On the pulse 26 September 2013

Breast Cancer Awareness Month
October is Breast Cancer Awareness Month and we have an exciting month planned for our supporters!

First, our theatre event is taking place at the Hampstead Theatre on Monday 7th October. This year’s play is Hysteria and stars Antony Sher as Sigmund Freud. There will be a drinks reception before the performance and a raffle held, with excellent prizes including a week in a Portuguese villa.

On Wednesday 9th October, we will be holding our annual Breast Cancer Awareness Stall in Royal Free Hospital. Cancerkin staff will be running a stall outside the Atrium, talking to people who pass by and handing out literature to raise awareness of the importance of checking your breasts regularly and demonstrating the correct technique. If you would like any information on how to check your breasts, or you are in the area, please do come and say “hello” and learn just how important regular checks can be.

On Tuesday 15th October, the Royal Free London NHS Trust will be holding a talk entitled Breast cancer awareness and innovations in treatment. The talk will take place the Sir William Wells Atrium, from 6.30pm to 8.00pm and will include interactive demonstrations of the latest technologies available at the Royal Free. Cancerkin will also have a stall at the event, explaining the non-medical support we offer to breast cancer patients.

Speakers will include Tim Davidson, consultant breast surgeon and clinical lead, Mo Keshtgar, professor of cancer surgery, Katharine Pigott, consultant clinical oncologist and Alison Jones, consultant medical oncologist. Mr Davidson is the Cancerkin Medical Director and Mr Keshtgar, Dr Pigott and Dr Jones are all members of Cancerkin’s Medical Advisory Panel.

For more information, or to book your free place, please email rfh.membership@nhs.net or call Nancy Bell on 020 7830 2071.

Regulators have approved a new “Herceptin jab”
Central funding bodies have approved a new Herceptin injection for HER2 positive breast cancer patients.

Currently, around 10,000 women a year are diagnosed with the aggressive HER2 positive breast cancer, which requires Herceptin to be given intravenously. Patients then require an average of 18 Herceptin doses – one every three weeks – a procedure that takes between an hour and ninety minutes each time.

Administering Herceptin via an injection, however, only takes between two and five minutes, potentially saving patients up to 25 hours in hospital over the course of their treatment. This could dramatically improve quality of life for patients, particularly those whose treatment can last over a year. The time saved could also mean major savings to the NHS, if it is introduced routinely.

The ease with which Herceptin can now be administered could mean that in future, it could now be offered in community clinics, closer to the patient’s home, which would make life easier for the patients.

Sally Greenbrook, Senior Policy Officer at Breakthrough Breast Cancer, said: “This is a good example of how research can make improvements to patients’ quality of life as well saving considerable time and money for the NHS. For eligible patients, the option to have their Herceptin administered by injection, rather than through a drip, will appeal to them and we’re pleased that this treatment will now be routinely available on the NHS.”

Professor Lesley Fallowfield, Director Sussex Health Outcomes Research & Education in Cancer, University of Sussex said: “Time is precious to women with breast cancer, far too precious to be waiting around in busy chemotherapy centres. If subcutaneous delivery of Herceptin were to replace intravenous administration in the NHS then patients would spend less time in hospital and more time getting on with their lives.”

For more information, please see the Telegraph, the Daily Mail or Breakthrough Breast Cancer.

On the pulse 20th September 2013

  • Look Good…Feel Better!
  • Study proves ‘brain fog’ is a side-effect of tamoxifen treatment

Look Good Feel Better!
The fabulous team from Look Good Feel Better joined us on Tuesday 17th September. The trained beauty therapists taught eleven women about skin care and how to hide some of the visible effects of treatment, whilst also giving general advice on how to expertly apply make-up. Everyone who attended also received a free make-up pack containing beauty products from well-known brands to let them recreate their looks at home!

Everyone who attended spoke of how useful and enjoyable they found the session, with comments such as “it was all wonderful” and “it was extremely good. I am very grateful. I really appreciated this boost to my confidence” common.

We would like to say a big thank you to everyone at Look Good…Feel Better for helping to organise the afternoon. Special thanks go to Maite Zamora, Katie Finger, Jessica Finger, Lillie Russo, Manisha Patel, Youna Peenith, Annie Levy, Tina Ryan and Jan Ogario, the beauty therapists who volunteered their time to come and run such a well-received workshop.

The next Look Good…Feel Better session takes place Tuesday 15th October, from 2pm to 4pm. To book your place, or for more information, contact Reema on 020 7830 2323 or email r.ved@cancerkin.org.uk. Please note, however, the workshop is open only to those women who have not attended a previous workshop.

Study proves ‘brain fog’ is a side-effect of tamoxifen treatment
A study published in the Journal of Neuroscience has proven that tamoxifen produces a mental fogginess similar to ‘chemo brain’. However, the authors also report that they have discovered an existing drug compound that counteracts these adverse effects.

The researchers, based at the University of Rochester, found that tamoxifen is toxic to certain cells in the brain and central nervous system, which causes the mental fogginess which has been anecdotally reported for some time. The scientists were then able to identify which of the cells were most vulnerable to tamoxifen toxicity.

They then screened a library of 1,040 compounds which are already in clinical use or clinical trials and identified an existing compound, known as AZD6244, which essentially eliminated tamoxifen-induced killing of brain cells when tested in mice. The researchers were also optimistic about finding that while AZD6244 protected brain cells, it did not also protect cancer cells.

This research is the result of two separate but related projects: one exploring the science behind “chemo brain” and another which investigates the use of tamoxifen in cancers other than early-stage, less-aggressive breast cancer.

Mark Noble, corresponding author of the study, said: “It’s critical to find safe treatments that can rescue the brain from impairment, because despite increasing awareness and research in this area, some people continue to endure short-term memory loss, mental cloudiness, and trouble concentrating. For some patients the effects wear off over time, but others experience symptoms that can lead to job loss, depression, and other debilitating events.

“As far as I know, no one else has discovered an agent that singles out and protects brain and central nervous system cells while also not protecting cancer cells.

“This creates a whole new paradigm; it’s where we need to go.”

For more information, please see the University of Rochester website or the Independent

On the pulse 12 September 2013

  • Cancerkin hosts an Awareness Event in Stepney Green
  • Study shows stopping tamoxifen before prescribed increases the risk of reoccurrence

Cancerkin hosts an Awareness Event in Stepney Green
This week, the East London team delivered an awareness talk at the Day Opportunities Redcoat Centre in Stepney Green, a community centre which focuses on enabling disabled individuals to be more self-reliant. Research has shown that people with disabilities are the least aware of the importance of checking your breasts regularly, and as such, it was particularly useful for Cancerkin to run an awareness stall here. Eleven women heard the breast care message and all spoke of how useful they found the information.

We would like to thank Jamie Squire from the Centre for inviting us to speak and being so welcoming and hospitable. We would also like to say a big thank you to our Awareness Ambassadors: Amina Akbar, who organised this event, and Janet Omondi who helped run the stall.

The East London Programme organises awareness events at a number of locations across London, entirely free of charge. Therefore, if you know of a community group that would be interested in hosting an informal talk on the importance of being breast aware, please contact Anisah on 020 7830 2310 or email eastlnd@cancerkin.org.uk.


Study shows stopping tamoxifen before prescribed increases the risk of reoccurrence
A recent study into whether woman prescribed tamoxifen after breast cancer took the drug as described was published recently in the British Journal of Cancer and has been widely reported in the media.

The researchers, based at the University of Glasgow, wanted to compare the cost-effectiveness of tamoxifen after breast cancer surgery for women who took the drug as described (‘highly adherent’) with those whose adherence to their prescription was low.

They therefore considered the medical records of 1263 women prescribed tamoxifen after breast cancer surgery to see how many women completed their prescribed course and how low adherence affected the risk of recurrence, death and medical costs. ‘Adherence’ was measured by examining how much of the expected treatment period for each patient was actually covered by tamoxifen prescriptions. The expected treatment time period was taken as five years, or cancer reoccurrence or death if these occurred before the end of the five year period. When less than 80 per cent of the treatment period had prescriptions this was classified as low adherence.

The results showed 38 per cent of women on the study had low adherence, and that women with low adherence had a shorter time to cancer reoccurrence, increased medical costs and poorer quality of life.

However, despite the media reporting women stopped taking tamoxifen due to ‘unbearable side effects’, the study did not actually consider the reasons for low adherence to the prescriptions.

Dr McCowan, lead author of the study, said, “High adherence to tamoxifen would seem to benefit both the patient and the NHS. We want to raise awareness among healthcare professionals that this is a real issue and that women need help and the correct advice to ensure they have the best possible chance of living beyond breast cancer.

“We do know that side effects of this treatment are an issue and we are currently analysing interviews with women to investigate reasons why they do or don’t take their medication and other issues around adherence. We hope to use these findings to develop interventions to help women and the NHS to get the most from the life-saving drugs that we already have.”

Martin Ledwick, head information nurse at Cancer Research UK, echoed the need for further research: “This study highlights the fact that a significant number of women don’t take their tamoxifen – either for as long as they should, or every day as prescribed.  Worryingly, this can make it more likely that their cancers could come back, leading to more treatment and a worse outlook for them…

“ [However]The study doesn’t look at why women didn’t take their tamoxifen as prescribed, and doesn’t differentiate between women who stopped taking the drug completely, and those who seemed to take it inconsistently.

“So to find out how best we can help women to stick to their treatment plan we would need to understand more about why they didn’t in the first place.”

For more information, please see Cancer Research UK, NHS Choices and Breast Cancer Campaign. Articles on the study can also be read on the Guardian, the Daily Telegraph and BBC News Online.

Holly Lovering
12th September 2013