OVER THE COURSE OF THE YEAR, Cancer Today puts out more than 100 stories for cancer patients and survivors and their family and loved ones. Through four print issues and weekly online updates, we share research updates, practical tips, breaking news from major conferences, personal stories from readers, and much more. As we prepare for the new year, we want to shine a light on some of the stories that most resonated with us and readers in 2024. Enjoy!
Taking a Shot Against Cancer Recurrences
Progress in cancer vaccines has been accelerating in recent years, and with several vaccines now in clinical trials, some experts expect we’ll see them on the market within a few years, Kendall K. Morgan reported in the spring issue. Cancer vaccines take several forms. Already, people can get vaccines that prevent infection-related cancers, such as the human papillomavirus (HPV) vaccine, which prevents the infection that causes more than 90% of cervical cancer cases. Therapeutic vaccines, including several in clinical trials now, are used as part of treatment after someone has been diagnosed with cancer. They teach the immune system to recognize specific features of the cancer cells and destroy them as they would other diseases, providing protection for years after treatment. While promising early results have many excited, there is also caution as researchers wait for results of larger and longer-term trials. “We’re very careful not to overpromise,” said Justin Johnson, the research laboratory program manager at the Cleveland Clinic Lerner Research Institute. “We don’t want to jump to conclusions and say because there is an immune response that this will confer protection [against recurrence] or get through phase II [clinical trials], but we’re hopeful.”
Improving Colorectal Cancer Screening Options
Colorectal cancer is, as one researcher described it, common, deadly and largely preventable. It is, she explained, the third most common cancer type diagnosed in the U.S. and the second most common cause of cancer death, but colonoscopy can find and remove lesions before they develop into cancer. For these reasons, doctors and researchers have been interested in finding ways to get more people screened for colorectal cancer, in line with national recommendations. At the American Association for Cancer Research (AACR) Annual Meeting 2024 in San Diego, which took place in April, researchers discussed the benefits and drawbacks of available and soon-to-available screening options. (The Food and Drug Administration approved a blood test to detect colorectal cancer in July, which was discussed during the panel but was not yet commercially available.) For the panelists, having multiple options has shown promise, but also creates challenges, such as getting people to undergo a colonoscopy they may have wished to avoid when a less invasive screening test identifies a concern. “We need policies that promote timely access to new tests, as well as abnormal test follow-up if we are going to really realize the promise of these tests for all populations,” Samir Gupta, a gastroenterologist with UC San Diego Health, said during the session.
Sensorimotor Training Helps Prevent Chemotherapy-induced Peripheral Neuropathy
A specialized exercise program showed promise for providing relief for people affected by chemotherapy-induced peripheral neuropathy in a study published this summer in JAMA Internal Medicine. Peripheral neuropathy is a common side effect of chemotherapy and other cancer medicines that can include numbness, tingling, burning or pain, typically in extremities like the hands and feet. This study explored using sensorimotor training, which involves a series of balance exercises performed under supervision, to relieve symptoms. The program decreased the rate of neuropathy by 50% to 70%, according to study results. Sensorimotor training is highly specific and is not likely to be available in many cancer centers yet, but people looking for relief now can still look into physical activity in general to improve neurofunction. Fiona Streckmann, a sports scientist at the University of Basel and the German Sport University Cologne, the study’s lead researcher, told Cancer Today that exercise doesn’t need to be strenuous; even getting outside for a walk can be beneficial.
Obesity has been linked to worse outcomes in several cancer types, and it may raise the risk of cancer mortality by up to 17%. This year saw a proliferation of GLP-1-like drugs that enhance insulin secretion, delay stomach emptying, and promote a feeling of fullness that helps people limit how much they eat, leading to the use of these drugs in diabetes treatment and for weight loss. The promise and wide uptake of these drugs for weight loss have led to speculation and ongoing research into their impact on cancer incidence and outcomes. For our summer issue, Cancer Today Editor-in-Chief William G. Nelson, MD, PhD, wrote about what scientists currently know about obesity, cancer and GLP-1-like drugs as patients and researchers consider their place in cancer prevention and care.
Cancer Care Does Not Move in Straight Lines
Cathy Nobil-Dutton shared her experience with uterine cancer and Lynch syndrome, an inherited condition that raises a person’s risk for multiple cancer types. Nobil-Dutton, a clinical social worker and personal trainer, recounted some of the ways cancer and treatment caught her by surprise, starting with her diagnosis. “I exercised every day and adhered to a healthy diet. I believed that if a person did all these things, cancer could be prevented,” Nobil-Dutton wrote. As she learned more about her cancer, and eventually Lynch syndrome, she had to adjust her expectations but keep moving ahead. Through everything, she has stayed fast to a valuable lesson: Cancer care does not move in a straight line.
If you are interested in sharing your story, email us at personalstories@aacr.org.
Regular Aspirin Use May Help Fight Colorectal Cancer
Taking low-dose aspirin routinely has been found to reduce the risk of stroke and heart attack, and the results of a study published in Cancer found that it may also lower the risk of developing colorectal cancer. The study analyzed colorectal cancer cells from 238 people, 12% of whom were taking low-dose aspirin. It found that there was less spread of cancer to the lymph nodes and a greater concentration of immune cells in the tumors of people who were taking aspirin. Findings published just five days later in JAMA found that aspirin was not associated with lower recurrence risk for people with early-stage breast cancer. “Just because a therapy is successful or not for one type of cancer doesn’t automatically tell you whether it will be successful or not for another type of cancer,” Wendy Y. Chen, a medical oncologist with Dana-Farber Cancer Institute and lead author of the breast cancer study, told Cancer Today.
Ushering in a New Standard of Care
Tagrisso (osimertinib) delayed disease progression in a study of people with EGFR-mutated stage III non-small cell lung cancer, likely changing the standard of care for this population. Prior to these findings, published this August in the New England Journal of Medicine, standard care included surgery followed by chemotherapy, radiation and immunotherapy. But research had suggested that for people with an EGFR mutation, short for epidermal growth factor receptor, immunotherapy was less effective than it was for other patients. Shortly after the release of these findings, national organizations updated their recommendations to include Tagrisso. In September, the Food and Drug Administration approved the drug for this population of lung cancer patients. Jorge Nieva, a medical oncologist at USC Norris Comprehensive Cancer Center in Los Angeles, told Cancer Today that the study provided “a very clear and sensible path forward.” He said that moving ahead, “The difference [in outcomes] is just too large to not undergo [Tagrisso] treatment.”
Many older adults with cancer are vulnerable to severe toxicities from common treatments in cancer care, due to other health conditions or their overall fitness. But not all older patients will need to adjust treatment, and identifying what patients may need special consideration can be difficult. “This person seems fit, but maybe they’re on 10 meds that they’re not taking correctly. Or maybe they have mild memory problems and need extra support,” Supriya G. Mohile, a geriatric oncologist at Wilmot Cancer Institute at University of Rochester Medicine in New York, told Cancer Today in a story for the winter issue. Many cancer centers do not have a department for geriatric oncology, and finding specialized care for these patients can be a challenge. In response, researchers have developed and studied tests, commonly called geriatric assessments, that can help oncologists identify patients who may need extra support or different treatments.
Despite the development of many new treatments, chemotherapy remains a staple in cancer care and a source of dread for some people newly diagnosed with cancer. Side effects of chemotherapy are widely known, but alongside other advances in cancer care have been efforts to better prevent, mitigate and manage these side effects, Marci A. Landsmann reported in the spring issue. Problems like infections that develop as a result of low blood cell counts were once a concern that limited treatment and resulted in patient deaths, but broad-spectrum antibiotics have been a powerful tool to deal with infection and keep patients well and in treatment. Nausea and vomiting are also common effects of chemotherapy, but antiemetics have gotten better and in some cases are given automatically with drugs that have very high rates of nausea. Mikkael Sekeres, chief of hematology and professor of medicine at the Sylvester Comprehensive Cancer Center in Miami, said patients sometimes go into chemotherapy expecting terrible side effects and feeling helpless when they happen, but that doesn’t always have to be the case. “A take-home [for better side-effect management] is to contact the doctor’s office. Let us know you’re having those side effects so we can manage them.” Sekeres said.
The Push for Inclusive Cancer Care
Getting the appropriate screening and care can be a challenge for people with intellectual or developmental disabilities (IDD). “It’s very hard to communicate accurately, even if you’re completely typical, so if you’re neurodivergent, there’s an extra barrier there,” said Wendy Ross, a developmental pediatrician and director of the Center for Autism and Neurodiversity at Jefferson Health in Philadelphia. Research has found that cancer is disproportionately found at later stages in people with IDD, and patients with certain conditions have a higher risk for harsh side effects. In this feature from the fall issue, Thomas Celona reported on some of the ways the health care system can be difficult for people with IDD to navigate and deal with, and some efforts that are being made to better serve this population.
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