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Less Can Be More: Reducing Treatment While Maintaining Effectiveness

Research is finding that lighter treatment loads can improve patients’ quality of life while not compromising treatment effectiveness. These findings have led some oncologists to scale back treatments such as surgery, radiation and chemotherapy and the side effects that come with them. “I tell patients, ‘I want you to live longer, but I also want you to live better,’” medical oncologist Ursina Teitelbaum of Penn Medicine in Philadelphia told CNN. “So what can we de-escalate in the concentration of your therapy so that you not only live longer but you feel better? That is the goal.” One study found that women with low-risk cervical cancer did not raise their chance of cancer progressing if they got a simple hysterectomy, removing only the uterus and cervix, instead of a radical hysterectomy that also removes surrounding parts of the cervix, portions of the vagina, and other tissue. A study of rectal cancer patients found similar outcomes for patients who received chemotherapy alone before surgery compared with chemotherapy and radiation. “In cancer, the fear and anxiety are huge, so it’s very frequent that we may use more, which could make people very sick,” said medical oncologist and hematologist Tatjana Kolevska, medical director of the Kaiser Permanente National Cancer Excellence Program. “We want to try everything to treat a patient, but in some cases, too much of an aggressive treatment could do more harm than good.”

Death Rates for Some Cancers on the Rise in Hispanic Americans

Death rates from cancer overall have declined among Hispanic Americans over the past two decades, but death rates have increased for certain cancers. Among the findings in a recent study, the overall death rate dipped by 1.3% yearly between 1999 to 2020, but liver cancer death rates rose by 1% per year for all Hispanic Americans, and pancreatic and uterine cancer death rates rose each year by 0.2% and 1.6%, respectively, for Hispanic American women. Also, for Hispanic American men ages 25 to 34, death rates rose annually by 0.7%, likely driven by increases in testicular and colon cancers. According to radiation oncologist Sophia Kamran of Mass General Cancer Center in Boston and a study co-author, many Hispanic Americans face challenges in accessing health care, including a lack of health insurance, a higher poverty rate, and language barriers. Despite that, Hispanic Americans have lower rates of some cancers than white Americans, including breast, prostate and lung cancers. Overall, cancer is the No. 1 cause of death among Hispanic Americans, accounting for 20% of deaths, according to the American Cancer Society. Heart disease is the No. 1 killer of Americans overall. The study raises questions about whether Hispanic Americans are being diagnosed at later stages of cancer and whether they are receiving optimal treatment, Kamran said in a story in U.S. News & World Report.

Artificial Sweetener to Be Declared a Possible Carcinogen

The World Health Organization (WHO) is set to classify aspartame—an artificial sweetener found in diet soft drinks, sugarless chewing gum and sugar substitutes like NutraSweet—as a possible carcinogen, a category that an analysis in the Washington Post calls the lowest level assigned by WHO to products that are potentially cancer-causing. By comparison, products that have greater evidence of a link to cancer, labeled “probable carcinogen,” include alcoholic beverages and very hot drinks. The latter have been linked to esophageal cancer, according to the Post story. Aspartame is popular with food manufacturers because of its sweetness and low calorie count, according to a story on Bloomberg. WHO is expected to announce the new classification along with other safety guidance on aspartame on July 14. In the U.S., the Food and Drug Administration has considered aspartame safe since 1974, but public safety advocates, including the Center for Science in the Public Interest, have concerns about aspartame, saying there is “compelling evidence that it causes cancer and is a potent carcinogen.” The American Beverage Association, in a statement to Bloomberg, said, “There is broad consensus in the scientific and regulatory community that aspartame is safe.”