On the pulse 23 July 2014

  • Goodbye Sophie
  • Scientists develop a tamoxifen gel which could be as effective as the pill form, with fewer side effects

Goodbye Sophie
This week we say goodbye to Sophie Wagener, who has been with us as an intern for the past eight weeks. Sophie was placed with us through IES Interns and she has been a huge asset to Cancerkin: welcoming patients, answering calls, assisting with fundraising, helping our East London team to run their complementary therapy sessions, doing useful research and much more! Always friendly, we know she will be missed by our patients as well us. Sophie returns to the USA to continue her studies at Bates University and we wish her every success and happiness in the future.

Scientists develop a tamoxifen gel which could be as effective as the pill form, with fewer side effects
A study published in Clinical Cancer Research has found that a tamoxifen gel could be as effective as tamoxifen pills, with fewer side-effects.

Tamoxifen is a hormone therapy which is usually prescribed for people whose cancer is ER positive. It comes as a tablet (or a liquid) which is taken orally on a daily basis, normally for 5 years, to lower the risk of breast cancer recurring after surgery or developing in the other breast. It also can be prescribed to women who are at high risk of developing breast cancer as a preventative measure. However, side effects are common, with more than 10 in every 100 people suffering from at least one of the following: hot flushes and sweats; changes in their periods; fatigue; feeling lightheaded; eye problems. Other, less common, side effects include weight gain, nausea, depression, blood clots and womb cancer. Because of these, some women are put off taking tamoxifen, or stop taking the drug before prescribed.

Scientists from the US therefore tested applying a gel form of tamoxifen to the breasts of women with the non-invasive cancer ductal carcinoma in situ (DCIS), with the aim of concentrating the drug in the breast, where it was needed, whilst minimising exposure to the rest of the body. The study compared the effects of the gel, 4-OHT, with oral tamoxifen. 26 women took part in the study: 13 women took tamoxifen orally and the other half received the gel. Both groups of women took or applied the tamoxifen daily.

The study found that after six to 10 weeks, the reduction in a marker for cancer cell growth in breast tissue was similar for both oral and gel tamoxifen. They also found equal amounts of 4-OHT present in the breast tissue of patients who used the gel or took tamoxifen orally. However, the blood levels of 4-OHT were more than five times lower in those who used the gel. This reduction in the levels of 4-OHT in the blood was also correlated with a reduction in the proteins which cause blood clots.

Dr Caroline Dalton, Senior Policy Officer at Breakthrough Breast Cancer, said: “We know that tamoxifen is a highly effective drug for both treating breast cancer and also, as recently recommended, for preventative use in those at high risk of breast cancer because of their family history. While tamoxifen use for breast cancer prevention has been described as a game changer, the side effects associated with the drug do put some women off taking it, so this research is promising.

“The study showed that women who applied the gel had similar levels of tamoxifen in the breast tissue to those taking the pill version, which is the normal form in which the drug is taken, and lower levels of the drug in their blood – which could lead to fewer side effects.

“Although these findings are very interesting, the research was conducted over a short time period on a small group of women who already had an early form of breast cancer. Results have not yet proved that tamoxifen gel can prevent breast cancer or that there will be fewer side effects compared to the pill form.

“Once more research has been carried out and we begin to see further results, this could be an exciting development for breast cancer prevention in those at higher risk in the future.”

For more information see News Medical or Breakthrough Breast Cancer.

On the pulse 18 July 2014

  • Hampstead Heath Walk 2014 update
  • Research published on two new methods for breast cancer screening

Hampstead Heath Walk 2014 update
Sponsorship money from Hampstead Heath Walk 2014 participants has been rapidly rolling in for the past month and we have so far raised over £32,000 – £2,000 more than this time last year! This is wonderful and we at Cancerkin say a huge “thank you” to everyone who has helped raise this through collecting sponsorship, making a donation or taking part in the walk.

If you took part in the walk and want to be in with a chance of winning prizes generously donated by Floris, Perfumers to HM The Queen Elizabeth II, there is only one month to send us any outstanding money. The final deadline for money to reach us is Friday 15th August. On that day we will count up how much has been raised in total and announce our top three fundraisers, who will each receive a luxury prize donated by Floris.

Any donations made on JustGiving will be sent straight to us, and funds collected by hand can either be brought in person to the Cancerkin Centre or sent in the post (our address is Cancerkin Centre, Royal Free Hospital, Pond Street, London, NW3 2QG). However, please do ensure that:

  • Your envelope is addressed to Holly Lovering and includes your sponsorship form with your name clearly marked;
  • All the sponsors on your form have provided their full home address as we can only claim gift aid on their donation using their home address;
  • You do not send cash in the post. Please ensure any cheques are made payable to Cancerkin.

Congratulations again to all our walkers and volunteers, and I will make sure you are updated with the final total in August.

Research published on two new methods for breast cancer screening
The pros and cons of breast cancer screening have been much debated in the past few years, with experts disagreeing on how exactly they balance out. New reports are published every week, but the debate about the benefits of screening continues.  Cancer Research UK has recently published a piece about techniques which could lead to future improvements in screening.

The argument for breast cancer screening is that it saves lives by detecting the disease earlier. However, it also “overdiagnoses” breast cancer by picking up slow growing cancers which don’t need treating. The rate of overdiagnosis is difficult to measure, but the 2012 Independent Breast Screening Review estimated that for every life saved by screening, three women are overdiagnosed.  As well as this, for every 1000 women invited to screening, approximately 40 are called back for further tests, of which eight are diagnosed with breast cancer. This means around 30 women in every 1000 have the short-term anxiety of thinking they might have cancer, only to be told they don’t.

Mammography is essentially x-raying a woman’s breasts. The NHS generally uses digital mammography to capture, manipulate and store the image rather than film because these images are better quality, need a lower x-ray dose and can be reanalysed using computers. A further development of this technique is digital breast tomography (DBT) which creates a 3D image of the breast.  A study published in the Journal of the American Medical Association analysed the impact of introducing DBT at 13 different centres across the US. The study found that DBT not only detected more cancers than conventional screening would have picked up, but also reduced the number of women who were recalled for things that turned out not to be cancer. However, to demonstrate the impact DBT has in terms of saving lives or overdiagnosis, long-term, randomised trials need to take place.

X-ray is not the only way to detect cancers. Magnetic resonance imaging (MRI) can also be used. MRI can be more sensitive than mammography and also avoids the need to use x-ray radiation. However, it is a lot more expensive than x-ray screening and so it is generally used in the NHS only to screen women who are at particularly high risk of developing breast cancer. However, the Journal of Clinical Oncology reports a German study of a method of using MRI for breast screening which takes 3 minutes (rather than the 40 minutes a full MRI study normally takes) with the same accuracy. This could reduce the cost significantly and many more women could be screened in one day.

Both these studies add to the body of research on screening and indicate that over time screening will become more effective, quicker and less worrying.

For more information, please see Cancer Research UK.

On the pulse 10 July 2014

  • Deco Diva
  • Taking aspirin may reduce mortality rates after breast cancer research

Deco Diva
This week, Kara Wilson opened her beautiful home and garden to perform a witty and fun one-woman show depicting the life of flamboyant artist Tamara de Lempicka. The evening was organised by one of our patients, Dalia Hartman Bergsagel and was held in support of Cancerkin.

Over 70 guests attended to watch Kara Wilson tell the story of Tamara’s life in pre-war Paris in prose and song while painting one of her paintings from scratch. The painting was then auctioned at the end of the evening, with all the proceeds going to Cancerkin. To play any part while painting is impressive enough, but to bring someone so wonderfully to life as Kara did was brilliant. The performance was enjoyed with great enthusiasm.

Photos from the event are on our website and facebook page, so do take a look!

So far, the evening has raised over £1,500 and so we would like to say a huge “thank you” to Kara for opening her house to stage such a fabulous performance and to Dalia for organising this wonderful event.

Taking aspirin may reduce mortality rates after breast cancer research
Research published in the British Journal of Cancer has found that taking a low dose of aspirin after a breast cancer diagnosis may reduce all-cause as well as breast-cancer specific mortality rates.

The Scottish study considered 4627 patients diagnosed with breast cancer between 1998 and 2008, and they were followed until February 2010. Of these patients, 1035 women were prescribed aspirin after diagnosis. After adjusting for factors such as age and treatment received, the researcher found that the women who were prescribed aspirin were half as likely to die from any cause in the following years, while there was a 58% reduction in breast cancer mortality.

There has been a lot of research into the effect of aspirin on cancer risk and cancer spread in recent years. However, these studies have not given definitive answers and taking aspirin can have serious side effects, including internal bleeding. Before any recommendations can be made much more research is needed on the effect aspirin has on preventing cancer or preventing reoccurrences, which then needs to weighed against the risk of side-effects.

Katherine Woods, Research Communications Manager at Breast Cancer Campaign, said: “”This study adds to growing evidence that aspirin may be beneficial in the treatment of cancer, which is an exciting possibility given aspirin’s low cost and relatively few side effects. However this trial didn’t account for all the factors that can influence the chances of survival after a breast cancer diagnosis, such as physical activity, and we cannot be sure that women who weren’t prescribed the painkiller were not taking aspirin that they had purchased themselves.

“As the study authors highlight, further research is needed to reveal whether aspirin is directly responsible for the better chances of survival seen in this study”

Breakthrough Breast Cancer’s Senior Policy Officer Sally Greenbrook agreed, saying: “It is too soon to pinpoint a definitive conclusion, and there is some way to go before any link between aspirin use and survival after breast cancer diagnosis can be made or explained.

“What we do know is that taking aspirin on a regular basis can lead to some quite serious side effects so we would recommend that any women concerned by this news, or anyone that thinks they should be taking aspirin for this reason, to speak to their GP.”

For more information on this recent study please see Breakthrough Breast Cancer, Breast Cancer Campaign or the Daily Mail Online. For more information on the research into aspirin and cancer, please see Cancer Research UK.