Chronic diseases

A positive outlook can be the most powerful ‘drug’ for surviving cancer. People who are anxious or distressed about their cancer diagnosis are up to four times more likely to die from the disease, new research has found. Although the cancer patients were given standard therapies, such as chemotherapy and radiotherapy, their survival rates varied widely, and one key factor was their psychological response to the disease, say researchers from University College London.

People who were distressed or anxious about having cancer were far less likely to survive across a range of different cancers. Leukaemia seems to be the one that is most affected by our mental outlook: people with negative thoughts were nearly four times more likely to die from the disease. Negative thoughts also influenced pancreatic cancer, with the death rate 2.76 times greater than in people with a neutral or more positive outlook, while those distressed by cancer of the oesophagus were 2.59 times more likely to die. Gloomy thoughts also made prostate cancer 2.42 times more deadly.

Researchers discovered this extraordinary mind-body connection when they analysed data, that had never before been published, on 163,363 men and women. During the 14 years they were monitored, 4,353 had died from cancer. Psychological profiles, where their response to the diagnosis was recorded, were gathered, and matched against the cancers, and other influences, such as smoking and heavy alcohol drinking, that may have impacted on mortality.

Conversely, a positive and optimistic outlook could help people survive cancer, the researchers suggest.

Source: British Medical Journal, 2017; 356/10.1136/j108

Red wine stops breast cancer from spreading, researchers have discovered this week. The wine’s ‘magic’ ingredient, resveratrol, blocks the growth effects of estrogen, which, in turn, stops the cancer cells proliferating.

The discovery, made by researchers from the University of Calabria in Italy, is [highlight]good news especially for women whose cancer is no longer responding to hormonal therapy[/highlight]. Red wine or resveratrol supplements could be a ‘pharmacological tool’ that can be added to the range of therapies for breast cancer, say the researchers.

They made the discovery when they tested cancer cells in the laboratory. Those that were treated with resveratrol stopped growing. “Scientists haven’t finished distilling the secrets of good health that have been hidden in natural products such as red wine,” said Gerald Weissman in an accompanying editorial.

Source: The FASEB Journal, 2011 Oct;25(10):3695-707;doi: 10.1096/fj.10-178871

A blood test which not only detects cancer but identifies where it is in the body, has been developed by scientists. The breakthrough could allow doctors to [highlight]diagnose specific cancers much earlier, even before signs such as a lump, begin to show[/highlight]. It is simple enough to be included in routine annual health checks alongside other tests such as for high blood pressure or cholesterol.

The test, called CancerLocator, has been developed by the University of California, and works by hunting for the DNA from tumours which circulates in the blood of cancer patients. The team discovered that tumours which arise in different parts of the body hold a distinctive ‘footprint’ which a computer can spot.

“Non-invasive diagnosis of cancer is important, as it allows the early diagnosis of cancer, and the earlier the cancer is caught, the higher chance a patient has of beating the disease,” said Professor Jasmine Zhou, co-lead author from the University of California at Los Angeles. “We have developed a computer-driven test that can detect cancer, and also identify the type of cancer, from a single blood sample. “The technology is in its infancy and requires further validation, but the [highlight]potential benefits to patients are huge[/highlight].”

Around 350,000 people are diagnosed with cancer in Britain each year, but 90 per cent of people will survive most types for at least five years if it is spotted early. In contrast only five to 15 per cent of people survive five years if cancer is picked up late. To create the new test, the US team built a computer database containing specific molecular patterns which occur in tissue when tumours were present. Some markers of DNA damage show up no matter which cancer is present, while others are specific to the type of tissue they originated from, such as lung of liver. They also compiled a ‘molecular footprint’ for non-cancerous samples which can be used to give patients the all-clear.

The test was checked ten times on blood samples from 29 liver cancer patients, 12 lung cancer patients and five breast cancer patients. It picked up eight out of 10 cancers, and gave a false positive on fewer than one in 100 occasions. Although the level of tumour DNA present in the blood is much lower during the early stages of these cancers, the program was still able to make a diagnosis demonstrating the potential of this method for the early detection of cancer, according to the researchers. Professor Zhou added: “In general, the higher the fraction of tumor DNAs in blood, the more accurate the program was at producing a diagnostic result.”

The research was published in the journal Genome Biology.

Source: Genome Biology 2017; 10.1186/s13059-017-1191-5

Yoga and deep breathing exercises twice a week can lift major depression. With antidepressant drugs failing in half of all cases, it’s an effective alternative that really does work, say researchers.

Reduces symptoms of chronic depression
The exercises “significantly” reduce symptoms of chronic depression, researchers from Boston University Medical Centre discovered when they tested the approach on a group of people diagnosed with major depressive disorder. Some had never taken antidepressants, but others were still taking the drugs, even though they weren’t helping.

The patients were taught Iyengar yoga, which requires precise movements and breath control. Some had two sessions a week, and others had three, but both were also asked to continue doing yoga and breath control at home on the other days. Both groups reported a major lifting of their symptoms, although those who attended three lessons fared slightly better. Even so, two sessions had a big effect, and may be more realistic for people with busy lives, say the researchers.

Yoga is a new way to treat depression, the researchers say, as it focuses on different neural pathways.

Source: Journal of Alternative and Complementary Medicine, 2017; doi: 10.1089/acm.2016.0140

In her recent doctoral dissertation, researcher Sanna Heikkinen from the University of Helsinki and Finnish Cancer Registry evaluates the contribution of the use of hormonal contraceptives and hair dyes to the spectrum of breast cancer risk factors. The analysis included self-reported survey data from 8000 breast cancer patients and 20,000 controls from Finland.

According to the results, use of hormonal intrauterine device was associated with 52% increased risk of breast cancer in post-menopausal women, when compared to women who had used copper intrauterine device. The use of other hormonal contraceptives was, by contrast, associated with 32% higher breast cancer risk among younger women under 50 when compared to women who did not use hormonal contraceptives. There was also a 23% observed increase in the risk of breast cancer among women who dyed their hair compared to those who didn’t.

To confirm the roles of these factors, further research on the effects of hormonal contraceptives, most specifically hormonal intrauterine device, and hair dyes is needed with other populations and a prospective study design.

“The biggest risk factor in breast cancer is high age, and known lifestyle-related risk factors include late age at first birth, small number of children, high alcohol consumption, and sedentary lifestyle,” Heikkinen stresses. Many of these factors have become significantly more common in Western countries, including Finland, during the last decades. In her research, Heikkinen also investigated the amount of opportunistic mammography, which was found to be very common. More than 60% of responders reported having had a mammography before the screening age of 50.

Accumulating radiation burden
“Women should be more extensively informed of the [highlight]harms of opportunistic mammography, such as accumulating radiation burden[/highlight] and the potential consequences of false positive or negative findings,” Heikkinen says.

Source: University of Helsinki, 8 march 2017

For a drug that’s based on rat antibodies, it’s not surprising that doctors are already starting to report life-threatening side effects in patients taking the new multiple sclerosis (MS) drug Lemtrada (alemtuzumab).

Inflammation in their brains
Two MS patients started to decline rapidly after they were given Lemtrada, and [highlight]MRI scans revealed that a new form of inflammation had affected large areas of their brains[/highlight]. The doctors at St Josef’s Hospital at Ruhr University in Bochum weren’t sure if the drug had worsened the MS or whether it had triggered a new type of auto-immune disease.

Not that Lemtrada is exactly new. It was developed as a cancer drug under the name Campath, but researchers at Genzyme, the drug company that developed it, thought it could work better as an MS therapy. Campath was withdrawn from the US and European markets in 2012 to make way for its relaunch as Lemtrada for treating MS, and at a much higher price.

The drug was licensed in 2013 in Europe as an MS drug, but [highlight]America’s drug regulators were less keen, arguing that its safety hadn’t been established by any good clinical trials[/highlight]. It was only when Genzyme threatened to file an appeal that the regulator, the Food and Drug Administration (FDA), agreed to grant a license in 2014.

Source: The Lancet Neurology 2017; 16: 104-6 doi:10.1016/S1474-4422(16)30382-9

We’re told to eat less salt to keep our blood pressure in check. But a major new study is the latest to suggest the guidelines are just plain wrong. Blood pressure was higher in people who kept to the 2.3 g of sodium (around 6 g of salt) recommended daily amount, and lower in those who consumed more.

Current recommendations for sodium intake may be misguided
“We saw no evidence that a diet lower in sodium had any long-term beneficial effects on blood pressure. Our findings add to growing evidence that current recommendations for sodium intake may be misguided,” said Lynn Moore from Boston University school of medicine, and the lead researcher.

Instead, eating plenty of potassium, calcium and magnesium every day did more to keep blood pressure in check, the researchers found when they looked at the diets and salt intake of 2,632 men and women aged between 30 and 64. Those who ate the highest amounts of potassium and sodium also recorded the lowest blood pressure levels.

Potassium maintains healthy blood pressure levels
Of these, Dr Moore thinks that potassium, derived from foods such as avocado, spinach, sweet potato, bananas and coconut water, has the most important role to play in maintaining healthy blood pressure levels. Spinach, chard, almonds and black beans are rich in magnesium, while calcium is found in milk and cheese, soya beans and nuts.

Source: Proceedings of Experimental Biology 2017 conference, Chicago, April 25, 2017

As if the cholesterol-heart disease theory wasn’t discredited enough, a new study into a group of people who’d suffered a heart attack discovered that all of them had ‘average’ cholesterol levels.

In other words, their ‘bad’ LDL (low-density lipoprotein) levels were normal, and wouldn’t have been a warning sign of heart disease. Instead, heart disease is as likely to be caused by smoking or a bad diet, say researchers from the Minneapolis Heart Institute.

The 1,062 patients they analysed had all survived a STEMI (ST-Elevation Myocardial Infarction) heart attack, one of the most serious kinds that happens when a major artery becomes blocked. It’s usually the result of atherosclerosis, or hardening of the arteries, which is supposed to happen when LDL cholesterol levels are high and start attaching to the artery wall until it’s blocked.

“Heart disease is a multi-factorial process and [highlight]factors other than cholesterol can raise your risk, even if your cholesterol is normal[/highlight]. In fact, we found that the average cholesterol level in this group of individuals were quite average,” said lead researcher Michael Miedema.

Despite having normal cholesterol levels, 79 per cent of the group met the new and tougher guidelines for starting statin therapy, whereas just 39 per cent would have done so under previous guidance.

Source: Journal of the American Heart Association, April 2017; doi: 10.1161/JAHA.116.005333

The importance of fasting as a cancer therapy has been underlined once again this week with the discovery that it slows the growth of leukaemia in children.

Fasting on alternate days inhibits the development and progress of cancer cells, and after seven weeks no cancerous cells could be detected in the bone marrow of laboratory mice. However, 68 per cent of cells were cancerous in the mice that weren’t put on the fast, and most died within 59 days, while the mice in the fasting group were still alive more than 120 days later, and had no symptoms of leukaemia. The mice weren’t given any drugs to treat the cancer.

The mice ate normally one day and then ate little or nothing at all the following day. The [highlight]therapy seems to work well with the ALL (acute lymphoblastic leukaemia) form of the cancer, which is the most common in children[/highlight], but not with AML (acute myeloid leukaemia), which more often afflicts adults. Around 90 per cent of cases of ALL in children are treatable, suggesting that 10 per cent aren’t, but the success rate is far lower when adults develop the cancer.

Researchers at UT Southwestern Medical Center, who carried out the fasting experiments, say that it could be an effective approach, especially for adults with ALL.

Source: Nature Medicine, 2017, doi:10.1038/nm.4252