On the pulse 27 March 2913

  • Patient Support Group with Mr Debashis Ghosh MS, FRCS(Edin), FRCS(General Surgery – Breast)
  • Awareness Event at the New Testament Church of God, Clapton
  • Research has shown the risk of heart disease after breast cancer radiotherapy is less than previously thought

 

Patient Support Group with Debashis Ghosh

We were very pleased to welcome Mr Debashis Ghosh to this month’s Patient Support Group. A Consultant Breast and Oncoplastic Surgeon at the Royal Free, Mr Ghosh gave a fascinating talk on oncoplastic surgery; a comprehensive approach to surgical planning that combines the principles of surgical oncology with plastic and reconstructive surgery. His lecture was comprehensive, and very clear, tracing the evolution of this form of surgery before discussing current types of surgery and how particular procedures are chosen that are best for the patients.

 

The talk was so well-received, with patients commenting that it had been one of the most interesting and engaging talks that they had attended at Cancerkin. Comments included that it was ‘Honest, Clear, Positive’, ‘full of positive ideas, hope and faith’ and ‘Mr Ghosh is a man we can trust’. Therefore, on behalf of all the patients who attended, we would like give Mr Ghosh a massive “thank you” for donating his time to give such a clear and informative talk.

 

The next patient support group will take place on Tuesday 30th April, from 11.00am to 1.00pm, while April’s Young Women’s Support Group (for patients under the age of 45) will take place on Wednesday 17th April. For more information about any of these sessions, or to reserve a place, please contact Reema on r.ved@cancerkin.org.uk or call us on 020 7830 2323.

 

Awareness Event at the New Testament Church of God, Clapton

Last week, Anisah and Awareness Ambassador Afaf Deria gave a breast awareness talk at the New Testament Church of God, Clapton in Hackney. Their talk focused on the signs and symptoms of breast cancer and was well received with lots of audience interaction and a long question and answer session. Feedback from the women who attended was very positive, with comments including “Excellent presentation – raised awareness and confidence” and “Excellent presentation – I found a lot of information that I was not aware of”.

 

The East London team were greeted with such enthusiasm and happy smiles; we would really like to say a big “thank you” to everyone who attended. We would like to particularly thank both Afaf Deria for her time and Evette Rodder for organising the session and welcoming us with such hospitality.

 

We are always looking for more community groups that could benefit from a breast awareness session. If you know of any, please contact Anisah on EastLdn@cancerkin.org.uk or call her on 020 7830 2323.

 

Research has shown the risk of heart disease after breast cancer radiotherapy is less than previously thought
A study published in the New England Journal of Medicine has, for the first time, calculated by how much radiotherapy for breast cancer increases the risk of heart disease. While, it has been known for a long time that radiotherapy often reduces the risk of breast cancer reoccurring after surgery, the heart often receives some incidental radiation exposure during this treatment. This is particularly true if the cancer is in the left breast or if the lymph nodes inside the chest are irradiated.

However, until now, doctors have been uncertain as to whether modern radiotherapy still increased the risk of heart disease, and, if it did, how big the risk was. This study, carried out by scientists at the University of Oxford and in Scandinavia, considered over 2,000 women treated with radiotherapy in Denmark and Sweden and found that while the risk of radiation-related heart disease was real, for most women it was small. It has also, for the first time, produced a dose-response relationship for ischaemic heart disease, the most common form, which means that doctors will now be able to use these findings to help treat patients by predicting the size of the risk for each individual.

The amount of radiotherapy given to patients is measured in Gray (Gy). For women with right-sided breast cancer, most radiotherapy regimes expose the heart to one or two Gy. The amount varies widely for left-sided breast cancer but is usually higher.

However, the study found the increased risk of heart disease after radiotherapy was modest. For example, a 50-year old woman with no cardiovascular risk factors has a 1.9 per cent chance of dying of heart disease before she turns eighty. After radiation treatment for breast cancer, in which the heart received 3 Gy, the risk increased to 2.4 per cent. This is outweighed by the benefit from radiation treatment, which can halve the recurrence rate and lower the death rate from breast cancer by about one-sixth.

The study also found that there are a few women who would have a substantial increase in the risk of heart disease if radiotherapy is given the usual way. This includes women who are already at increased risk of heart disease and women for whom the distance between the heart and the chest wall is very small.

Professor Sarah Darby, study author based at the University of Oxford, said: “We carried out this work because doctors could not reliably estimate the risk of heart disease in women treated with radiotherapy for breast cancer.  Doctors can now estimate the risk and know that in most cases it will be very small so that they can reassure their patients.  In addition, the few women for whom radiotherapy poses undue risk can now be identified, so that alternative techniques can be considered.”

Dr Carolyn Taylor, another study author at Oxford University’s Clinical Trial Service Unit, added “Already our work is being used in cancer centres throughout the world and we’ve heard it’s making a difference to patients. It’s important to remember that for most women treated today the benefits of breast cancer radiotherapy far outweigh the risks.”

For more information, please see Cancer Research UK or the New York Times.

Holly Lovering                                                                                                                    27th March 2013

On the pulse 20 March 2013

  • Annual Lecture 2013
  • Hyde Park Walk 2013 – Registration open!
  • Volunteers needed…
  • Cancerkin’s Pamper Day 2013
  • Blood tests could provide a simple way to monitor a patient’s response to breast cancer treatment
  • The Telegraph’s breast cancer series

Annual Lecture 2013
The Annual Lecture was held on the 19th March and was a great success. Professor Dame Carol Black DBE MD FRCP MACP FMedSci, Principal of Newnham College, Cambridge, the first UK National Director for Health and Work and current chair of the Department of Health’s Public Health Responsibility Deal, Health at Work Network gave a fascinating talk exploring the issues surrounding chronic disease and employment. As one guest noted, the talk was “not only very relevant and beneficial to the patients but also very current in light of all the upcoming NHS changes and programmes”. For a flavour of the topics discussed, please see our twitter feed, as we ‘live-tweeted’ the evening.

Dame Carol also answered questions after the lecture, which included how line managers and colleagues have a big impact on how successful a return to work is and how hospitals and GPs could facilitate the process.  As she said, if she had the money, she would put it into management!

We would like to say a big thank you to John Carrier, Cancerkin President, for leading the evening and Tim Davidson, Cancerkin’s Medical Director for chairing the question and answer session. We would especially like to thank Dame Carol for what was a most enlightening and enjoyable talk.

Hyde Park Walk 2013 – Registration open!
The Hyde Park Walk, our flagship event, will take place this year on Sunday 9th June 2013. We will be sending out invitations in the next few weeks, but it you can’t wait to register, you can find the 2013 entry form on our website.

The Hyde Park Walk is always a great day out and we would love for you to join us with your friends, family and colleagues. Teams are always encouraged; for photos of the fun at last year’s event, please see our website or facebook group.

If you have any questions, please contact Holly on h.lovering@cancerkin.org.uk or call us on 020 7830 2323.

Volunteers needed…
Following on from that message about the Hyde Park Walk invitations, it’s time to ask for help to fold letters and stuff envelopes again! We are looking for volunteers to help with the mail out for the Hyde Park Walk. If you have any time to spare over the next few weeks (no matter how small!) and would like to come along and help, we would love to hear from you. Any helpful friends, family or neighbours you can bring along will be welcomed as well. We will, of course, provide tea, coffee and biscuits.

Please contact Holly, either on h.lovering@cancerkin.org.uk or on 020 7830 2323, if you would like to help.

Cancerkin’s Pamper Day 2013
Photos from our Pamper Day can now be seen on our website and facebook group. Take a look!

Blood tests could provide a simple way to monitor a patient’s response to breast cancer treatment
A new study published in the New England Journal of Medicine has shown that breast tumour DNA circulating in the bloodstream could be used to measure how well a patient’s breast cancer is responding to treatment.

Researchers at the Cancer Research UK Cambridge Institute at the University of Cambridge took regular blood samples from 30 women, who were having chemotherapy for metastatic breast cancer, for two years. They focused on three biomarkers that can measure how advanced the disease is: circulating tumour DNA, levels of a protein called Cancer Antigen 15-3 and free-floating tumour cells.

They then compared these results with CT scans to see if changes in the biomarkers matched up with changes in the cancer. They found that tumour DNA in patient’s blood gave the most accurate ‘real time’ picture of the changes taking place in the body, tracking the cancer changes through several cycles of treatment. This study also indicated that tumour DNA can reveal how a patient’s cancer is changing and evolving on a genetic level; for example, the scientists were able to find faults in specific genes in some patients’ cancers that weren’t there when their tumours were first biopsied.

Professor Carlos Caldas, co-lead author of the article, said: “This study offers a practical application of cancer genomics and highlights the potential of personalised cancer medicine. By understanding the point at which a cancer changes we can select the most effective treatments and minimise side effects for patients.”

This technique could provide an alternative to invasive biopsies, quickly and easily monitoring the responses of patients to treatment, particularly in cases where repeat biopsies would be prohibitively expensive and invasive.

However, while these results are very exciting, they are based on samples from a very small number of women. More testing with a much larger group of patients is needed to prove that measuring tumour DNA is an accurate and reliable way of monitoring cancer.

For more information, please see articles here and here on the Cancer Research UK website and the a further article on the Nature website.

The Telegraph’s breast cancer series
Last week the Telegraph published a five-part series in which Baroness Delyth Morgan (CEO, Breast Cancer Campaign), Antonia Dean (Clinical Nurse Specialist, Breast Cancer Care) and their own Judith Potts answered readers’ questions on many issues related to breast cancer.

To view this informative series, please see the Telegraph’s website.

On the pulse 13 March 2013

  • March’s Patient Support Group with Mr Debashis Ghosh
  • Young Women’s Support Group
  • Scientists develop laser that could identify cancerous lumps without the need for a biopsy

March’s Patient Support Group with Mr Debashis Ghosh
We are very pleased to say that at this month’s PSG, taking place on Tuesday 26th March from 11am to 1pm, Mr Debashis Ghosh, Consultant Breast and Oncoplastic surgeon at the Royal Free Hospital will talk to us about his work. His areas of special interest are: treatment of breast cancer; screening; family history; benign breast disease; gynaecomastia; oncoplastic breast conservation; risk reducing surgery; revision; reconstruction; symmetrisation surgery; and intraoperative radiotherapy. He is a co-author of the chapter on breast and oncoplastic surgery, in Kirk’s Operative Surgery.

Mr Ghosh is actively involved in breast surgery research including the pioneering use of a portable gamma camera for sentinel node biopsies. As a member of the Breast Team of the Royal Free and UCL Medical School, he is involved in trials in the use of intraoperative radiotherapy, radioactive iodine and seed localisation. He is currently working on the use of fluorescence in cancer surgery. (Cancerkin donated the Intrabeam Intraoperative Radiotherapy Device to the RFH in October 2009 after raising £250,000 to buy it).

We are very lucky to secure Mr Ghosh, and so would love to see as many of you as possible for what is sure to be an interesting and relevant talk on the latest developments in breast cancer treatment. Please contact Reema, on r.ved@cancerkin.org.uk or 020 7830 2323 for more information or to reserve your place

Young Women’s Support Group
At this month’s Young Women’s Support Group, we were delighted to be joined by Tina Kelleher, who works at the Royal Free as a Specialist Nurse Practitioner – Breast. Tina answered a variety of questions about drug side effects and the menopause in cancer treatment, clarifying some of these complex issues for us.

As usual, it was great to see everyone sharing their experiences and swapping support and advice with each other. We would like to say a big “thank you” to Tina for once again donating her time to speak to our patients. For details on next month’s young women’s group (taking place on 10th April 2013, from 4.00pm to 6.00pm) please contact Reema on r.ved@cancerkin.org.uk or call us on 020 7830 2323.

Scientists develop laser that could identify cancerous lumps without the need for a biopsy
Scientists at the Science and Technology Facilities Council in Oxfordshire are developing an instant laser test for breast cancer, which would be carried out at the same time as a mammogram. This would remove the need for a return hospital appointment.

Currently, if a breast x-ray or mammogram shows abnormalities a cell sample is then taken using a needle. Up to 90% of these biopsies come back negative.

However, this new technology can pinpoint dangerous changes without breaking the skin. It works by shining a laser on suspicious areas and analysing the reflected light. The pattern and colour of the light that is bounced back depends on the chemical composition of the breast, and so cancerous lumps produce a different ‘signature’ to benign ones.

This test can be carried out at the same time as the mammogram, removing the need for a second hospital appointment as well as the worrying wait for a result.

Lead scientist, Nicholas Stone, said: “This technique, if applied at mammography, could have a huge impact on those 75,000 patients a year having to return for biopsies, with associated anxiety, when they are found to have nothing wrong.”

This trial is still in a very early stage, but tests on pork have produced promising results and work on human breast tissue is due to start. It is likely, however, to be a decade before the test can be proved accurate and safe enough to be used in hospitals.

Dr Laura McCallum, of Cancer Research UK, said: “If the researchers can prove this technology can tell what is cancer and what’s not, it could save some women from an invasive test and an anxious wait.”

Mia Rosenblatt, Head of Policy and Campaigns at Breast Cancer Campaign also welcomed the research into new technologies to make detection of breast cancer easier, saying: “The concept of a laser test to spot breast cancer has huge potential benefits in reducing anxiety for the patient as well as resulting in time savings for the NHS. The research is at an early stage so much more testing is needed before it can be used in everyday practice but this could be one to watch in years to come.”

For more information, please see the Telegraph or Breast Cancer Campaign.