Author Archives: admin

Invest in the NHS Cancer Workforce

Covid-19 exposed the terrible strain the NHS cancer workforce has been under for years. This is now the greatest threat facing the NHS. We are calling for the Government to use the Spending Review to fund the additional provision of NHS staff to diagnose, treat and care for cancer patients. Follow this link or just click on the image to read more and add your name to this petition:-

https://petition.parliament.uk/petitions/596566

 

New drug could slow tumour regrowth in inoperable bowel cancer.

Adavosertib found to delay tumour growth in some patients in clinical trial, with few side effects

Researchers have identified a potential new targeted treatment for incurable bowel cancer.
The medication has shown promise in a clinical trial in slowing the regrowth of tumours among some patients with the condition.
The trial looked at whether a drug called adavosertib, taken as a daily pill, could delay tumour regrowth among patients with an aggressive sub-type of inoperable bowel cancer who have limited treatment options. Researchers compared 44 patients who took adavosertib with 25 patients who did not. They found that the drug delayed tumour growth by about two months on average and had relatively few side effects.

The drug had more effect in the 31 patients with left-sided/rectal tumours, increasing overall survival – meaning patients lived longer.
The lead author, Dr Jenny Seligmann, of the University of Leeds, said: “These results show promising signs that adavosertib may be effective in delaying regrowth of bowel cancer in some patients and is well tolerated.
“The findings are particularly encouraging as the subset of patients involved represent a third of all bowel cancer patients and, while other patients have treatments developed specifically for their tumour types, this group currently has very limited treatment options.”
The scientists caution that larger trials are needed to establish whether the drug improves survival compared with standard treatment.
The drug was trialled among patients on a treatment break after chemotherapy.

However, the research suggested adavosertib could benefit patients with other types of bowel cancer or alongside standard treatments in other lines of therapy. The subset of patients who took part in the trial had tumours with two common mutations, RAS and TP53. Scientists hypothesised these mutations would make the tumours more sensitive to the drug.
According to researchers, about a third of colorectal cancer patients have tumours with these two mutations.

In the UK more than 42,000 people are diagnosed with bowel cancer every year. It is the fourth-most common cancer in the UK and the second-biggest cancer killer.

The findings come from a large collaborative UK trial called Focus4 which aimed to investigate the best ways to help people with inoperable bowel cancer who have already received some chemotherapy. Co-author Prof Louise Brown, from the Clinical Trials Unit at UCL and statistical lead for the Focus4 trial, said: “The results for the adavosertib arm of the trial are potentially important and represent a glimmer of hope for patients in this group.”

Adavosertib kills cancer cells by inhibiting a protein that helps to regulate the process of cell division in the tumour.
Side-effects included fatigue, diarrhoea, neutropenia (involving low levels of white blood cells called neutrophils) and nausea, but none occurred in more than 11% of patients.

A second study from a separate part of the Focus4 trial called Focus4-N, also published in the Journal of Clinical Oncology, looked at outcomes among patients who had a complete break from treatment after chemotherapy.
They were compared with outcomes among those who continued chemotherapy using a simpler tablet called capecitabine.
Researchers found that, among those who had a complete break, the cancer started to grow sooner than in those on continued maintenance therapy.
But that maintenance therapy did not lead to an increase in how long people lived, the study suggested.

The Focus4 trial is funded by the EME Programme – an MRC/NIHR partnership – and Cancer Research UK and is run from the MRC Clinical Trials Unit at UCL in collaboration with Oxford University, Leeds University and Cardiff University.

Obesity Causes Cancer!

Watch this video to see how cancer (especially bowel and breast cancer) are linked to obesity.

The statistical evidence of this link is undeniable. This diagram gives a clinical explanation of the causal relationship:

To read the complete Cancer Research UK article follow this link

 

Old Man Cycling

“My name is Mike. Over the years, our family has had help from a variety of charities, this is in a small way maybe turning the support the other way. How am I doing that? Bit of a bike ride. This is a long cycle, not sure how well that is going to go, and these charities are listed as potential beneficiaries. They all need support as recently charity fund raising has suffered.”

To read more, click on the image above which shows the charities that will benefit.

Mike is a member of C-Side and we wish him all the best for this mammoth test of endurance to take place on Sunday 19th June. Please find it in your hearts to make a modest sponsorship contribution. You can see that there are a wide range of beneficiaries, many of them might be of particular value to you one day!

To read more about the Chase the Sun event click here.

 

 

Swimming with a Stoma

Gill Castle is on a mission to break down fear and stigma around swimming with a stoma bag.

She proudly wears her colostomy pouch, which she needs following a traumatic childbirth – something Gill calls an “unspoken topic of conversation”.

To raise awareness of stomas and birth trauma, Gill has spent the winter months swimming in the sea off the coast of north-east England.

She told her story to BBC World Service’s Newsday. Click on the picture to watch the video.

 

 

 

 

 

 

Stoma Advice

Long standing C-Side members will remember Helen Bracey, She was engaging, informative and an altogether outstanding guest speaker. Helen now works for Convatec and in their newsletter she describes eight top tips for maintaining healthy skin around your stoma :-

  • keep stoma care routines simple – avoid using products on the skin containing perfumes, chemicals or anything else which may cause irritation
  • always ensure your skin is completely dry before attempting to attach the baseplate of your stoma bag
  • make sure your bag fits snugly and check the hole cut into your baseplate is the right size for your stoma
  • check your skin regularly – even take pictures to help record changes
  • if you notice output on your skin this could be a sign your bag isn’t fitted correctly 
  • a healthy diet can help towards healthy skin ask your GP for advice
  • consider a barrier cream or adhesive remover if you don’t already use them
  • as soon as you feel any soreness or itchiness around your stoma contact your stoma nurse

You can watch Helen giving this advice, in person, by clicking on this Youtube video link

Click on the Convatech logo above, to find out more about the company, its products and the information it offers to those with a stoma.


BSUH Stoma Care Service

It would be remiss to not mention here the excellent service that Kate Evans and her team provide within the NHS.

Click on this link to download the BSUH Stoma Care Service leaflet.

UK-US Brexit Trade Deal – Increased Bowel Cancer Risk

Fears of illness caused by nitrites commonly used in US, but currently banned in Britain and EU.

Processed meat increases the risk of bowel cancer.
 
Processed meat increases the risk of bowel cancer. Photograph: Alamy
 

British stores could be flooded with “dangerous” bacon and ham from the US, marketed under misleading labels, as the result of a transatlantic trade deal, says the author of a new book based on a decade of investigation into the food industry.

The meat has been cured with nitrites extracted from vegetables, a practice not permitted by the European Commission because of evidence that it increases the risk of bowel cancer. But it is allowed in the US, where the product is often labelled as “all natural”. The powerful US meat industry is likely to insist that the export of nitrite-cured meat is a condition of a post-Brexit UK-US trade deal, which the UK government is under intense pressure to deliver.

“The American processed-meat industry acts just like big tobacco,” Guillaume Coudray, author of Who Poisoned Your Bacon Sandwich?, told the Observer. “It obscures the truth about nitro-meats and clouds the facts for its own commercial benefit – and they have been at it for decades. They have done this despite clear and overwhelming evidence that nitro-meats cause bowel cancer.”

Coudray’s claims echo the row over chlorinated chicken. The practice of washing poultry meat with chlorine is common in the US but banned in the UK. The government has said it will not allow the import of chlorinated chicken and hormone-treated beef under a transatlantic trade deal, but has refused to sign those pledges into law.

The US processed meat industry uses nitrites derived from celery juice to cure pig meat, keep it pink and preserve it so it can stay on supermarket shelves longer. Nitrites are harmless in themselves, but when they are cooked and ingested, they produce nitrosamines which are carcinogenic.

In 2015 the World Health Organization linked 34,000 worldwide cases of colorectal cancer a year to diets high in processed meats. Its report – based on epidemiological data from hundreds of thousands of people – advised that eating 50g of processed meat a day, the equivalent of a couple of bacon rashers, raised the risk of bowel cancer by 18% over a lifetime.

Coudray, whose book is published this week, said: “The American meat industry uses celery juice nitrites to cure bacon and ham. The Americans overtly mislead their consumers by claiming their products are ‘nitrite-free’ or ‘all natural’, whereas such claims have been banned in Europe.

“A free trade deal between the UK and the US poses a real risk of flooding the British market with dangerous bacon. As a result of inaccurate and misleading American packaging, consumers will have no way of knowing which products are genuinely safer.”

Despite its ban on vegetable-derived nitrites, the EU continues to allow conventional nitrites. But, said Coudray, progressive meat producers in the UK, France, Italy, Germany and Denmark had “taken great strides” in recent years to remove all nitrites from their products. For example, Italian producers have made Prosciutto di Parma for three decades without the use of nitrites. Naked Bacon, the UK’s biggest bacon brand, is also nitrite-free.

“France is considering banning nitrites altogether in a landmark bill before the French parliament,” said Coudray. “It is time the UK government did the same – and guaranteed these substandard American products will be banned entry into Britain.”

Bee Wilson, a food historian and writer who contributed a foreword to Coudray’s book, told the Observer: “The really interesting thing to watch is whether the French ban on nitrite-cured meat will come into force. If it does, this will be a huge shift in food policy which could encourage other governments in Europe to follow suit. But at the moment there is no sign of the rest of the EU following France.

“The traditions of curing bacon with these chemicals became established at a time when no one knew that they caused any harm. But now that we do know that they cause harm, the question is what to do next. [This] needs tougher regulation at a governmental level so that the whole industry is forced to change in unison.”

Coudray’s book also reveals aggressive lobbying by the US meat industry to overturn a UK ban on nitrite-cured meat during the second world war amid shortages of bacon and ham. Confidential diplomatic cables obtained by Coudray show the head of the US Bureau of Animal Industry accusing the British of “unfair discrimination”. The British board of trade warned that the US was “very disturbed about this matter”, “will not let it rest”, and “might be expected to take reprisals”.

US nitrite-cured bacon was allowed into Britain in 1944, prompting a 20-year campaign by the UK’s processed meat industry to be allowed to use nitrites. It was eventually successful.

Is FIT fit for purpose? Yes.

Re. Restoring Cancer Services (posted 18/1/2021). This may be of interest – from the British Journal Of Cancer 19th Jan 2021 – Don


Diagnostic Performance of a faecal immunochemical test for patients with low-risk symptoms of colorectal cancer in primary care: an evaluation in the South West of England.

Background: The faecal immunochemical test (FIT) was introduced to triage patients with low-risk symptoms of possible colorectal cancer in English primary care in 2017, underpinned by little primary care evidence.

Methods: All healthcare providers in the South West of England (population 4 million) participated in this evaluation. 3890 patients aged ≥50 years presenting in primary care with low-risk symptoms of colorectal cancer had a FIT from 01/06/2018 to 31/12/2018. A threshold of 10 μg Hb/g faeces defined a positive test.

Results: Six hundred and eighteen (15.9%) patients tested positive; 458 (74.1%) had an urgent referral to specialist lower gastrointestinal (GI) services within three months. Forty-three were diagnosed with colorectal cancer within 12 months. 3272 tested negative; 324 (9.9%) had an urgent referral within three months. Eight were diagnosed with colorectal cancer within 12 months. Positive predictive value was 7.0% (95% CI 5.1–9.3%). Negative predictive value was 99.8% (CI 99.5–99.9%). Sensitivity was 84.3% (CI 71.4–93.0%), specificity 85.0% (CI 83.8–86.1%). The area under the ROC curve was 0.92 (CI 0.86–0.96). A threshold of 37 μg Hb/g faeces would identify patients with an individual 3% risk of cancer.

Conclusions: FIT performs exceptionally well to triage patients with low-risk symptoms of colorectal cancer in primary care; a higher threshold may be appropriate in the wake of the COVID-19 crisis

Click here for the full article

Ed – Thanks to Don for sending this in.

Self-Management and the “app”

Electronic devices for home use which measure physical health parameters such as blood pressure, heart rate, blood oxygen levels and activity etc. proliferate. Results from them may be shared, usually as a part of a treatment programme, with a doctor, nurse or pharmacist. However, what is not being regularly monitored is the patient’s general health and well-being. IT companies have been encouraged to develop software to allow  patients to record and display this at home, using a mobile programme or app – one such is Vinehealth.

It would be good if C-Side members, could evaluate this, since there is no doubt that programmes such as this will become commonplace in the not too distant future.

You can learn more about Vinehealth here (or click on the picture). You can download the app from the App Store (Apple) and Google Play, It is free to download and use and is unlikely to present any risk to confidential information. Remember it is a mobile app, designed for use on a phone (IOS or Android) or an iPad; not at present on a laptop or similar.

New Recovery Plan for Cancer Services

The NHS has set out how it plans to return essential cancer services to pre-COVID-19 levels in a new plan. The Cancer Recovery Plan outlines actions to:-

  • restore demand for endoscopy services to at least pre-pandemic levels
  • reduce the number of people waiting longer than they should for diagnostics and/or treatment, set by the NHS, at least to pre-pandemic levels on both screening and symptomatic pathways
  • ensure sufficient capacity to manage future increased demand, including for follow-up care

To read more about the specific target areas, as described in an article in Beating Bowel Cancer UK, please click here or click on the above picture.