Chemothrapy: What’s New

Originally developed in the 20th Century, Chemotherapy is one of the most widely-used cancer treatments.

Interestingly enough, chemotherapy was discovered by accident when scientists during World War II found that soldiers who had been injured by nitrogen mustard were struggling to produce normal white blood cell counts.

By the mid-40s, researchers from Yale began investigating potential therapeutic methods of using the very same mustard agents to treat lymphoma. They began by testing mice with established lymphomas, proving that it was possible to control and curb the growth of the cancerous cells.

Over the course of the following decades further progress was made in the field with scientists from both sides of the Atlantic contributing to this innovative new world of treatment by poison. In the late 40s, researchers from Harvard developed folate analogues to battle folic acid, whilst Eli Lilly discovered that plant alkaloids extracted from Vinca rosea and other similar plants, could also prove beneficial to treating Hodgkin’s disease and leukaemia in children.

But what is the current state of chemotherapy – is it still as relevant as it once was? Do we need to reevaluate its importance in the modern health climate?

Breast Cancer Patients Might Not Need Chemo

For decades chemotherapy has been considered as one of the go-to treatments for cancer. Despite the damage that it has on the body, medical professionals have deemed it to be one of the best treatments available, especially for breast cancer.

But a recent study from Harvard Medical School has suggested otherwise. It’s been estimated that of the 23,000 UK women who are diagnosed with the most frequently diagnosed form of breast cancer each year, less than a third would actually need chemotherapy.

Using genetic testing, this research has identified certain groups of women who are able to receive alternate treatment thereby saving them from the considerable discomfort of many of the side effects of chemotherapy which include: vomiting, nausea, loss of hair and a failure with the immune system. Being able to safely determine which patients will benefit from chemo and which won’t should prove instrumental in reducing costs for the NHS, as well as increasing overall patient care.

International trial re-purposes accidental poisoning drug

In the world of medicine the solution to a problem can often be right under your nose the whole time, or at least that’s what Professor Micheal Sullivan from the University of Melbourne found after discovering that doses of sodium thiosulfate (STS) could significantly reduce hearing loss in children being treated with popular chemotherapy drug Cisplatin.

Although it’s known as one of the best treatment drugs for many types of childhood cancer it typically causes 66% of patients to suffer some form of hearing loss.

STS, which is usually used to treat accidental cyanide poisoning works can be administered quickly and serves to protect the hair cells in the inner ear which are vulnerable to damage during Cisplatin-based treatment. A reduction of hearing loss was found to occur just six hours after STS was administered to patients without hampering the cancer treatment. Thanks to the extensive pool of 116 subjects used for a clinical trial led by Professor Peppy Brock from Great Ormon Street Children’s Hospital, Professor Sullivan can now begin using STS for this purpose immediately.

MRI Scans: What’s New

MRI Scans have long been a standard method for Oncologists to search for abnormal tissues and tumours.

Despite CT scans often being considered as far more accurate in terms of diagnosing many forms of cancer, MRI scans are still relied on a day-to-day basis by professionals around the world to inspect otherwise inaccessible regions of the body such as the brain, spinal cord, bones and blood vessels. Regardless of how useful this machine is to modern healthcare there are still ways that we can improve how we use this technology.

This month a number of stories have emerged highlighting how improved vigilance and focused innovation can help us avoid making errors in the future and increase our methods of diagnosis when using this valuable piece of equipment:

Patients in Wales are ‘too big’ for MRI Scanners

At what point do we start building larger MRI scanners to accommodate for obese patients? In a recent study concluded by Cardiff and Vale University Health Board it was found that over 200 scans have had to be cancelled since 2014 due to patients being ‘too big’ to fit into MRI Scans.

Although this story has (rather predictably) been picked up by the tabloids as a form of click-bait it’s important for us to look past the sensationalist responses and put consideration into how to respond to this problem. After all, obesity is one of the leading preventable causes of death in the country with 28.1% of the country being classed as obese.

A man in India dies after MRI accident

Rajesh Maru, 32, was invited to enter a room to visit a relative undergoing a routine MRI scan in a state-run hospital in Mumbai. He was allowed to enter the room with an oxygen cylinder in his hand which was pulled violently towards the machine along with Mr. Maru. The impact of the cylinder against the machine caused a leak of liquid oxygen which the visitor inhaled which led to his death soon after.

It might be easy to dismiss this case as another example of lax health and safety in a developing country, but this kind of accident can all too easily occur – in fact a similar incident led to the death of a young boy in New York in 2001. This should serve as a wake-up call to practitioners at all responsibility levels.

Erasable MRI Scans could improve diagnoses

As many radiation oncologists will know, the use of contrast agents to make scans easier to read can be both a blessing and a curse. These magnetic dyes, administered orally or directly into the blood stream, can help oncologists identify tumours with greater accuracy but they can often be difficult to distinguish from normal body tissues damaging the efficacy of the process.

Researchers at the California Institute of Technology have been working on the development of ‘erasable’ contrast agents which should allow technicians to ‘turn off’ contrasting agents through the use of ultrasound. Mikhail Shapiro, assistant on the project, is hoping that this advancement will lead to contrast agents becoming far more visible in scans thus reducing false-positive results and other misdiagnoses.

Gerald’s Near Miss

At the age of 55, Gerald Manson from Wolverhampton had considered himself rather lucky in life.

Gerald Manson, a gardener from Wolverhampton, had thought his life was charmed until he found a rather nasty surprise when he lifted up his shirt at work.

“I’d never been ill a day in my life, never taken a day off sick and still had all my teeth – I always thought I was lucky!”

Having a physical vocation is what Gerald attributes his excellent health to. Since the age of 15 he has worked as a gardener/labourer, a role that often involves a lot of moving around and often long days spent outside breathing the fresh air.

“My job’s really varied, its what I love about being a gardener. One day I could be laying down a blanket of turf, the next day I could be fitting a series of garden fencing panels. I love doing DIY and gardening, so getting hired for these kinds of jobs is an absolute God send.”

After 40 years of working outside, at the age of 55 Gerald is still going although a recent run in with a melanoma did briefly stop him in his tracks:

“I’m not a small bloke, I drink a few pints each week and I probably eat a few too many chips so I suppose I’d always ran the risk of getting some kind of illness, but had always been lucky enough to avoid it. If I ever expected to get ill, it was through my bad habits rather than anything else.”

Melanoma, otherwise know as skin cancer, is one of the most common forms of cancers in the UK. Signs to look out for are any changes in colour or shape of existing moles, but for the unaware these kinds of cancer can easily go unnoticed. In Gerald’s case it took a particularly observant off-duty GP to notice that there was something the matter.

“I don’t usually take my shirt off whilst I’m working out of professional courtesy, but last summer there were a couple of scorchers that I had to work through where it truly felt like the only way to cool down. I’d been fitting some fences for a client on this particular day and assuming they’d popped out for a spell, I took the opportunity to pop my shirt off.”

Half-way through the job, Gerald was stopped by his client who had come out to offer him a drink but had been stopped in her tracks by the formations of abnormally shaped moles on his back.

“She asked me if they’d always been like that and I had to ask her what she was talking about. Don’t get me wrong I give my back a good scrubbing each night, but I never really get a good look at it. Soon she had me lie down on the floor so she could take photos to send to her colleagues. Within seconds she had replies confirming her initial theory, I had a huge collection of melanomas on my back and they needed.”

This kind of chance diagnosis does not happen very often, so Gerald can count himself lucky. Thankfully, he completed his treatment successfully and is now back where he belongs: in someone’s garden!

Summer Radiation Oncology Conferences

Are you in need of a refresher on your specialty?

The field of Radiation Oncology is always expanding and growing, luckily there are plenty of conferences on this summer for you to catch up with all the changes.

It can be easy to fall behind the current best practices in the industry, one of the best ways of keeping up to speed is by attending a conference. Not only do conferences give you the chance of learning about any new changes that might be helpful to your day-to-day tasks, but they’re also a great way of staying ahead of the curve. Only the very cream of the crop are hired by conference organisers to speak so you can guarantee that you’re going to get your money’s worth and also get a glimpse at what’s yet to come.

The Summer conference schedule is jam-packed this year with plenty of events that will get you the info that you need, see below for our selection:

Global Congress on Prostate Cancer 2018

Only 600 place are available for this year’s PROSCA Congress, but that doesn’t mean that you should discount it as an option. This event offers the unparalleled opportunity to get completely up to date on all things Prostate Cancer in the space of three days. Professionals of all pedigrees can benefit from in-depth lectures from top tier industry experts, participation in debates and have the opportunity of meeting other prostate management experts from around the world.

Where? Fankfurt Am Main, Germany

When? June 28-30 2018

How much? Researchers and students can apply for €250, whereas physicians must pay €850

Congress on Cancer in Women 2018

Focusing on the advances of Oncology and Radiotherapy treatments for women, this particularly niche conference offers you the chance to dive deep into a set of exclusive learning modules on topics such as gynecological cancer, hematology, melaonoma and breast cancer. Endorsed by the Mexican Society of Radiotherapy and the National Cancer Institute of Mexico, this conference will feature numerous presentations, as well as guest speakers from Europe and the United States.

Where? Hilton Mexico City, Mexico

When? July 27-28 2018

How much? See site for details

IASLC Latin America Conference on Lung Cancer 2018

Argentina hosts this year’s Latin American conference on Lung Cancer, a disease that is the leading cancer-related killer in the world. Surgeons, oncologists and radiologists alike will find their agenda of much interest as speakers from around the world, such as Luis E. Raez, Susana Vanoni and Ignacio Wistuba will be present to provide details of the progress made in their fields of expertise.

Where? Sheraton Hotel, Cordoba, Argentina

When? August 15-18 2018

How much? Early bird registrants can gain access for as little as $150 for non-IASLC members whereas students and residents can register for free.

Canadian Association of Radiation Oncology 32nd Annual Scientific Meeting

Above all else this revered annual conference provides students, therapist, nurses and oncologists with the opportunity to get a complete understanding of specific therapies and treatments for cancer. Practical lectures are held over the course of four days with speakers including Dr. Thomas DeLaney, Dr. Laura Dawson and Dr. Luc Beaulieu who will be offering an insight into his breakthroughs in permanent seed implantation for prostate cancer.

Where? Le Centre Sheraton Montreal Hotel, Canada

When? September 10-15 2018

How much? Full conference access for students comes at $275, whereas non-member practitioners must pay $798