participants across the UK reports New York Post. The research has shown that all cancers are influenced by obesity except for brain, cervical, and testicular cancers. Obesity causes men to be more at risk for breast, liver, and kidney cancers. For women, obesity causes them to be more at risk for gallbladder, endometrial, and esophageal cancers. An increase in fat accumulation in the abdomen makes women more at risk for esophageal cancers. An increase in total body fat in men cause a higher risk for liver cancer. Postmenopausal women are at a higher risk for breast cancer when they are obese. Obesity is the fastest growing risk factor for cancer. Click here for more information.

Immunotherapy in the Elderly

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This blog was originally published by Cancer Today by Emma Yasinki here.

Immune checkpoint inhibitors can be effective treatments for elderly people with some types of advanced cancer, but more information is needed on their risks and benefits in this group.

by Emma Yasinski

​Photo by graffoto8​ / iStock / Getty Images Plus

CHECKPOINT INHIBITORS, a type of immunotherapy drug, help spur the immune system to kill cancer cells. These drugs can be effective treatments for some patients who otherwise would have few options.

Beginning in 2011, with the approval by the U.S. Food and Drug Administration of the first checkpoint inhibitor, seven of these immunotherapy drugs have come onto the market for treatment of various cancer types.

Enthusiasm for these drugs is widespread, including among elderly patients with advanced cancer. Now, some frail elderly patients who might previously have opted out of chemotherapy are choosing immunotherapy in hopes of achieving a long-term response.

But data on immunotherapy side effects and outcomes are more limited in elderly people than in younger patients. Some doctors worry that all the excitement surrounding checkpoint inhibitors is preventing older patients from getting palliative and hospice care that could be more likely to improve their lives.

Rawad Elias, an oncologist at Hartford Hospital in Connecticut, studies immunotherapy in older patients and presented on the topic at the American Society of Clinical Oncology Annual Meeting in Chicago in June 2019. Cancer Today spoke with Elias about the benefits and risks of checkpoint inhibitors and how their availability may affect treatment decisions for older patients.

Q: Are there common misconceptions among patients and families about checkpoint inhibitors?
A: We’re very excited about [immunotherapy] because it’s an option now other than chemotherapy, [but] it doesn’t work in all cancers. Even in the cancer[s] that it works for, it doesn’t work in all patients. And most patients, in fact, do not respond to checkpoint inhibitors.

We often see patients who … ask us, “OK. How about immunotherapy?” And we’ll have to explain that, unfortunately, in your type of cancer, it doesn’t even work.

Q: What do we know about the efficacy of checkpoint inhibitors in older patients?
A: Unfortunately, older adults are underrepresented in clinical trials. Older adults constitute about 60% of cancer patients, and [in] the clinical trials of checkpoint inhibitors, they [made up] about 40% [of participants]. Also, patients who are enrolled on clinical trials are usually the … fit people with [few] medical complications. So we don’t really understand the clinical profile of these drugs in the real-world population.

We did some work in the past looking … if the efficacy of the checkpoint inhibitors is similar across age groups. We published that in the Journal for ImmunoTherapy of Cancer based on [an] age cutoff of 65. The efficacy of checkpoint inhibitors was considerable in younger and older adults. What we don’t know about, though, is what’s the impact of frailty on these medications? And does that make patients more prone to toxicity? Does it make the efficacy of the drug less?

Q: What are the special considerations older patients need to take into account when considering checkpoint inhibitor therapy?
A: What we don’t know about … is the impact of low-grade toxicity or any toxicity on older adults. We tend to call things like fatigue or a little bit of nausea “low-grade” toxicity, but we don’t know the impact of this low-grade toxicity on an 80-year-old person who already has trouble getting out of the house.

When it comes to older patients with an advanced cancer, this is a really critical thing to discuss: What’s your quality of life during this period of time, and what matters most to you as a person? The goal is not to go and treat the cancer. The goal is to treat you as a person. And it’s only you as a patient who gets to determine: What does that mean?

For example, [one of my patients], even though therapy could have been an option for her, she’s a frail older adult. We talked about [the fact that] the impact of treating her with immunotherapy would be potentially more fatigue and coming to the doctor’s office [more frequently]—coming in once every two weeks or once every four weeks … getting bloodwork, waiting in the waiting room to see the doctor and then getting the infusion, then going back home, then coming back again. So the question is: Does that make sense to you? My patient … decided that doesn’t make sense to her based on what we think … [immunotherapy] is going to achieve.

Q: Why are some people concerned that the increasing popularity of checkpoint inhibitors could hinder access to palliative and end-of-life care?
A: Unfortunately, when we’re treating cancer patients, we’re treating a very hard disease and even small things get us excited. In the hype or the excitement about checkpoint inhibitors, many may skip that conversation [about risks and alternatives like palliative care] and go straight to, “Let’s start you on checkpoint inhibitors and see what happens.” And what’s happening in most patients is that they do not respond, and we forget about palliative care which we know, for sure, makes people have a better quality of life, keeps them outside the hospital, keeps them at home. This is not to say older adults should not be treated, but to say that there are concerns about these drugs. They do not work for everyone.​ ​​

Emma Yasinski​ is a Florida-based freelance science and medical journalist.​