CANCER CARE
increase the irratiated tissue to the size of a small orange. This is to take into account of; not being sure exactly where the edge of the tumour is, the fact that no matter how precisely you position the patient, they are likely to move and wriggle and that, inevitably, bodies change shape as organs such as the bladder and stomach fill and empty. To allow for these effects we have to treat a bigger volume of tissue and the beams of radiation need to cover a big enough area to take this into account.
“However, we need to keep this overlap area to an absolute minimum and if we can carry out the imaging immediately prior to carrying out the treatment, we then have the ability to limit the safety margin to a minimum.
“Long term that offers the prospect of reduced side effects and possibly increase tumour control because radiotherapy is a delicate balancing trick where you know that you are going to damage some normal tissues. But this is a good trade for knowing that you are going to kill the tumour.
“If we can reduce the number of side effects by around 5 per cent, then with the patient’s informed consent a clinician could perhaps accept a smaller reduction in the side effects in order to increase the dose to the tumour. By changing the balance we have the chance to lessen morbidity and increase tumour control, even if only slightly, by one or two per cent.
“In basic terms, we might be able to cure 51 per cent of patients, instead of half. This is only a small change but at Oldham we will treat 1,200 patients a year and the small change could result in saving an extra twelve patients every year. Each of those patients is an individual and you want to do the best for them.”
26 nhe
A Significant advance announced in
treatment of cervical cancer
medical researcher at the University of Leicester has made
a significant advance in the treatment of cervical cancer.
Dr Paul Symonds from the Department of Cancer Studies and Molecular Medicine has demonstrated that the use of a particular drug in collaboration with radiotherapy gives significantly better results than radiotherapy alone.
The study used the case histories of 1,412 patients from 42 different cancer treatment centres which were collected in 2001-2 as part of an audit which Dr Symonds led for the Royal College of Radiologists.
This information included not
only the treatment used but also follow-up notes which continued for five years on average, indicating whether or not cancer recurred in the pelvic area.
The new research, supported by the Medical Research Council, studied the use of a drug called cisplatin, a platinum-based molecule which directly affects the DNA strands within cells to cause controlled cell death or ‘apoptosis’.It was already known that a combination of radiotherapy and cisplatin was more effective than radiotherapy alone in curing cancer of the cervix but there was no reliable data on the long-term effects of the combined treatment.
Working with colleagues in London and Manchester, Dr
Symonds examined the long- term survival rates of patients after the treatment was complete. Complex statistical analysis was used to eliminate variable factors in comparing radiotherapy with ‘chemoradiotherapy’.
The results showed that the addition of cisplatin to radiotherapy treatment of cervical cancer reduces the likelihood of death by a full 23 per cent.
This is an important breakthrough and will be featured in the September issue of the publication Clinical Oncology alongside an editorial written by patients who have recovered through the dual treatment and another editorial presenting a doctor’s view.
Benefit from breastscreen mammograms questioned in new study
A
new study suggests benefits of breast cancer screening may
be more modest than previously estimated.
In a nationwide study in Norway, women in their 50s and 60s who got a mammogram every other year reduced their risk of dying from breast cancer by only a “modest” 10 per cent, compared with those who didn’t get the exams, according to a study in today’s New England Journal of Medicine.
While deaths from breast cancer fell 28% from 1996 to 2005 among participating women, they also fell 18% for unscreened women.
The study’s authors argue that mammograms can’t get all the credit for the falling death rate.
Instead, mammograms probably cut mortality by only 10%, the difference between the two groups, the study says.
That’s a much smaller benefit than the UK screening programmes figure of 35 per cent, put forward in their 20 year review published in 2009.
Professor John Boyages, a leading expert on breast cancer and author of Breast Cancer: Taking Control, agrees with the conclusions of the study.
Boyages - currently on sabbatical at Oxford University and Great Western Hospital in Swindon - has published more than 130 research and clinical articles about the subject of breast cancer.
He says the new study supports
his view – put forward in his new ‘breast cancer bible’, released this week in the UK – that getting the right treatment is critical to survival.
But, he adds, screenings also play their part.
Speaking from his home in Oxford, he said: “The study was very well done and the results are realistic. We probably can’t continue to quote screening results from the ‘70s and ‘80s when care was more fragmented and we didn’t have better hormonal treatments, chemotherapy and targeted therapy.
“It’s not enough to pat ourselves on the back when we find a cancer. We must make sure women get the right treatment the first time.
Sep/Oct 10
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