Category: Cancer

Hormone Therapy of Little Benefit with Radiotherapy after Prostate Surgery

Findings could help patients avoid side significant effects and improve quality of life

Credit: Darryl Leja National Human Genome Research Institute National Institutes Of Health

A new study led by UCLA Health investigators suggests that adding hormone therapy to post-operative radiotherapy may provide little survival benefit for most men with prostate cancer, especially for those with very low PSA levels before treatment. 

The researchers found that for men with low PSA levels prior to radiotherapy, adding hormone therapy, whether short-term or long-term, did not improve overall survival. Men with higher PSA levels before radiation may see modest improvements in survival and metastasis-free survival, suggesting hormone therapy may be beneficial primarily for this higher-risk group.

The results were published in The Lancet and presented by Dr Amar Kishan, professor and executive vice chair of radiation oncology at the David Geffen School of Medicine at UCLA, during the plenary session of the American Society of Clinical Oncology Genitourinary Cancers Symposium in San Francisco. 

“Hormone therapy, which impacts the ability of testosterone to stimulate prostate cancer growth and repair, has been shown to improve outcomes when combined with radiotherapy in men whose prostates are still intact. However, whether it has a similar benefit for men receiving radiotherapy after prior surgery has remained unclear,” said Kishan, first author of the study and co-director of the cancer molecular imaging, nanotechnology and theranostics program at the UCLA Health Jonsson Comprehensive Cancer Center. “At the same time, hormone therapy carries significant side effects, including severe fatigue, hot flashes, sexual dysfunction, weight gain, bone loss and metabolic changes that can increase cardiovascular risk. Our findings show that for most men with detectable but low PSA levels (<0.5 ng/mL), after surgery to remove the prostate, post-operative radiotherapy is highly effective on its own. By safely omitting hormone therapy in these patients, we can potentially spare them months of treatment that may substantially affect their quality of life without extending survival.”

To better understand the impact of hormone therapy in this setting, the researchers conducted a large-scale, individual patient-level meta-analysis through the MARCAP Consortium, an international collaboration co-led by Kishan that is designed to evaluate long-term outcomes across randomized clinical trials.

The team analysed data from 6057 men enrolled in six randomised trials comparing post-operative radiotherapy alone to radiotherapy combined with either short-term (4-6 months) or long-term (24 months) hormone therapy. By pooling individual patient data rather than relying on summary trial results, investigators were able to examine outcomes in greater detail, including how pre-radiation PSA levels influenced treatment benefit.

Patients were followed for a median of nine years, allowing researchers to assess long-term overall survival, metastasis-free survival and recurrence outcomes. The analysis also enabled direct comparisons between short-term and long-term hormone therapy to determine whether extending treatment duration improved outcomes.

The researchers found that overall, 83.6% of men who received post-operative radiotherapy alone were alive after 10 years, compared with 84.3% for those who received post-operative radiotherapy plus hormone therapy.

Researchers found that pre-radiotherapy PSA levels, a measure of prostate-specific antigen in the blood after prostatectomy, played a crucial role. Men with low PSA levels before radiotherapy (≤0.5 ng/mL) saw no benefit from hormone therapy. In contrast, men with higher PSA levels showed modest improvements in survival, suggesting that hormone therapy may only be worthwhile for those with elevated PSA. 

The study also examined the duration of hormone therapy. Short-term therapy did not improve overall survival, though it slightly reduced the risk of cancer spreading. Long-term therapy showed a small survival benefit, particularly for men with higher PSA levels after prostatectomy. However, the team’s statistical analysis demonstrated that extending short-term therapy to long-term therapy did not further improve survival, although it did modestly lower the risk of metastasis.

“Our goal is always to treat the cancer while minimizing harm,” said Kishan. “This study helps us move toward more personalised care for men with prostate cancer. By better identifying who truly benefits from hormone therapy, we can make treatment smarter, reduce unnecessary interventions and focus on improving patients’ overall well-being.”

Building on those findings, ongoing research is working to further refine that approach. Trials such as the BALANCE Trial aim to pinpoint biomarkers that can identify which men are most likely to benefit from hormone therapy after surgery, helping tailor treatment decisions even more precisely.

Source: UCLA Health

Method Spots Early Signs of Infection in Post-mastectomy Reconstruction

Rapid detection, treatment of infections could avoid complications, additional surgeries after mastectomy

Many of those women opt to have their breasts surgically reconstructed, most commonly with implants, but a relatively high percentage develop infections after implant surgery, requiring intravenous antibiotics and often removal of the implant. This can lead to additional surgeries, delays in cancer care and increased costs, as well as added emotional distress for women already under strain from cancer diagnosis and treatment.

To address this problem, researchers at Washington University School of Medicine in St. Louis have developed a new tool to detect reconstruction-related infections early, before they cause symptoms. This method, reported in the Journal of Clinical Investigation, could allow for preemptive treatment that preserves implants, improves patient outcomes and reduces the psychological and financial burden on patients.

Led by Jeffrey P. Henderson, MD, PhD, a WashU Medicine professor, the study identified biomarkers of infection in fluid drained from reconstruction patients’ breasts days or even weeks before symptoms appeared. This represents a major opportunity for improvement over existing diagnostic methods, which rely heavily on clinical symptoms, such as redness and inflammation, that take time to appear and can overlap with normal reactions to surgery.

The findings are available online and will publish in print Feb. 16 in the Journal of Clinical Investigation.

“The ability to identify with a molecular signature early on that a patient will go on to have an infection opens up the possibility of surveillance as part of standard care,” Henderson said. “This has the potential to enable earlier treatment that would be far more effective – and potentially curative – in patients who would otherwise progress to prolonged courses of treatment and surgery, or even implant removal and reconstructive failure.”

Small molecules, big impact

The study originated when Henderson’s WashU Medicine colleague Margaret A. Olsen, PhD, a retired professor of medicine in the Division of Infectious Diseases who studies hospital infections, noticed high rates of infection among US patients who had reconstruction with implants after mastectomy. The discovery prompted Henderson and Olsen, a co-author on the study, to ask WashU Medicine plastic surgeons who performed breast reconstruction what they would need to improve outcomes in these patients. Their answer was simple: a clear yes/no test for infection.

To develop such a test, Henderson and lead author John A. Wildenthal, an MD/PhD student, leveraged their expertise in metabolomics, the study of metabolites that are created or broken down during cellular processes in the body. Metabolites can indicate the presence of an infection because they include byproducts of both the body’s response to pathogens and the metabolic activity of the pathogens themselves. By analysing changes in metabolite levels, scientists can identify patterns that are characteristic of infections, enabling early diagnosis.

Henderson and colleagues coordinated with WashU Medicine plastic surgeons to obtain fluid samples from 50 patient volunteers during several routine follow-up visits after surgery. The patients included women who later developed infections after post-mastectomy reconstruction and those who did not.

The researchers analysed the samples for differences between the two groups and identified metabolites that were significantly associated with infection and that appeared days to weeks before clinical signs and symptoms of infection. Further, they found that the presence of certain metabolites indicated more serious infections that might require more aggressive treatment.

“Originating from clinical intuition and validated through a clinical study, the evidence in this paper now supports proactive, targeted interventions to predict and address infections before they become clinically significant,” said Justin M. Sacks, MD, a co-author on the paper. “Such interventions can substantially reduce the burden of complications, implant loss and reconstructive failures in these patients.”

For instance, the findings could lead to the development of a point-of-care test that could be provided during a woman’s routine post-operative visits, noted co-author Terence M. Myckatyn, MD, a professor of surgery at WashU Medicine, who performs plastic and reconstructive surgery for breast cancer patients.

“If the test is positive, antibiotics can be started preemptively in these select patients to thwart infection,” Myckatyn said. “And perhaps just as important, we would not give antibiotics to those with a negative test, thereby adhering to a thoughtful approach for antibiotic stewardship.” Such careful use of antibiotics is important for preventing antibiotic resistance, he said.

In the near term, the team is planning additional studies to validate the results. Then a diagnostic tool could be developed and tested in clinical practice. In the future, the broader metabolomic findings about the development of tissue infection in humans could allow physicians to more selectively target a variety of post-surgical infections, for example, by revealing new drug targets.

“While better techniques are always being sought, the reality is that infections still occur despite a meticulous surgical approach,” said Myckatyn. “To be able to identify biomarkers that can portend an infection days before it develops is huge.”

Source: Washington University

Aspirin not a Quick Fix for Preventing Colorectal Cancer

Photo by cottonbro studio

Daily aspirin use does not offer a quick or reliable way to prevent colorectal cancer in the general population and carries immediate risks of serious bleeding, a new Cochrane review finds. 

Colorectal cancer is one of the most common types of cancer worldwide. Prevention typically involves following a healthy lifestyle and periodically undergoing routine screening tests. In recent years, researchers have also explored the role of off-the-shelf medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), in reducing the incidence of colorectal cancer.

NSAIDs, which include ibuprofen and aspirin, are commonly used to reduce inflammation, fever, and pain. However, their role in the primary prevention of colorectal cancer remains uncertain and controversial.

Researchers from West China Hospital of Sichuan University in China analysed 10 randomised controlled trials including 124 837 participants, assessing whether aspirin or other NSAIDs could prevent colorectal cancer or precancerous polyps (adenomas) in people at average risk. The team found no suitable trials for non-aspirin NSAIDs, so their conclusions focus exclusively on aspirin.

Little to no short-term benefit and uncertain long-term effects

The review found that aspirin probably does not reduce the risk of colorectal cancer in the first 5 to 15 years of use. Possible protective effects after more than 10–15 years of follow-up were observed in some studies, but the certainty of this evidence is very low.

These potential long-term benefits come from observational follow-up phases of trials, in which participants may have stopped aspirin, started it independently, or begun other treatments, making the findings vulnerable to bias.

“While the idea of aspirin preventing bowel cancer in the long run is intriguing, our analysis shows that this benefit is not guaranteed and comes with immediate risks.”

— Dr Zhaolun Cai, lead author 

Immediate and well-established risks

The findings also show clear evidence that daily use of aspirin increases the risk of serious extracranial haemorrhage and probably increases the risk of haemorrhagic stroke. 

Although higher doses carry the greatest risk, low-dose (“baby”) aspirin also raises bleeding risk. Older adults and those with a history of ulcers or bleeding disorders may be particularly vulnerable.

The authors therefore caution that any potential long-term benefit must be weighed against the immediate and well-established risk of bleeding.
 

“My biggest worry is that people might assume that taking an aspirin today will protect them from cancer tomorrow. In reality, any potential preventive effect takes over a decade to appear, if it appears at all, while the bleeding risk begins immediately.”

— Dr Bo Zhang, senior author

Not a ‘one-size-fits-all’ solution

Previous evidence has shown potential benefits for people at high genetic risk of colorectal cancer, such as those with Lynch syndrome. However, this review focuses strictly on people at average risk, and the long-term evidence for them proved highly uncertain.

The authors urge that patients should not start taking aspirin for cancer prevention without a careful conversation with their healthcare professional about their personal risk of bleeding.
 

“This review reinforces that we must move away from a one-size-fits-all approach. Widespread aspirin use in the general population simply isn’t supported by the evidence. The future lies in precision prevention – using molecular markers and individual risk profiles to identify who might benefit most and who is most at risk.”

— Dr Dan Cao, senior author

The research team concludes that the story of aspirin for cancer prevention is far more complex than previously believed and that the balance of benefits and harms changes over time.

Dr Zhang adds:

“As scientists, we must follow the evidence where it leads. Our rigorous analysis of the highest-quality trials reveals that the ‘aspirin for cancer prevention’ story is more complex than a simple ‘yes or no.’ The current evidence does not support a blanket recommendation for aspirin use purely to prevent bowel cancer.” 

Read the review here.

Source: Cochrane

Ibuprofen: How an Everyday Drug Might Offer Protection Against Cancer

Photo by Towfiqu barbhuiya: https://www.pexels.com/photo/bottle-with-pills-11361813/

Dipa Kamdar, Kingston University; Ahmed Elbediwy, Kingston University, and Nadine Wehida, Kingston University

Ibuprofen is a household name – the go-to remedy for everything from headaches to period pain. But recent research suggests this everyday drug might be doing more than easing discomfort. It could also have anti-cancer properties.

As scientists uncover more about the links between inflammation and cancer, ibuprofen’s role is coming under the spotlight – raising intriguing questions about how something so familiar might offer unexpected protection.

Ibuprofen belongs to the non-steroidal anti-inflammatory drugs (NSAIDs) family. The connection between NSAIDs and cancer prevention isn’t new: as far back as 1983, clinical evidence linked sulindac – an older prescription NSAID similar to ibuprofen – to a reduced incidence of colon cancer in certain patients. Since then, researchers have been investigating whether these drugs could help prevent or slow other cancers too.

NSAIDs work by blocking enzymes called cyclooxygenases (COX). There are two main types. COX-1 helps protect the stomach lining, maintains kidney function, and plays a role in blood clotting. COX-2, on the other hand, drives inflammation.

Most NSAIDs, including ibuprofen, inhibit both, which is why doctors recommend taking them with food rather than on an empty stomach.

Ibuprofen and endometrial cancer

A 2025 study found that ibuprofen may lower the risk of endometrial cancer, the most common type of womb cancer, which starts in the lining of the uterus (the endometrium) and mainly affects women after menopause.

One of the biggest preventable risk factors for endometrial cancer is being overweight or obese, since excess body fat increases levels of oestrogen – a hormone that can stimulate cancer cell growth.

Other risk factors include older age, hormone replacement therapy (particularly oestrogen-only HRT), diabetes, and polycystic ovary syndrome. Early onset of menstruation, late menopause, or not having children also increase risk. Symptoms can include abnormal vaginal bleeding, pelvic pain, and discomfort during sex.

In the Prostate, Lung, Colorectal, and Ovarian (PLCO) study, data from more than 42,000 women aged 55–74 was analysed over 12 years. Those who reported taking at least 30 ibuprofen tablets per month had a 25% lower risk of developing endometrial cancer than those taking fewer than four tablets monthly. The protective effect appeared strongest among women with heart disease.

Interestingly, aspirin – another common NSAID – did not show the same association with reduced risk in this or other studies. That said, aspirin may help prevent bowel cancer returning.

Other NSAIDs, such as naproxen, have been studied for preventing colon, bladder, and breast cancers. The effectiveness of these drugs seems to depend on cancer type, genetics, and underlying health conditions.

Ibuprofen’s broader potential

Ibuprofen’s possible cancer-protective effects extend beyond endometrial cancer. Studies suggest it may also reduce risk of bowel, breast, lung, and prostate cancers.

For example, people who previously had bowel cancer and took ibuprofen were less likely to experience recurrence. It has also been shown to inhibit colon cancer growth and survival, and some evidence even suggests a protective effect against lung cancer in smokers.

Inflammation is a hallmark of cancer and ibuprofen is, at its core, anti-inflammatory. By blocking COX-2 enzyme activity, the drug reduces production of prostaglandins, chemical messengers that drive inflammation and cell growth – including cancer cell growth. Lower prostaglandin levels may slow or stop tumour development.

But that’s only part of the story. Ibuprofen also appears to influence cancer-related genes such as HIF-1α, NFκB, and STAT3, which help tumour cells survive in low-oxygen conditions and resist treatment.

Ibuprofen seems to reduce the activity of these genes, making cancer cells more vulnerable. It can also alter how DNA is packaged within cells, potentially making cancer cells more sensitive to chemotherapy.

A word of caution

But not all research points in the same direction. A study involving 7,751 patients found that taking aspirin after an endometrial cancer diagnosis was linked to higher mortality, particularly among those who had used aspirin before diagnosis. Other NSAIDs also appeared to increase cancer-related death risk.

Conversely, a recent review found that NSAIDs, especially aspirin, may reduce the risk of several cancers – though regular use of other NSAIDs could raise the risk of kidney cancer. These conflicting results show how complex the interaction between inflammation, immunity, and cancer really is.

Despite the promise, experts warn against self-medicating with ibuprofen for cancer prevention. Long-term or high-dose NSAID use can cause serious side effects such as stomach ulcers, gut bleeding, and kidney damage.

Less commonly, they may trigger heart problems like heart attacks or strokes. NSAIDs also interact with several medications, including warfarin and certain antidepressants, increasing the risk of bleeding and other complications.

The idea that a humble painkiller could help prevent cancer is both exciting and provocative. If future studies confirm these findings, ibuprofen might one day form part of a broader strategy for reducing cancer risk, especially in high-risk groups.

For now, experts agree it’s wiser to focus on lifestyle-based prevention: eating anti-inflammatory foods, maintaining a healthy weight and staying physically active.

Everyday medicines may yet hold surprising promise, but until the science is settled, the safest prescription for cancer prevention remains the oldest one: eat well, move often, and listen to your doctor before reaching for the pill bottle.

Dipa Kamdar, Senior Lecturer in Pharmacy Practice, Kingston University; Ahmed Elbediwy, Senior Lecturer in Cancer Biology & Clinical Biochemistry, Kingston University, and Nadine Wehida, Senior Lecturer in Genetics and Molecular Biology, Kingston University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Does Mental Health Affect Cancer Mortality?

Study finds a link between mental health diagnoses and early death.

Photo by Alex Green on Pexels

In a study of adults with cancer, those who developed a mental health condition within the first year after their cancer diagnosis had a higher likelihood of dying over the next few years. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

In the analysis of data on all patients at University of California–affiliated hospitals, researchers identified all adult patients who were diagnosed with cancer in 2013–2023 but had no documented mental health disorder before their diagnosis.

Among 371 189 patients, 39 687 (10.6%) developed a mental health disorder within a year. After taking potentially influencing factors into account, a mental health disorder diagnosis was linked to a 51% higher risk of death in the initial 1–3 years after cancer diagnosis. This elevated risk diminished to a 17% higher risk after 3–5 years and then disappeared.

The findings support the importance of prompt screening and treatment of distress and mental health following a cancer diagnosis.

“Over the past several years, we’ve had an increasing appreciation for the important relationship between cancer, its treatment, and mental health,” said lead author Julian Hong, MD, MS, of the University of California, San Francisco. “This study reproduces our prior work by leveraging the shared experience across the University of California system, reinforcing a relationship between mental health conditions and mortality for patients with cancer and highlighting the need to prioritize and manage mental health.”

Source: Wiley

The Next Cancer Breakthrough may be Stopping it Before it Starts

Source: Unsplash CC0

Ahmed Elbediwy, Kingston University and Nadine Wehida, Kingston University

Cancer treatment follows a familiar pattern: doctors spot symptoms, diagnose the disease and start treatment. But scientists are now exploring a radical shift in how we tackle cancer. Instead of waiting for tumours to appear, they want to catch the disease decades before it develops.

This approach is called “cancer interception”. The idea is simple: target the biological processes that cause cancer long before a tumour ever forms.

Researchers are hunting for subtle early warning signs. These include genetic mutations that quietly build up in our cells, giving them advantages against our immune defences.

They’re also looking at precancerous lesions like moles or polyps, and early visible changes in tissue. All of these appear long before cancer becomes obvious.

Large genetic studies reveal that as people age, their bodies accumulate small groups of mutated cells called clones that grow silently. Scientists have studied this particularly well in blood. These clones can help predict who might develop blood cancers like leukaemia, and the genetics, inflammation and environmental factors strongly influence them.

Crucially, doctors can measure and track these changes over time. This opens up possibilities for early intervention.

A 16-year study followed around 7,000 women and uncovered how these mutations work. Some mutations helped clones multiply faster, while others made them particularly sensitive to inflammation.

When there was inflammation, these sensitive clones expanded. Breaking down these patterns helps researchers identify people with a higher chance of developing cancer later.

Not a sudden event

The research reveals something fundamental about cancer. It’s not a sudden event that instantly produces a tumour.

Instead, cancer develops through a slow, multi-step process with detectable warning signs along the way. These early signs could become powerful targets for stopping cancer before it starts.

Scientists are developing blood tests to spot cancer long before symptoms appear. These tests, called multi-cancer early detection tests (MCEDs for short), search for tiny fragments of DNA in the blood.

MCEDs work by looking for circulating tumour DNA, or ctDNA – DNA fragments that cancerous or precancerous cells release into the bloodstream. Even very early cancers shed this DNA, so the tests might detect disease long before it shows up on a scan.

The results so far look promising. MCEDs can boost survival rates through early detection, especially for colorectal cancer. When doctors diagnose colorectal cancer at stage one, 92% of patients survive five years. But when they catch it at stage four, only 18% survive that long.

If colon cancer is caught at stage one, most patients are still alive after five years. Credit: National Cancer Institute

The tests aren’t perfect, though. They miss some cancers entirely, and positive results still need follow-up tests to confirm.

Even so, research suggests MCEDs could become crucial for catching cancers that usually go unnoticed until much later. The potential to save lives is significant.

Heart doctors already use a similar approach. They calculate a person’s risk using age, blood pressure, cholesterol and family history, then prescribe drugs like statins years before a heart attack happens.

Cancer researchers want to copy this model. They envision combining genetic mutations, environmental factors and MCED results to guide early cancer prevention.

But cancer differs from heart disease in important ways. Cancer doesn’t follow a predictable path, and some early lesions shrink or never progress.

There’s also the risk of over-diagnosis. Being told you’re at higher risk when you feel perfectly healthy creates anxiety.

Cancer prevention tools also vary widely in their effectiveness, unlike statins that work broadly across different cardiovascular risk groups. The risk-based model shows promise, but needs careful handling.

Treating cancer risk instead of cancer itself raises difficult ethical questions. When someone feels completely healthy, judging whether intervention will truly help them becomes harder.

There’s a danger of causing unnecessary worry or harm. Scientists warn that doctors sometimes overestimate benefits and underestimate risks, particularly for older adults.

MCED tests bring their own ethical concerns. Accuracy isn’t the only issue that matters.

The tests sometimes flag cancer when none exists, leading to follow-up scans and biopsies that patients don’t actually need. The anxiety from all of this carries a high cost, both for patients and the healthcare system.

If these tests are expensive or only available privately, they could make health inequalities worse. This concern hits hardest in low-income countries.

In the US, the medicines regulator is investigating how MCED blood tests should work. They’re examining how reliable the tests need to be and what follow-ups doctors should require to keep patients safe.

The UK is following suit. The National Cancer Plan for England, published on February 4, 2026, commits to providing 9.5 million extra diagnostic tests through the NHS each year by March 2029.

The plan also states that ctDNA biomarker testing will continue in lung and breast cancer. It will extend to other cancers if proven to be cost effective.

What all this shows is clear. Cancer doesn’t suddenly appear; it’s a steady process that begins decades earlier. Catching it before it grows could save countless lives. The question now is how to do that safely, fairly and effectively.

Ahmed Elbediwy, Senior Lecturer in Cancer Biology & Clinical Biochemistry, Kingston University and Nadine Wehida, Senior Lecturer in Genetics and Molecular Biology, Kingston University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Cancer Treatment Moving Towards Earlier Immunotherapy

Killer T cells surround a cancer cell. Credit: Alex Ritter, Jennifer Lippincott Schwartz and Gillian Griffiths, National Institutes of Health (CC BY 2.0).

Immunotherapy given before or after surgery is increasingly used across several cancer areas. In an article published in the Journal of Internal Medicine, researchers at Karolinska Institutet present a comprehensive review of studies across seven tumour areas, showing how the field is moving towards earlier treatment.

For several years, immunotherapy has transformed the treatment of advanced cancer that can no longer be removed surgically. It is now used more frequently in earlier stages of disease as well – before surgery, known as neoadjuvant treatment, or after surgery, known as adjuvant treatment. In the new article, the researchers summarise findings from studies on several cancer diagnoses, grouped into seven tumour areas: skin cancer, lung cancer, breast cancer, gastrointestinal cancer, gynaecological cancer, head and neck cancer, and urological cancer.

Suggested benefits of treatment both before and after surgery

Several studies in recent years have shown that adjuvant immunotherapy after surgery can reduce the risk of the disease returning. Additional studies indicate that neoadjuvant treatment, given while the tumour is still in place, in many cases can provide the immune system with better conditions to recognise tumour cells. In several tumour areas, the results also suggest that immunotherapy given both before and after surgery may offer advantages compared with adjuvant treatment alone. 

At the same time, the authors emphasise that the results vary between different cancer types and that the treatment involves challenges, such as the risk of side effects and the possibility that some patients may receive more treatment than necessary if surgery alone would have been sufficient.

“We see that immunotherapy in early stages of disease is developing rapidly across many tumour areas. By bringing together studies from many cancer types, it becomes clearer how the field is evolving and what experiences can be shared between different specialties,” says last author Hildur Helgadottir, researcher at the Department of Oncology-Pathology at Karolinska Institutet.

How the researchers carried out the review

The work behind the article is a collaboration between 14 researchers at the Department of Oncology-Pathology, Karolinska Institutet. All of them also work with cancer treatment in clinical care. Because the researchers come from seven different tumour areas, the article gathers experiences from many parts of cancer care.

“It is valuable that we have come together from so many different tumour areas. This gives a broader understanding of how immunotherapy is used across cancer care and can, in the long term, support both clinical decision-making and future research,” says Hildur Helgadottir.

The researchers also point to areas where more knowledge is needed. One of these is the development of biomarkers, measurable characteristics that can help healthcare determine which patients benefit from immunotherapy, both before and after surgery. They also discuss how introducing immunotherapy at earlier stages raises questions about costs, side effects, and whether healthcare resources will be sufficient, questions that current studies do not yet clearly answer.

Information about funders and potential conflicts of interest can be found in the scientific publication.

Publication

Perioperative immune checkpoint inhibitor therapy across tumors: Insights and shared lessons from a rapidly evolving field.
Björkström K, Matikas A, Svedman FC, Björgvinsson E, Zupancic M, Villabona L, Eriksson H, Skribek M, Fernebro J, Lindskog M, Frödin JE, Ullén A, Ekman S, Helgadottir H
J Intern Med 2026 Feb;():

Source: Karolinska Institutet

Half of All Men Over 60 Have Prostate Cancer – an AI Tool Could Speed Diagnosis

Photo by National Cancer Institute on Unsplash

Increasing use of blood tests to detect prostate cancer is leading to overworked doctors. NTNU has now created an AI diagnostic tool that can help lighten the burden.

Diagnostic tools based on artificial intelligence are now making their way into Norwegian hospitals. AI can independently read X-ray images and detect bone fractures, or assess cancer tumours in both the breast and prostate.

“AI tools can take over the detection of simple and clear-cut cases, allowing doctors to spend their time on more complex ones,” said Tone Frost Bathen. She is a professor at NTNU and the project manager of an AI-powered analysis tool for prostate cancer called PROVIZ.

Tests on patients at St Olavs Hospital indicate that the tool is very promising.

“AI can enable radiologists to determine more quickly and more accurately whether a patient needs a biopsy, and where in the prostate it should be taken from,” explained Bathen.

“The PROVIZ project started as early as 2018. It takes a long time to develop diagnostic tools in medicine because safety standards must be high. The application alone to be allowed to test the tool on patients was 500 pages. It is important to create a tool that clearly shows how the result was reached, and that fits into a busy hospital workday,” says Tone Frost Bathen, Professor at NTNU. Photo: Anne Sliper Midling / NTNU

A recent study shows that patients trust medical test results only if an experienced doctor confirms what has been detected.

“Trust in doctors and health professionals is key for artificial intelligence to gain a place in the diagnosis of prostate cancer. Technology alone is not enough. Human contact and professional assessment remain indispensable,” said Simon A. Berger, a PhD research fellow at NTNU.

Prostate cancer is a natural part of getting older

Prostate cancer is the most common form of cancer among men in Western countries.

Examinations have detected prostate cancer in 10% of 50-year-olds, 50% of 60-year-olds and approximately 70% of men over the age of 80.

This shows that the disease is naturally linked to ageing.

“Prostate cancer is something most men die with, not from,” added Berger.

A blood test called PSA can help detect prostate cancer. Since it has become more common for men to take this blood test, the number of new prostate cancer cases has risen sharply. There are now approximately 5000 new cases each year.

When more people are tested for something that many individuals naturally have as part of the ageing process, the next medical step after the blood test must also be carried out more often, so that doctors can obtain a broader clinical picture of its severity.

Most trust in doctors

Currently, this next step involves taking an MRI scan, which provides a detailed image of the prostate gland and the surrounding tissue. These images need to be interpreted manually by an experienced radiologist. As the number of images taken has increased sharply, this has created a need for new and more efficient ways of making diagnoses.

Through the PROVIZ project, NTNU researchers have developed an AI-powered tool that can help doctors interpret MRI images of the prostate. PROVIZ is currently available only for use as part of the ongoing research project, but efforts are underway to apply for a patent and make the tool commercially available.

High international competition for commercial AI tools

Several research groups around the world are now working on developing AI-based diagnostic tools for prostate cancer.

PROVIZ has completed its first clinical testing in collaboration with St. Olavs Hospital, and the results were good. The next step is a much larger clinical trial, as well as a regulatory approval process.

“Right now, we are seeking approximately 20 million NOK to finance this phase. Once funding is in place, the tool could be on the market in the US within a year, and in Europe in just over a year,” says Gabriel Addio Nketiah, a researcher at NTNU and responsible for the commercialisation of PROVIZ.

For a tool like this to be efficiency-enhancing in routine hospital practice, patients must also trust the findings detected through the use of AI.

“Patients have high expectations that AI can be used for faster diagnostics and to reduce healthcare waiting lists. Many see AI as a kind of safety valve – an additional resource that doctors can use alongside their professional judgment,” says Simon A. Berger, a PhD research fellow at NTNU.

Berger interviewed 18 men who had been diagnosed with prostate cancer through the use of PROVIZ. The study shows that trust in doctors and health professionals plays a decisive role in whether patients accept AI in the health services.

“Patients trust AI in lower-risk cases such as bone fractures, but not in cases where the perceived risk is higher, such as cancer. When the perceived risk is high, we place the greatest trust in specialized doctors who can confirm what AI has found,” explained Berger.

Doctors as guarantors

In his interviews, Berger identified three different dimensions of trust.

  1. Foundational trust in the healthcare system: many patients had positive experiences from previous encounters with the healthcare system. This laid a positive foundation.
  2. Inter-personal trust in health professionals: patients trusted the doctors and their assessments. This trust was crucial for accepting AI because the doctors explained and vouched for the technology.
  3. Possible trust in AI: even though patients recognized the potential of AI, they always wanted a human assessment as well in prostate cancer diagnostics. They were concerned about accountability, professional judgement and AI’s (in)ability to see the whole clinical picture.

“The relationship between patient and doctor is still key. For AI to be accepted in clinical practice, health professionals must be active communicators and guarantors of safety. In order for doctors to serve as guarantors, they must first understand how AI arrived at its conclusions so they can verify that it has made the correct assessment. Patients accept the use of AI within a framework they already trust,” concluded Berger.

NTNU owns an MRI scanner at St. Olavs Hospital that is currently undergoing a major upgrade. It helps researchers obtain the best possible images to be used in, among other things, PROVIZ. “Unfortunately, there are few investors in medical technology right now, but we hope that someone sees the societal value of our project,” says Professor Tone Frost Bathen at NTNU. Photo: Anne Sliper Midling / NTNU

By Anne Sliper Midling

Source:

Berger SA, Håland E, Solbjør M. Patient Perspectives on Trust in Artificial Intelligence-Powered Tools in Prostate Cancer Diagnostics. Qualitative Health Research. 2025;0(0). doi:10.1177/10497323251387545

Source: Norwegian Tech News

Does a Past Abortion or Miscarriage Affect Breast Cancer Risk?

Photo by National Cancer Institute

The potential effect of induced abortion and miscarriage on the risk of breast cancer has remained debated and has been a persistent source of misinformation. Many previous studies have been small and based on self-reported data. Now, a study published in Acta Obstetricia et Gynecologica Scandinavica found that prior abortion or miscarriage was not linked with an increased risk of developing pre- or postmenopausal breast cancer.

In the nationwide Finnish registry-based study, investigators analysed data on 31 687 women with breast cancer diagnosed in 1972–2021 and 158 433 women without breast cancer.

The risk of breast cancer was found to be similar among women with a history of induced abortion and women with no history of abortion, both before and after 50 years of age. Risks were also similar among women with and without a past miscarriage.

In addition, breast cancer risks did not vary significantly by the number of abortions or miscarriages, nor by the time of first abortion or miscarriage.

“Miscarriage or induced abortion as potential risk factors for breast cancer has continued to raise concerns and has led to the spread of misinformation. In this study using high-quality Finnish registry data, we can reliably eliminate these concerns,” said corresponding author Oskari Heikinheimo, MD, PhD, of the University of Helsinki and Helsinki University Hospital. “Induced abortion or miscarriage are not risk factors for breast cancer, even if there are several of them. This information is important and reassuring for millions of women around the world.”

Source: Wiley

Could a Common Vitamin Treat Glioblastoma?

Findings indicate vitamin B3 looks promising to help rearm a compromised immune system

Unrestricted tumour growth in mouse brain, left, compared to the tumour growth in a mouse who received niacin treatment, right (both after 42 days). Courtesy Yong lab

Edward (Ed) Waldner had no idea why he didn’t feel well, but he knew he didn’t feel like himself. At 55 years of age, he felt exhausted all the time. It didn’t seem to matter how hard he had worked that day. He wondered if he had sleep apnoea. He noticed his walking was off. His heels would drag now and again. One day, when his symptoms were worse than usual, he decided to go to the Emergency department. 

“The doctor said I had a mass on my brain and needed to see an oncologist,” says Waldner. 

The mass was glioblastoma, a deadly brain cancer. Treatment often involves a three-pronged approach: surgery to remove as much of the tumour as possible, followed by radiation and chemotherapy. However, despite advances in cancer treatment, the aggressive cancer comes back. 

University of Calgary researchers are investigating whether adding high doses of vitamin B3 or niacin to the treatment plan could be beneficial. They approached Waldner about being in the trial.

“I have no problem trying to help anybody. I agreed. I want to help myself, too,” says Waldner. “I can tell you being part of this research helps me mentally because we’re trying. When I left the hospital after surgery I was told, that’s it, that’s all we can do.”

Hotchkiss, Charbonneau members partner for study

The research is led by two members of both the Hotchkiss Brain Institute and Arnie Charbonneau Cancer Institute – Dr Gloria Roldan Urgoiti, MD, PGME’16, an oncologist specialised in brain cancers, and Dr Wee Yong, PhD, a neuroscientist whose research focuses on immune effects on the brain. Together, they designed a study to investigate whether niacin could rejuvenate compromised immune cells to kill tumour cells. The research began in the Yong lab, with mice, where findings showed niacin prolonged survival. That work evolved into a Phase I and II clinical trial.

“Normally, the immune system will try to counter and prevent tumour growth; however, this brain cancer supresses the immune system,” says Yong, a professor at the Cumming School of Medicine (CSM). “Niacin treatment rejuvenates immune cells so they can do what they are supposed to do, attack and kill the cancer cells. I see it as an ongoing ‘battle for the brain.’”

Studying the benefits of adding niacin to chemotherapy, radiation

The clinical trial was designed to determine the maximum dose and potential benefit of controlled-release niacin that could be added to the recommended chemotherapy and radiotherapy treatments. Researchers decided the study would stop if the progression-free survival over six-months did not improve by at least 20 per cent compared with older studies. Early results involving 24 patients showed 82 per cent of the participants were free of progression of the cancer at six months; an increase of 28 per cent from previous studies. The researchers say this is a promising advancement for this incurable cancer. 

“Glioblastoma is the most aggressive brain cancer in adults. Survival of patients with this condition hasn’t changed significantly for 20 years,” says Roldan Urgoiti, a clinical associate professor at the CSM. “Anything that may help should be explored, but it requires strict protocols and safety monitoring.”

The findings were published in the Journal of Neuro-Oncology.

The researchers caution that high amounts of vitamins, like niacin, have toxicity and can have a negative impact on someone’s health if not monitored closely by medical professionals. 

The team hopes to be able to do the final analysis, that will include 48 participants by the end of 2026 or early 2027. 

Waldner says he’s feeling really good these days and is just happy to hear the word “stable” when he goes for his regular scans. 

Source: University of Calgary