Category: Cancer

Categories : CancerTags :

Triple-negative Breast Cancer Survival Nearly Doubled with New Treatment

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Results of a global, multicentre, phase III clinical trial indicate that datopotamab deruxtecan (Dato-DXd) is effective in improving survival for untreated, advanced triple negative breast cancer (TNBC) 

Photo by National Cancer Institute on Unsplash

A global, multicentre phase III trial, TROPION-Breast02, led by a senior medical oncologist and researcher from the National Cancer Centre Singapore, has demonstrated a significant breakthrough in improving the survival of patients with untreated, advanced triple negative breast cancer (TNBC) using the novel antibody-drug conjugate (ADC) datopotamab deruxtecan (Dato-DXd). Published in the Annals of Oncology, the findings demonstrate the potential of Dato-DXd as an effective new treatment option for this aggressive disease.

“In the TROPION-Breast02 trial, first-line Dato-DXd demonstrated clinically meaningful and significant improvements in progression-free survival and overall survival for these TNBC patients, and a higher overall response rate compared with chemotherapy. As a medical oncologist treating triple-negative breast cancer patients for the past 20 years, I am deeply encouraged that this data shows we now have a much-needed new tool to help women affected by this devastating disease,” said lead investigator Prof Rebecca Dent, Deputy CEO (Clinical) and Senior Consultant in the Division of Medical Oncology at the National Cancer Centre Singapore.

The burden of triple negative breast cancer (TNBC)

Breast cancer is the leading cause of cancer death in women globally. Approximately 10 to 20% of breast cancers are TNBC, an aggressive subtype that disproportionately affects young women under the age of 40. TNBC is associated with early recurrence, high likelihood of metastasis and shorter survival. In recent years, TNBC patients with PD-L1-positive tumours or germline BRCA mutations have been eligible for immunotherapy. However, 70% of TNBC patients are ineligible for immunotherapy and receive first-line chemotherapy treatment, which has modest and limited efficacy. Approximately half of patients with metastatic TNBC do not receive treatment beyond first-line chemotherapy, making it an urgent need to find new treatment options to improve clinical outcomes.

A new treatment for TNBC

To address this need, clinician-investigators from multiple centres around the world conducted the TROPION-Breast02 open-label, phase III clinical trial using Dato-DXd to treat TNBC. Dato-DXd is an ADC that delivers a potent cancer-killing drug directly to tumour cells by targeting the TROP2 protein. Currently, Dato-DXd is approved for the treatment of patients with unresectable or metastatic, hormone receptor-positive, HER2-negative breast cancer, but not TNBC.

In total, 644 TNBC patients were enrolled in TROPION-Breast02 across multiple sites across the globe including the United States, Canada, Europe, China, Korea, Japan and Singapore. Patients were randomly assigned to two treatment arms: intravenous Dato-DXd 6 mg/kg once every three weeks (323 patients) or the investigator’s choice of chemotherapy (321 patients). Patients had to be 18 and above to enrol, have locally recurrent inoperable or metastatic TNBC that was untreated, and be ineligible for treatment with immunotherapy.

Trial results showed that:

  • Progression-free survival (PFS) was significantly longer with Dato-DXd compared with chemotherapy: median PFS 10.8 months versus 5.6 months (nearly double) 
  • Overall survival (OS) was improved with Dato-DXd compared with chemotherapy: median OS 23.7 months versus 18.7 months 
  • Patients treated with Dato-DXd had an overall positive response rate to treatment of 63% compared to patients treated with chemotherapy who had an overall response rate of 29%. Median duration of response, or how long patients responded to treatment, was 12.3 months in the Dato-DXd arm and 7.1 months in the chemotherapy arm.

Dato-DXd’s most common drug-related adverse events were stomatitis (inflammation of tissue lining the mouth or lips), nausea, alopecia and neutropenia (lower levels of a type of white blood cell), whilst the most common for chemotherapy were alopecia, neutropenia and fatigue. Only 4% of patients on Dato-DXd stopped treatment due to drug-related adverse events compared to 7% of patients on chemotherapy.

What this means for TNBC patients

Not only did the trial find Dato-DXd to be an effective treatment for untreated, inoperable metastatic TNBC, but ASCENT-03, a separate, earlier phase III clinical trial of TROP2-directed ADC sacituzumab govitecan, also demonstrated improved PFS compared to chemotherapy. Combined, the results from TROPION-Breast02 and ASCENT-03 indicate that TROP2-directed ADCs are a promising class of drugs to treat TNBC.

The team is further evaluating Dato-DXd in phase III clinical trials to treat patients with Stage I-III TNBC with residual invasive disease after neoadjuvant systemic therapy, Stage II-III triple-negative or hormone receptor (HR)-low, HER2-low or -negative breast cancer and metastatic TNBC PD-L1 expressed tumours.

Dato-DXd is currently under review as first-line treatment for unresectable, metastatic TNBC by the US Food and Drug Administration and the Singapore Health Sciences Authority.

Source: National Cancer Centre Singapore

Categories : CancerTags :

Treating Tumours Independently of Oxygen

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Graphical abstract by Montesdeoca et al., JACS 2026.

Most tumours grow so rapidly that vascular growth cannot keep up, and oxygen-depleted areas form within them. A new active agent could make it possible to treat them with photodynamic therapy.

Photodynamic treatment of cancer is based on administering an initially inactive substance that is only activated in the tumour via targeted light irradiation. It then generates reactive oxygen species that kill the cancer cells. However, this method reaches its limits when no oxygen is present, as is the case with many fast-growing tumours. Professor Johannes Karges’ research group at Ruhr University Bochum has achieved a breakthrough that makes the treatment of such tumours possible: When oxygen is absent, an alternative action mechanism comes into effect. This uses hydrogen peroxide, a natural metabolic product of the cells. The researchers report their findings in the Journal of the American Chemical Society from April 6, 2026.

An entirely new action mechanism

Photodynamic therapy, or PDT, is an established method for treating cancer and is widely used in clinical practice. Karges and his team have developed an entirely new action mechanism that functions independently of the oxygen concentration within the tissue: Light converts the ruthenium-based active agent into an excited electronic state. When oxygen is present, energy is transferred to molecular oxygen, creating singlet oxygen, which has a harmful effect on cells. “This process corresponds to the conventional, oxygen-dependent mechanism of photodynamic therapy,” says Karges.

When oxygen is absent, another mechanism comes into effect. The cause is the coordination of intracellular iron to the active agent. This interaction alters the electronic characteristics of the system such that instead of a transfer of energy, an ultra-fast, metal-to-metal transfer of electrons occurs from the excited ruthenium centre to the iron centre. The hydrogen peroxide is thereby converted into highly reactive hydroxyl radicals. “Because hydrogen peroxide is a natural metabolic product of the cell, this process can occur independently of the molecular oxygen,” explains Karges. The hydroxyl radicals that have formed cause oxidative damage to central cellular structures and thus kill the cancer cells.

This means that the substance remains active even under severe conditions where past therapies have failed. In the current study, the researchers demonstrated this with breast cancer cells. “This method can be used for many different types of tumours, in principle,” says Karges. “However, we have not yet begun trying this out with human subjects and are working to develop this.”

Source: Ruhr University Bochum

Categories : Cancer Cardiovascular DiseaseTags :

New Study Finds Common Blood Pressure Drug Boosts Cancer Treatment

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Credit: Pixabay CC0

Dartmouth Cancer Center (DCC) researchers have discovered that an existing, widely used blood pressure medication may help improve the effectiveness of certain cancer treatments – potentially expanding their use to many more patients and reducing toxicities.

In a new study led by clinician-scientist Tyler J. Curiel, MD, MPH, FACP, investigators found that the FDA-approved blood pressure drug telmisartan can significantly enhance the cancer-killing activity of the targeted cancer therapy olaparib.

“This study shows that a common, safe, convenient, tolerable, and inexpensive once-daily pill may significantly improve how well an important class of cancer therapies works,” said Curiel.

Exploiting cancer’s weakness

PARP inhibitor drugs, such as olaparib, work by exploiting weaknesses in how some cancer cells repair damaged DNA. PARP inhibitors are particularly effective in tumours with certain gene mutations. However, many tumours lack these mutations, limiting the number of patients who can benefit from these drugs. Cancers can also eventually develop resistance to PARP inhibitors.

In early studies, Curiel’s team discovered that when combined with olaparib, telmisartan can make tumours more vulnerable to PARP inhibitors, even when the tumours lack the gene mutations that usually make this type of drug effective.

The combination also stimulated an immune response within the tumour. Specifically, the combination of the two drugs fuelled the production of a type of molecule that helps the immune system recognize and attack cancer.

“This immune activation appears to be a key reason the combination works so well,” Curiel said.

Unique among blood pressure drugs

Telmisartan belongs to a class of medications called “angiotensin II receptor blockers” (ARBs), commonly prescribed to treat hypertension, or high blood pressure. But the DCC study found that the cancer-treatment-enhancing effects were unique to telmisartan among all of the ARBs tested.

Telmisartan also reduced levels of a protein inside tumour cells that cancers use to evade immune attack – further increasing its therapeutic potential.

“This study was about PARP inhibitors,” Curiel said. “But we also have a lot of evidence that telmisartan makes certain other chemotherapies and immunotherapies more effective through related mechanisms. Its potential could therefore extend to many other types of cancers and treatments.”

Bench to bedside: clinical trials

Telmisartan’s widespread use and high tolerability, even in people without high blood pressure, make it ideal for clinical use. Curiel’s team is already using the combination strategy in patients through two ongoing clinical trials at DCC.

One trial is for men with metastatic, castration-resistant prostate cancer. The first patient enrolled in the study experienced what Curiel described as an exceptional response to treatment. The second trial is in platinum-resistant ovarian cancer, which just enrolled its first patient.

“We are encouraged by what we are seeing so far,” Curiel said. “We have multiple trials in development to determine whether this approach can help more patients benefit from more effective cancer treatments.”

Source: Dartmouth Cancer Center

Categories : Cancer Surgeries & ProceduresTags :

Liquid Nitrogen Saves Teen’s Leg in SA Medical First

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Patient’s own bone treated and reimplanted in breakthrough procedure

Medical first: Dr Herman Breet, Dr Jadine Du Plessis, and Dr Jaco Viljoen (left to right) performed South Africa’s first liquid nitrogen limb salvage surgery at Netcare Unitas Hospital this week.

Thursday, 16 April 2026: In a South African first, a Centurion-based surgeon has successfully performed a hip and limb salvage procedure using a liquid nitrogen dipping technique.

This pioneering approach, performed at Netcare Unitas Hospital in Tshwane this week, could significantly expand treatment options for certain patients with orthopaedic cancers, particularly those who would typically require removal of the affected bone and its replacement with a large prosthesis.

The operation saved the leg of a 15-year-old boy with Ewing’s sarcoma, an aggressive bone cancer. Standard treatment usually involves removing the cancerous section of bone and replacing it with either a large metal prosthesis or the patient’s own bone after irradiation to destroy cancer cells.

“When I explained that conventional surgery meant no more contact sports, I saw the devastation in his eyes – and in his father’s. That’s when I knew we had to try something different,” recalls Dr Jaco Viljoen, an orthopaedic surgeon with a special interest in orthopaedic oncology.

“I’d been prepared for this exact scenario for ten years. When I mentioned there might be another way – a chance he could play sport again – their faces lit up,” says Dr Viljoen.

During the four-and-a-half-hour procedure, Dr Viljoen led a skilled team in removing a 24-centimetre section of the teenager’s femur (thigh bone) where the cancer had developed. Working alongside Dr Viljoen were assistants Dr Jadine Du Plessis and Dr Herman Breet, anaesthetist Dr Bianca Brits, and scrub nurses Registered Nurse Gloria Kgwete and Enrolled Nursing Assistants Leah Lekoane and Mahlatse Motheta.

The team treated the removed segment by immersing it in liquid nitrogen at -179°C to destroy cancer cells. The bone was then reimplanted, marking the first time this technique had been performed in South Africa.

“This kind of complex surgery is only possible with an exceptional team. Every person in that operating theatre played a crucial role in giving this young man his future back,” Dr Viljoen said.

Ewing’s sarcoma is the second most common bone tumour in children and adolescents, according to a recent study in The Lancet Oncology. This aggressive cancer primarily affects individuals aged 10 to 20, with about 80% of cases diagnosed before the age of 20. It most commonly arises in the long bones of the legs and arms, as well as in the pelvis and chest wall, accounting for 10 to 15% of all bone cancers. Without treatment, the disease progresses rapidly, making early intervention critical.

“A day after surgery, the patient was alert and showed good neurovascular function in the affected leg – promising early signs. He even managed a few assisted steps with his physiotherapist, Leonie De Lange. Follow-up tests will monitor how well the treated bone integrates, and we’re cautiously optimistic about his progress,” comments Dr Viljoen.

“This technique marks a significant departure from standard treatment. The traditional approach would have involved the complete removal of the affected bone, followed by a complex prosthetic reconstruction of the hip, which often limits long-term mobility and rules out a return to contact sports. A second alternative – irradiating the patient’s bone before reimplantation – can compromise bone integrity and increase the risk of non-union, often requiring further surgery. For this keen young rugby and cricket player, preserving his natural bone and joint function was a critical consideration,” he adds. 

The ideal solution stemmed from a Japanese technique Dr Viljoen had been holding in reserve. The sophisticated procedure, though developed by specialists in Japan more than a decade ago, is rarely performed worldwide – particularly not in patients with Ewing’s sarcoma – and requires exceptional precision. The extreme cold destroys cancerous tumours while preserving the bone’s architecture, allowing it to heal naturally once reimplanted and secured with surgical pins.

“We’ve effectively preserved his bone and hip joint. His own bone will regenerate and integrate with the surrounding tissue. For a young person, that’s game-changing, as his leg can continue to develop normally.

By preserving his natural anatomy, this procedure offers him the possibility of returning to full activity once healed. This technique offers hope of avoiding amputation in other clinically appropriate patients,” explains Dr Viljoen.

Dr Viljoen previously headed the Tumour, Sepsis and Limb Reconstruction Unit at Steve Biko Academic Hospital. A graduate of the University of Pretoria, he completed his orthopaedic specialisation in 2015 and now practises privately at Netcare Unitas Hospital and Netcare Montana Hospital.

“Dr Viljoen and his colleagues have added another chapter to South Africa’s legacy of medical excellence. But, this is about more than innovation – it’s proof that worldclass orthopaedic care happens right here at home, offering hope to patients facing life-altering conditions such as Ewing’s sarcoma,” adds Dr Erich Bock, managing director of Netcare’s hospital division.

“This is what sets exceptional healthcare apart – seeing the whole person, not just the disease. Dr Viljoen and his team haven’t just treated cancer – they’ve preserved a young man’s dreams. That is the true essence of person centred healthcare,” concludes Dr Bock.

Categories : CancerTags :

Anaemia Linked to Increased Cancer Risk

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Anaemia detected in healthcare is associated with an increased risk of both cancer and higher mortality. This is shown in a new population-based study from Karolinska Institutet, published in BMJ Oncology. The findings may help guide clinical follow-up of patients with anaemia in routine care.

Anaemia is common among patients in healthcare and is defined by haemoglobin levels below the normal range. In this study, the researchers analysed the association between newly detected anaemia and the risk of cancer and mortality, and examined whether different types of anaemia, classified by the size of red blood cells, play a role. 

The study is based on register data from the Stockholm Early Detection of Cancer Study (STEADY‑CAN) and includes almost the entire adult population of Stockholm County between 2011 and 2021. In total, just over 190 000 adults with newly detected anaemia were included, along with an equal number of age- and sex-matched individuals without anaemia. All participants were over 18 years of age and cancer-free at study entry. 

The participants were followed for up to 18 months after anaemia was detected. During this period, 6.2 per cent of men and 2.8 per cent of women with anaemia developed cancer. The corresponding figures among individuals without anaemia were 2.4 per cent and 1.1 per cent, respectively. Mortality was also higher in the group with anaemia. 

“We found that both the risk of cancer and the risk of death are highest during the first months after anaemia is detected, but that the increased risk persists later during follow-up as well,” says Elinor Nemlander, researcher at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and first author of the study. 

Type of anaemia matters 

The study also shows that the type of anaemia is important. Individuals with small red blood cells, known as microcytosis, had a particularly high risk of cancer, especially cancers of the gastrointestinal tract and the haematopoietic system. By contrast, individuals with large red blood cells, macrocytosis, showed a stronger association with increased mortality, but not with cancer to the same extent. Red blood cell size is measured using the laboratory value MCV, which is included in routine blood tests. 

“Our findings suggest that anaemia may be a sign of underlying disease rather than a condition in its own right. Blood tests that are already part of routine care can provide important information about which patients need closer follow-up,” says Elinor Nemlander. 

Source: Karolinska Institutet

Categories : Cancer ExerciseTags :

Metformin May Echo the Benefits of Exercise in Prostate Cancer Care

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Photo by Jonathan Borba on Unsplash

A new study has found that metformin may mimic one of exercise’s core biological effects in men with prostate cancer, raising levels of a molecule tied to energy balance and weight control even when patients are inactive. The findings suggest that metformin could help counter the metabolic strain of hormone therapy, when fatigue and other side effects often limit physical activity.

Led by physician-scientists at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, the study appears in the journal EMBO Molecular Medicine.

Exercise is one of the most reliable ways to support health during cancer treatment. It helps regulate weight, blood sugar, and cardiovascular health – factors that shape how patients feel during therapy and how well they recover afterward.

For many people with cancer, however, regular exercise isn’t always feasible. Fatigue, hormone therapy, pain, or advanced disease can limit physical activity precisely when metabolic health becomes most important.

That reality has led researchers to ask a practical question: If exercise confers its benefits through specific biological signals, could some of those signals be activated in other ways?

According to the research, the answer may be yes. Sylvester investigators report that metformin raises levels of a naturally occurring molecule involved in how the body manages energy and weight in prostate cancer patients.

The finding does not suggest that a pill can replace physical activity. Instead, it offers insight into the internal pathways that underlie exercise’s metabolic benefits – and how those pathways might still be engaged when movement is limited.

“This study reflects what’s possible when laboratory science, metabolic biology, and clinical investigation are intentionally brought together for transdisciplinary studies,” said Sylvester researcher and first author, Marijo Bilusic, MD, PhD, genitourinary medical oncologist and professor of medicine and medical oncology at the Miller School. “The result isn’t a new cancer biomarker, but a clearer understanding of how a widely used drug may support metabolic health during prostate cancer treatment – an outcome that matters to patients and clinicians alike.”

The molecule at the heart of the study

At the center of the collaborative, team-science study is a molecule called N-lactoyl-phenylalanine (Lac-Phe). While its name is technical, its role is relatively simple.

Lac‑Phe is produced when the body is under metabolic demand. It forms when lactate, which accumulates during exertion, combines with phenylalanine, a basic building block of protein. Scientists first took notice of Lac‑Phe because its levels spike after intense exercise, coinciding with shifts in energy use and appetite regulation.

In preclinical and early human studies, higher Lac‑Phe levels have been associated with reduced appetite and improved weight control – two effects commonly linked to regular physical activity.

Lac-Phe does not rise only with exercise. Scientists observed elevated Lac-Phe levels in people taking metformin, even in the absence of physical activity. That overlap raised an important question for cancer care: Could a pathway typically associated with exercise be activated pharmacologically in patients whose treatments limit movement?

Why prostate cancer patients are a focus

To explore that question, the Sylvester team focused on prostate cancer, where hormone-based therapies are known to disrupt metabolism, contributing to weight gain, insulin resistance, and cardiovascular risk.

Notably, Lac-Phe levels in patients treated with metformin approximated those previously reported after strenuous exercise. This occurred even though patients were not exercising at the time of blood collection, and the effect persisted after hormone therapy began.

“From a clinical standpoint, seeing a metabolic signal that mirrors what we associate with intense exercise was striking,” said Bilusic. “For patients whose treatments or symptoms limit physical activity, that kind of effect could be especially meaningful.”

Higher Lac-Phe levels were not associated with anti-tumour response to metformin. The metabolite did not correlate with changes in prostate-specific antigen (PSA), a standard marker used to monitor prostate cancer.

What Lac-Phe might mean for patients

That distinction is central to the study’s interpretation. While more expanded studies are needed to determine the utility of Lac-Phe as a marker of anticancer efficacy, it appears to reflect how the body manages energy, weight and metabolic strain during treatment. These results were confirmed to ensure the findings were not limited to one clinical setting. In fact, increases were also observed in patients receiving other metabolic therapies, suggesting Lac-Phe may reflect a broader metabolic response rather than a drug‑specific effect.

“Cancer therapy often affects the body in ways that go beyond the tumour,” said Sylvester researcher Priyamvada Rai, PhD, co-leader, Tumor Biology Program and professor of radiation oncology at the Miller School. “Supporting metabolic health can influence how patients tolerate treatment and how they feel over time, even if it doesn’t directly change tumour growth. This study was an opportunity to investigate molecular pathways that can be therapeutically activated for better outcomes to treatments that induce metabolic stress.”

Metformin raises a stress hormone called GDF‑15, but this study found that Lac‑Phe was more closely tied to weight changes. Because the two didn’t rise together, metformin likely affects weight through multiple pathways, with Lac‑Phe playing a bigger role.

Taken together, the findings offer a clearer picture of how a widely used diabetes medication may influence metabolic health during prostate cancer care.

“What’s encouraging about this work is that it reminds us cancer care isn’t only about targeting tumours – it’s also about supporting the whole patient,” said Rai. “By better understanding how treatments affect metabolism, we can begin to identify ways to help patients maintain strength, resilience, and quality of life throughout their care.”

Source: University of Miami

Categories : Cancer TransplantsTags :

Will the NHI Cover the Full Cost of Saving a Life?

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The public health sector serves roughly 84% of South Africans, yet per-person spending in private healthcare is around five times higher. The National Health Insurance (NHI) is designed to change that equation. As President Ramaphosa stated, the right to healthcare “cannot depend on where you were born, how much you earn or where you live.”

For patients with blood cancer and blood disorders, that promise could not be more urgent. On World Health Day 2026, Palesa Mokomele, Head of Community Engagement and Communication at DKMS Africa, says this is an opportunity to ask whether the NHI is being designed to reach them. “Blood cancer and blood disorder patients depend on highly specialised treatment pathways – exactly the kind the NHI has an opportunity to strengthen. They cannot be an afterthought in the benefit package conversation.”

The NHI Act was signed into law in May 2024 but has not yet commenced, with key constitutional challenges set to be heard in May 2026. Despite legal uncertainty, the government has been clear that foundational work will continue.

The Reality on the Ground

Stem cell transplantation is one of the most effective treatments for blood cancers and blood disorders, and among the most resource-intensive, requiring specialist physicians, trained nurses, dedicated infrastructure, and in 70% of cases, a matched unrelated donor (MUD).

The capacity to deliver these treatments is already under severe strain. Just 25% of South Africa’s oncologists serve more than 75% of the population. Long treatment delays, limited resources, high patient volumes, and advanced disease at presentation make for a deeply challenging environment.

“What we see is a system doing its best under enormous pressure,” says Mokomele. “The NHI has a real opportunity to address those structural gaps, but it requires deliberate investment where the need is greatest.”

What Universal Coverage Must Include

The NHI benefit packages for the treatment of blood cancer and disorders have yet to be finalised. With South Africa projected to see a 78% increase in cancer incidence by 2030, whether those packages cover the full cost of finding, matching, and transplanting an unrelated donor will be a test of whether universal health coverage means what it says.

“We are not here to debate the merits of the NHI,” shares Mokomele. “We are here to make sure that when it is implemented, it works for every patient. The full treatment pathway must be funded, and the clinical infrastructure to deliver it must be in place.”

President Ramaphosa has called for genuine partnerships between the public and private health sectors, academic institutions, NGOs, and communities. “That vision of cross-sector collaboration reflects exactly how we believe this challenge must be met,” notes Mokomele.

A Blueprint for Access

DKMS Africa’s Access to Transplant programme offers a practical example of barrier-free access in the public sector. Working across six provinces, it aims to invest in infrastructure upgrades at public hospitals, training for specialist nurses and mobilises its global network to collaborate with physicians, and patient support services addressing practical barriers, such as transport and housing, that often cause patients to abandon treatment.

“When you remove barriers systematically, outcomes improve,” points out Mokomele. “Each barrier removed is a patient who makes it to transplant. That is the model the NHI needs to learn from and scale.”

The organisation is also preparing for a more centralised system, ensuring its programmes can integrate into national frameworks while maintaining global standards – through early diagnosis education, donor registry diversification, stronger referral pathways, and local research capacity.

Your Health System, Your Voice

The decisions being made about the NHI benefit package today will shape healthcare for decades. Young South Africans will inherit both the growing burden of disease and the system designed to address it.

“World Health Day is a reminder that universal means everyone,” concludes Mokomele. “We are asking young South Africans to support us in uniting towards a healthcare system that works for everyone.”

Categories : CancerTags :

Vaping is Likely Carcinogenic, Finds New Review

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Credit: Pixabay/CC0 Public Domain

Nicotine-based vapes (e-cigarettes) are likely to cause cancers of the lung and oral cavity, according to a new study led by UNSW Sydney and published in Carcinogenesis. The study is titled “The carcinogenicity of e-cigarettes: a qualitative risk assessment.”

The work analyses a wide body of global research and was led by UNSW cancer researcher Adjunct Professor Bernard Stewart AM, with investigators from The University of Queensland, Flinders University, The University of Sydney, as well as Royal North Shore, The Prince Charles and Sunshine Coast University hospitals.

The team brought together experts from multiple disciplines, including pharmacists, epidemiologists, thoracic surgeons, and public health researchers. Together, they examined the evidence from different scientific perspectives.

“To our knowledge, this review is the most definitive determination that those who vape are at increased risk of cancer compared to those who don’t,” Prof Stewart says.

This assessment of carcinogenicity review argues that while researchers have long focused on vaping as a gateway to smoking, less attention has been paid to whether the devices might cause cancer on their own.

It is one of the most detailed attempts yet to determine whether vaping itself may cause cancer, independent of tobacco smoking. The analysis draws together clinical studies, animal experiments, and laboratory research examining the chemicals produced by e-cigarettes.

“Considering all the findings—from clinical monitoring, animal studies and mechanistic data—e-cigarettes are likely to cause lung cancer and oral cancer,” Prof Stewart says.

He says that though the consistency of findings across those disciplines was striking, the exact number of attributable cancer cases remains unclear.

“Our assessment is qualitative and does not involve a numerical estimate of cancer risk or burden. We’ll only be able to determine the precise risk once longer-term studies are available.”

Growing public health concerns

E-cigarettes were first sold in the early 2000s. Early marketing framed them as a “safer” alternative to tobacco cigarettes, as well as a possible aid for quitting smoking.

But the colourful, flavoured devices of today have spread quickly and widely, particularly among young people.

“E-cigarettes are known to be a gateway to smoking and hence cancer,” says co-author UNSW Associate Professor Freddy Sitas. “But the extent to which they may cause cancer in their own right has not received as much attention in research. The evidence was remarkably consistent across fields. It dictated an unequivocal finding now, though human studies that estimate the risk will take decades to accumulate.”

A clear outcome

Smoking has been studied for more than a century. Though e-cigarettes are relatively new, inhaling nicotine-laced aerosols is already linked to addiction, poisoning, inhalation injuries, and burns.

While researchers wait for long-term population studies showing whether people who vape are more likely to develop cancer, they must rely on multiple other forms of evidence.

The team identified numerous carcinogenic compounds in e-cigarette aerosols, including volatile organic chemicals and metals released from heating coils.

They examined several types of evidence: biomarkers in people showing DNA damage, oxidative stress, and tissue inflammation; experiments in mice that caused lung tumours; and laboratory studies showing cellular damage and disrupted biological pathways linked to cancer.

Taking all the results together, the researchers say the evidence points strongly in one direction.

A compounding problem

There is also growing evidence that many smokers who switch to vaping don’t quit cigarettes.

“Most of those who use e-cigarettes to quit smoking end up in ‘dual-use limbo,’ unable to shake off either habit,” says A/Prof Sitas. “What we do know from recent epidemiological evidence from the U.S. is that those who both vape and smoke are at an additional four-fold increased risk of developing lung cancer.”

History repeating

A/Prof Sitas and Prof Stewart traced parallels between the early scientific evidence linking smoking to disease and emerging concerns about vaping.

It took nearly a century of scientific investigation—from the mid-1800s to the landmark US Surgeon General’s report in 1964—before smoking was officially recognised as a cause of lung cancer.

During that time, early warning signs were often dismissed or overlooked.

“Early reports linked smoking to infectious diseases such as tuberculosis, followed by cardiovascular disease, stroke and lung cancer,” A/Prof Sitas says.

He says the same pattern may now be unfolding with vaping, and that researchers should not repeat the delay that occurred with cigarettes.

“E-cigarettes were introduced about 20 years ago. We should not wait another 80 years to decide what to do.”

Source: University of South Wales

Categories : Cancer Urology

Increased Bladder Cancer Survival with New Combination Treatment

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Photo by National Cancer Institute on Unsplash

A combination of immunotherapy and targeted cancer treatment given before and after surgery may reduce the risk of recurrence and improve survival in patients with muscle‑invasive bladder cancer who cannot tolerate conventional chemotherapy. The findings come from a new study from Karolinska Institutet, published in The New England Journal of Medicine.

Muscle‑invasive bladder cancer is a serious disease with a high risk of recurrence. To lower the risk of recurrence, patients are often given cisplatin‑based chemotherapy before surgery, but around half of patients cannot receive this treatment, commonly due to impaired kidney function. In the phase 3 study, all participants underwent standard surgery, in which the bladder is removed. One of the groups also received a new combination treatment with the immunotherapy pembrolizumab and the targeted drug enfortumab vedotin before and after surgery.

Large differences between the groups

The results show that 75% of participants treated with the combination therapy were alive without recurrence two years after enrolment, compared with 39% in the control group. When the researchers looked at overall survival, a larger proportion of patients in the treatment group were also alive after two years. In addition, no tumour cells were found in the removed bladder tissue in 57% of patients in the treatment group, compared with 9% in the control group. In total, 344 participants from 27 countries took part in the study.

“These are very promising results for patients with few treatment options available before surgery. It is also reassuring that the treatment does not appear to affect the ability to proceed with surgery, which can otherwise be a concern when treatment is given beforehand,” says Anders Ullén, professor of oncology at the Department of Oncology‑Pathology at Karolinska Institutet and the study’s last author.

Side effects occurred in both groups

All patients who received the combination treatment experienced some form of side effect. Common side effects included itching and hair loss, and the most frequent serious side effect in both groups was urinary tract infection. Serious complications also occurred among those who underwent surgery alone, which the researchers note reflects the fact that many patients in this group are older and have other underlying health conditions.

“It is always important to balance the benefits of treatment against the risk of side effects. At the same time, the results indicate that the treatment may offer clinically meaningful improvements, reduce the risk of recurrence and improve survival for many patients. We hope that the findings can help inform future treatment practice,” says Anders Ullén.

Source: Karolinska Institutet

Categories : CancerTags :

Study of North Korean Defectors Reveals Cancer Risk Changes

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North Korean defectors who resettled in South Korea share genetics but markedly contrasting early-life exposures with South Korean residents. Research published in the Journal of Internal Medicine compared overall and site-specific cancer incidence rates between North Korean defectors and native South Koreans.

Breast cancer cells. Image by National Cancer Institute

Using the Korean National Health Insurance database, researchers matched 25 798 North Korean defectors and 1 276 601 South Korean residents. Defectors had higher risks of infection-related cancers (such as liver and cervical cancers) and lower risks of breast, colon, and prostate cancers (which are more prevalent in developed countries). Over time, though, their cancer profile changed, suggesting adaptation to South Korean society.

“The study provides a model for understanding how cancer epidemiology evolves in such transitions, offering lessons that may help guide prevention and health planning for other vulnerable groups in transition worldwide,” said corresponding author Sin Gon Kim, MD, PhD, of the Korea University College of Medicine.

Source: Wiley