A Not-So-Sunless Tan?

Exposure to ultraviolet rays in tanning beds or outdoors is linked to increased risk of developing melanoma. Sunless tanning—using products like lotions, creams or sprays to achieve tanned skin—has been recommended as a safe alternative to tanning outdoors or in a tanning machine. But a study published July 25 in JAMA Dermatology raises concerns that sunless tanning could encourage other forms of tanning. Sunless tanning itself does not raise cancer risk. But the researchers found that American adults who engage in sunless tanning are more likely to use tanning beds and report recent sunburns. The study “suggests that sunless tanning products could inadvertently reinforce desires to achieve tanned skin,” study author Matthew Mansh of the University of Minnesota Medical School and University of Minnesota Health said in a press release.

Financial Toxicity Update

It’s increasingly clear that the out-of-pocket costs associated with a cancer diagnosis can put financial strain on patients, a phenomenon known as financial toxicity. A study of U.S. patients with early-stage breast cancer published July 23 in Cancer explores what physicians are doing to help patients deal with the cost of cancer. Surveying 2,502 patients and their doctors, the authors found that about half of medical oncologists said that someone in their practice often or always discussed finances with patients. Around 43 percent of radiation oncologists and 16 percent of surgeons reported these conversations. However, about 73 percent of the patients surveyed who said they were experiencing financial strain said that they did not feel that physicians and their staff had helped. “We found that even though many doctors reported that they routinely make services available to their patients to help with financial concerns, many patients still reported unmet needs,” said study author Reshma Jagsi of the University of Michigan in Ann Arbor in a press release.

Overdiagnosing Thyroid Cancer

Since the mid-1990s, the rate at which Americans are diagnosed with thyroid cancer has tripled. However, deaths from thyroid cancer haven’t seen a similar increase, indicating that the increase in reported cases has likely resulted from detection of cancers that would not have proven fatal had they gone untreated. In a perspective article published in the New England Journal of Medicine July 26, researchers outline ways to reduce overtreatment of small papillary thyroid tumors—a type of tumor judged to be lower-risk. One option for patients diagnosed with small papillary thyroid cancers is active surveillance, in which the cancer is monitored but not immediately treated. A second option is removing just half of the thyroid, instead of the whole gland. This allows the thyroid to continue functioning in many patients, and this less extensive operation carries fewer risks of complications. Despite the potential benefits of choosing to remove just the half of the thyroid affected by cancer, the proportion of patients with small papillary thyroid cancer who receive a full thyroidectomy is increasing. “Primary care practitioners should introduce patients to the idea that not all cancers threaten life, while cancer doctors must make sure that the treatments they recommend aren’t worse than the disease,” the authors of the perspective say in a separate opinion piece publish in STAT.

What’s Going on With Watson?

IBM Watson, a supercomputer that uses artificial intelligence, doesn’t always make good recommendations when it comes to guiding medical care, a story published in STAT+ July 25 suggests. Internal IBM documents present cases where Watson for Oncology suggested unsafe treatment courses for cancer. For instance, the algorithm recommended a treatment for a lung cancer patient with severe bleeding that can lead to “severe or fatal hemorrhage” and is contraindicated in patients who are bleeding seriously. Memorial Sloan Kettering Cancer Center, which was involved in training the algorithm, said in a statement that “it believes the lung cancer recommendation cited in the presentation was part of IBM’s system testing, and was not given to a real patient,” accordin​g to STAT.

A New Targeted Treatment

On July 20, the U.S. Food and Drug Administration approved​ Tibsovo (ivosidenib) for certain patients with acute myeloid leukemia (AML). The drug is an IDH1 inhibitor, meaning that it targets a mutated version of the enzyme IDH1 in cells. Patients with relapsed or refractory AML that has a specific type of IDH1 mutation are approved to be treated with the new drug. The price for a 30-day supply is $26,115.​