General research news

April 2012

Breast cancer reclassified into 10 new categories

Research from Cancer Research UK has reclassified breast cancer into 10 new categories after studying 2000 tumour samples from women with breast cancer. The categories, or subgroups, are based on the common genetic features of the tumours and how aggressively they grow and spread. The researchers highlight that these findings could revolutionise the way women with breast cancer are diagnosed and treated in the future, and lead to the development of new targeted treatments.

The next stage of the research is to investigate how tumours in each of the subgroups behave, and what causes them to grow and spread. This information may help doctors to better understand which cancers require aggressive treatment, such as chemotherapy, and which could be treated with less aggressive treatments. The research has also discovered several new breast cancer genes, which may help in the development of new types of drugs. However, it is important to note that the development of any new treatments as a result of this research is a long way off.

To read the media release issued by Cancer Research UK, visit their website.

‘Chemobrain’ not always to blame

A small research project conducted at the University of Missouri has found that chemotherapy may not always be to blame for cognitive difficulties in women being treated for breast cancer. The cognitive function of 36 women was tested after their breast cancer surgery but before commencing chemotherapy. 27% of women experienced difficulties with verbal fluency while 14% of women had difficulty with memory. The researchers found that the more stress women reportedly experienced, the more issues they experienced with cognitive function. This research highlights the need for health professionals to assist women in managing their stress and anxiety as a way of coping with cognitive issues experienced after their breast cancer diagnosis.

To read the abstract of this research, visit the PubMed website.

Zometa may protect bones

Three separate studies that were presented at the 2011 San Antonio Breast Cancer Symposium have shown that women diagnosed with hormone receptor-positive breast cancer may have a reduced risk of recurrence in their bone if they are treated with Zometa. Zometa is a type of drug called a bisphosphonate, which strengthens the bones and can be used to treat reduced bone density <http://www.breastcancer.org/dictionary/b/bisphosphonates_t.jsp>). The studies suggest that this risk can be reduced in postmenopausal and older premenopausal women when Zometa is introduced at the beginning of their hormone therapy.

For more information on this research, visit the US-based breastcancer.org website.

Cognitive behavioural therapy to treat menopausal symptoms

Research conducted in the UK has investigated whether cognitive behavioural therapy (CBT - therapy that helps people to change their thoughts, feelings and behaviours) can help women being treated for breast cancer effectively manage hot flushes and night sweats associated with menopause. In this study, cognitive behavioural therapy was held in a 90 minute group session once a week for six weeks, and included paced breathing, as well as cognitive and behavioural strategies to assist in managing symptoms.

The results highlighted that CBT significantly helped women in managing hot flushes and night sweats, and this benefit was maintained 26 weeks after starting therapy. The authors provide recommendations that CBT can be incorporated into breast cancer survivorship programs to assist women in managing hot flushes and night sweats.

To read the abstract of this research, visit The Lancet Oncology website.

March 2012

Managing chemobrain

Researchers from the United Kingdom have explored the information and support that is available to women who have experienced symptoms of chemobrain, to help researchers understand the impact that chemobrain may have on the day-to-day lives of women. The research results highlighted that women treated with chemotherapy experienced difficulties with fatigue, low mood, memory and attention, and remembering tasks. Oncology health professionals highlighted that more information and support was needed to help women manage these symptoms.

Researchers identified four possible interventions to support women experiencing symptoms of chemobrain, which included providing them with information, cognitive activities, support to help women deal with the emotional distress that often results from chemobrain, and advice for family members and employers of women. The researchers highlighted the need for health professionals to address the issue of chemobrain when communicating with women who are being treated with chemotherapy.

To read the abstract of this research, visit the US based PubMed website.

Lymphoedema treatment – mainstream and complementary therapies

Research from Australia has examined the use and perceived effectiveness of mainstream and complementary therapies to treat lymphoedema in breast and ovarian cancer survivors. The results from the research highlighted that, in the past twelve months, 90% of women who participated in the research had used mainstream treatments such as massage to treat their lymphoedema. 50% of women had also used various complementary therapies. The majority of women who were using complementary therapies were also using mainstream treatments.

Out of 27 different complementary therapies used, the most common therapies included vitamin E supplements, yoga and meditation. The majority of women also rated the perceived effectiveness of these complementary therapies as high. The researchers highlighted the need for a larger study to test how mainstream treatments and complementary therapies work together to provide effective treatment for lymphoedema.

To read the abstract of the research, visit The Journal of Alternative and Complementary Medicine’s website.

Improving communication on the risks associated with cancer treatment

Researchers from the University of Michigan have identified ten ways that health professionals can improve communication about the risks associated with cancer treatment, with their patients. These can also be used by patients when seeking clarification from health professionals about their treatment. The ten tips for health professionals are:

use plain language to explain the risks associated with cancer treatment
explain the absolute risk (how likely the risk is) to the patient
present the information using visual aids to help patients understand the meaning behind the numbers
Using numbers rather than percentages to explain risk. For example, use: ”60 people out of 100 people are at risk. The remaining 40 people are not at risk” instead of saying “60% of people are at risk”
Explain whether the risk occurs as a result of the treatment, or whether the risk will occur regardless of having treatment
Consider the order that information is provided to patients. Research has found that patients are more likely to remember the last piece of information that they hear
Encourage patients to write the information down, or provide them with a written copy of the information.
Consider not paying too much attention to averages as often this is not helpful to patients when making decisions
Provide patients with treatment options that are relevant to them rather than overwhelming them with information that is not appropriate to their individual circumstances
Explain to the patient whether their risk will change over time

To read the press release, visit the University of Michigan Health System’s website.

Keeping your cancer family history up to date

Research from the United States has found that a person’s family history of cancer should be updated every 5 years to ensure that they are being correctly and appropriately screened. In reviewing the records of 11,000 people involved in the Cancer Genetics Network who had a family history of cancer, the study found that over time as people’s family histories changed, their eligibility for high risk cancer screening also changed. For example, 7.2% of women were eligible for high risk breast cancer screening at age 30, but by the age of 50, this number had increased to 11.4%.

The study recommends that every five to ten years patients and their doctors should talk about the patient’s family history of cancer to ensure that the patient receives the most appropriate cancer screening.

To read more about the research, visit the BreastCancer.org website.

Letrozole versus Tamoxifen – trial results

Results of a clinical trial presented at the European Multidisciplinary Cancer Congress highlighted that post-menopausal women who were diagnosed with hormone receptor-positive early breast cancer, who received letrozole for five years after their surgery had improved disease-free survival (living without a cancer recurrence) and improved overall survival (living whether or not the cancer came back), compared to the women who received tamoxifen for five years. The research also highlighted that women who took a combination of letrozole and tamoxifen (two years of one drug and three years followed by another) had similar outcomes to the women who took letrozole alone for five years.

However, the researchers also highlighted that each drug has differing side-effects, and doctors should consider the woman’s individual medical history when prescribing treatment.

If after reading this research summary, you have any questions or concerns about the hormone therapy treatment that you may have taken, you may like to consider discussing these with your medical oncologist or health care team.

To read more about this research, visit the BreastCancer.org website.

June/July 2011

Sexual wellbeing in breast cancer survivors

Research presented at the American Society of Clinical Oncology (ASCO) Conference in Chicago, has examined the relationship between cancer related fatigue, mood disorder, quality of life and sexual wellbeing in Australian women. The results found that after surgery and prior to radiotherapy and or chemotherapy, 40% of women reported problems with sexual desire and 60% reported problems with physical sexual wellbeing issues. The results highlighted that after treatment, both sexual desire and physical sexual wellbeing issues improved, but remained lower than before they started treatment.

Fatigue, treatment or demographic variables didn’t affect a women’s sexual wellbeing. The researchers did notice that women who had been diagnosed with a mood disorder were more likely to report sexual wellbeing issues.

To read the abstract and basic statistics involving this research, visit ASCO Annual 11 Meeting website.

Do recurring cancers in women with breast cancer differ from their initial cancer?

Researchers from Fox Chase Cancer Centre in the United States have found that when a woman is diagnosed with a recurrence of breast cancer, their second tumour will vary from their initial tumour, and that health professionals should tailor the treatment to the second tumour not the first. The results highlighted that when researchers compared the first and second tumours, they found that the majority differed in key characteristics including whether the tumour will respond to hormone treatment. The results also highlighted that the amount of time being cancer free did not affect whether there were any differences between the first and second tumour.

To read the abstract, visit Science Daily’s website.

The research highlights the importance of pathology and how this can help to deliver a tailored regime to women diagnosed with breast cancer. To help you understand your pathology report, BCNA has developed a Pathology Fact Sheet as well as a Glossary of Pathology Terms.

Delay in time from diagnosis to surgery doesn't affect progression

Research published in the journal, Annals of Oncology has found that delay from diagnosis to surgery does not affect tumour size or cancer progression in women. The researchers followed 818 clinically node negative breast cancer patients who had undergone surgery between 2003 and 2006. To measure the changes in tumour size, the baseline size was based on mammography and sonography and, size at surgery was determined by pathology reports.

The results highlighted that the median time from diagnosis to surgery was 21 days, with a range from 1-132 days. Reasons for increased time between these two periods were associated with the women being older, if they were undertaking a total mastectomy versus breast conserving surgery and if they would be having reconstructive surgery.
The researchers concluded that modest time between diagnosis and surgery are not significantly associated with change in tumour size.

To read the abstract, visit the Annals of Oncology website.

Opposing views - is it ethical for medical practitioners to prescribe alternative and complementary medicines that may lack an evidence base?

Yes

This view from Marie Pirotta who works in the Department of General Practice at the University of Melbourne, highlights that ethical recommendations regarding alternative and complementary therapies take place in a careful discussion about a patients personal diagnosis. It was highlighted that it is important for general practitioners to have these discussions with their patients, as this helps them to explore the risk and benefits about the proposed treatment in relation to their other treatments and to monitor this over the long term. It was also highlighted that for doctors to ethically have these discussions, they need to keep up to date with research surrounding these therapies.

To read the entire viewpoint, visit the Medical Journal of Australia’s Opposing Views webpage.

No

This view from John Dwyer, Emeritus Professor of Medicine at the University of New South Wales, highlights that the information around alternative and complementary treatments isn’t scientifically based and that consumers are provided with information that isn't true and is deceptive. It was highlighted that research into the many claims by alternative medicines at different universities is welcome, and that if these therapies were found to not achieve what they had promised, then prescribing them would be unethical. Emeritus Professor Dwyer also highlighted the need for doctors to talk to their patients about alternative therapies that they are using, as this could be impacting their medical care, through chemical interactions.

To read the entire viewpoint, visit the Medical Journal of Australia’s Opposing Views webpage.

Immediate reconstruction after mastectomy

Research published in the Plastic and Reconstructive Surgery journal, has examined the outcomes, risks and side effects of an immediate breast reconstruction after a mastectomy.

170 women in the study underwent an immediate reconstruction (over a 10 year period). 15 women experienced major complications, which led to further delays in treatment for eight women. During the time period fifteen women were diagnosed with recurrent breast cancer, and there were no delays in this diagnosis, due to them undertaking immediate reconstruction.

The results further highlighted that immediate reconstruction resulted in no complications to radiation therapy; however 10% of women experienced severe breast distortion. For women who had immediate reconstruction and radiotherapy, the cosmetic outcomes were similar to those women who hadn't undergone immediate reconstruction.
The researchers hope that the results will help reassure women and surgeons that immediate reconstruction is a safe and beneficial alternative for women.

To read more about the research, visit Medical News Today website.

More research in the United States around breast reconstruction, has examined the impact of neoadjuvant chemotherapy and how this affects their decisions to undergo reconstruction.

Impact of chemotherapy before surgery on breast reconstruction

Researchers at the Dana-Farber / Brigham and Women's Cancer Centre in the United States, have studied 665 women from 1997-2007 who underwent neoadjuvant chemotherapy (neoadjuvant chemotherapy is where women receive chemotherapy before their surgery, in an effect to shrink the tumour size). They found that immediate reconstruction was performed in 23% of those women who underwent neoadjuvant chemotherapy and 44% of those who hadn’t received neoadjuvant chemotherapy. Twenty one per cent of women who had neoadjuvant chemotherapy and 14% of women who had adjuvant chemotherapy underwent delayed reconstruction.

The results further highlighted that when controlling for age, disease stage and radiotherapy, women who underwent neoadjuvant chemotherapy were less likely to undergo immediate reconstruction, and that the rate of complications was similar whether chemotherapy was given prior to surgery or after.

To read the abstract of this research, visit the US based PubMed website.

Patient’s chemotherapy preferences

Research presented at ASCO in Chicago, has examined what women with breast cancer are willing to put up with (effectiveness, toxicity, how it is administered) amongst various chemotherapy options. The researchers spoke to 121 women with early and secondary breast cancer and found that survival was the most important attribute to women, especially for example, when one chemotherapy could provide a three month advantage compared to no advantage.

The results highlighted that differences in the side-effects, such as gastrointestinal problems, low immunity and fatigue would have the most impact on a women’s treatment preferences. The side-effects that would have the least impact included muscle pain and hand and foot syndrome (reddening, swelling, numbness and blistering on palms and soles). Participants also reported that a more convenient form of administration would be less important compared to a greater than 13% chance of severe side-effects. However if the chance of side-effects was less than 13% the form of administration would be more important.

To read the abstract of this research, visit ASCO Annual 11 Meeting website.

Continuing hormone therapy in older women

Researchers in the United States have examined the reasons why older breast cancer survivors may not adhere to hormonal therapy (tamoxifen or aromatase inhibitors). It should be noted that the abstract doesn’t define at what age the researchers considered women to be older.

Results from 1402 breast cancer survivors found that 23% discontinued their hormone therapy within 5 years of their surgery. The reasons for finishing hormone therapy early included;

side effects (47%)
feeling that they had finished their therapy (17%)
their health professional had told them to stop (15%) and
cost (8%).

The results further highlighted that woman who were older, had a lower income, were unmarried and had lower insurance coverage, were more likely to not complete their hormone therapy.

To read the abstract, visit ASCO Annual 11 Meeting.

Images of cancer different to statistics and real life experiences

Research published in the Journal of Communications compared images of people with cancer in cancer consumer magazines, to United States statistics and those people at actual risk of cancer. The researchers found that images in cancer consumer magazines showed younger people, more women and more Caucasian people.

When the researchers looked for visual signs of cancer, they found very few individuals in the photos showed obvious signs of cancer treatment; i.e. head scarves, skin and nail issues or thin bodies. Instead, most images showed healthy looking people, with some actively engaged in construction work, or exercising. When the researchers examined the content, they found that the majority of the articles with these images discussed treatment issues.

The authors provided recommendations that suggest images of people with cancer in these consumer magazines should reflect the actual experience, to help reinforce the information that is contained in the article.

To read the abstract of this article, visit the Taylor and Francis Online website.

May 2011

Positive effect of yoga during radiotherapy

Research to be presented at the American Society of Clinical Oncology in Chicago has found that for women undergoing radiotherapy, yoga provides benefits including reducing fatigue. The results highlighted that women who included yoga breathing techniques, postures, relaxation and meditation techniques into their treatment were more likely to have better physical function, better health, lower stress levels and were able to find meaning in their diagnosis.

The study followed 163 women, who were randomised to one of three groups a) yoga, b) simple stretching or c) no instruction in yoga or stretching. At the end of the study those women in the yoga or simple stretching group reported a decrease in fatigue. Women who had undertaken yoga during their radiotherapy reported that they saw benefits in their physical and general health, at one, three and six months after their treatment ended. The researchers highlighted that yoga is a useful tool to help women in undertaking the transition from active treatment to everyday life.

The next stages include a further research trial to understand why yoga can lead to an improvement in physical functioning, quality of life and biological outcomes during and after radiotherapy. This will involve including a larger group of people to confirm its effectiveness, monitor side effects and to compare it to the current usual practice. The trial will also examine the cost benefit to the hospital, health care costs in general and the work productivity of the women.

To read the abstract of this research, please visit ASCO Annual Meeting 11 website.

Few women regret undertaking an elective mastectomy twenty years later

Research presented at the American Society of Breast Surgeons Conference, has found that 90% of women who had an elective mastectomy to decrease their risk of breast cancer in the healthy breast were satisfied with this decision 20 years later. Whilst women stated that there had been adverse effects as a result of this decision, 92% of women indicated that they would make the same choice again.

When discussing the adverse events associated with their decision, women reported body image, sense of being a women and sexual wellbeing as the most common events. Women stated that making the decision to have an elective mastectomy meant that "I don't seem to worry about breast cancer now" and "By having a prophylactic mastectomy, my fears (many) were erased, not 100% but close to it’”.

The researchers stated that knowing few women regret the decision of having an elective mastectomy can be some comfort to women who are currently making this decision. However they did highlight that the decision is a personal one for each women to make.

To read the press release and abstract of the research, please visit the American Society of Breast Surgeons website.

If you would like to connect with others who have or are currently deciding to have an elective mastectomy, BCNA’s Online Network provides this opportunity. To read blog posts on this topic, enter the search terms ‘prophylactic mastectomy’ to see which members have been discussing these issues.

Nurses uncomfortable to talk about sexual wellbeing with their cancer patients

Research presented at the Oncology Nursing Society conference in the United States has highlighted that nurses and health care professionals are uncomfortable and unprepared to begin discussions about sexual wellbeing with their patients. Researchers examining the literature on nurse’s knowledge, attitudes and beliefs about sexual wellbeing found that there were multiple barriers to discussing sexual wellbeing, including lack of knowledge, confidence and being comfortable in starting this conversation.

The majority of nurses were aware of the need to address their patients sexual wellbeing concerns, but felt that their limited knowledge and not being confident in their ability to answer the questions prevented them from doing so. To assist the nurse’s knowledge, the researchers organised for an information session lead by an expert in the area of sexuality and cancer and a patient information brochure to be given to patients. Results from the evaluation highlighted that the nurses felt more confident in discussing sexual wellbeing with their patients and were more likely to discuss the topic.

The researchers noted that education about sexual wellbeing for cancer patients should be incorporated into nursing school curriculum and throughout nurse’s continuing education.

To read the abstract of this article visit the Health News Top Stories website.

Lack of assessment of cardiac toxicity in breast cancer trials

Women with breast cancer who are treated with anthrayclines, can experience cardiac problems after they have completed their treatment. However researchers published in the journal, Annals of Oncology have reviewed the American based clinicaltrails.gov website and found that few trials, (in both early and secondary breast cancer) are measuring cardiac toxicity as primary or secondary endpoints in their trials. Clinical trials can have more than one primary or secondary endpoint.

The results highlighted that across all clinical trials reviewed there is no consistent manner in which cardio toxicity is recorded. The researchers also found that for many studies, the duration of follow up is not long enough for cardiac problems to be identified and that to address these problems; a standardised cardiac toxicity assessment needs to be developed.

To read the abstract of this article, visit the journal Annals of Oncology website.

If you would like to subscribe to BCNA's monthly Research Bulletins, please visit the Research Bulletins page.

April 2011

Sexual wellbeing issues for women after breast cancer treatment

Research published in the European Journal of Cancer has examined how breast cancer survivors feel about their sexual wellbeing. Through focus group interviews with twelve women, researchers found that breast cancer survivors felt like an outsider in their own bodies and that they experienced their bodies in new and different ways. Women also stated their bodies were ‘unruly’, that their feelings were constantly changing, and that their sexual wellbeing was not what it used to be.

The researchers highlighted that there is a challenge for nurses to identify the sexual wellbeing needs of their patients and to help them address these issues.

To read the abstract of the article visit the European Journal of Cancer’s website.

Work in London is looking at the impact of breast cancer treatment on sexual wellbeing. Professor Myra Hunter, from the South London and Mauley National Health Service Foundation Trust’s Psychosexual and Relationship Service, has worked with many women who are dealing with the emotional and physical impact of treatment on their sexual wellbeing. Professor Hunter has found that breast cancer can impact a woman’s body image and self-esteem, and that some women feel that they aren’t in control of their body. She has found that the stress surrounding a woman’s diagnosis and treatment may not only affect her sexual wellbeing but also that of her partner. Professor Hunter highlighted that once most women end their treatment, sexual wellbeing issues will improve. However, for 20–30% of women, these problems can persist and are more likely for those women who have had chemotherapy as part of their treatment.

The centre is hoping to normalise women’s sexual wellbeing issues by providing information on managing menopausal symptoms, stress and helping facilitate improved communication between partners.
To read the full text of the article visit Medical News Today’s website.

Researchers in the United States have spoken to lesbian women about their perceptions of discrimination while undergoing breast cancer treatment, and how this affects their quality of life. Results from an online survey highlighted that lesbian women’s perceptions of discrimination and social support are important indicators for predicting their quality of life. The researchers concluded that further research on breast cancer survivorship in lesbian women should be undertaken.

To read the abstract of this study visit the Journal of Cancer Survivorship website.

To find out more about resources for lesbians with breast cancer visit the resources for lesbians page.

Arm and shoulder problems and the effect on quality of life

Research published in the Journal of Cancer Survivorship has examined the association of arm and shoulder problems, including restricted mobility and lymphoedema, and different aspects of quality of life in breast cancer survivors. Results found that lymphoedema, pain and restricted mobility in the arm and shoulder are associated with poorer quality of life in the long term. The researchers concluded that in order to improve quality of life, these problems should be diagnosed and treated.

To read the abstract of the research visit the Journal of Cancer Survivorship website.

To find out more information about lymphoedema visit the Lymphoedema page.

Recovery in the year after breast cancer treatment

Research from America has examined the impact of chemotherapy on the physical and psychosocial recovery of women following breast cancer treatment. The results highlighted that the women who underwent chemotherapy were more likely to have severe physical symptoms including musculoskeletal pain, vaginal problems, weight problems and nausea. The researchers concluded that these symptoms should be managed as part of the ongoing follow-up care for these women.

To read the abstract of the research visit the Journal of Clinical Oncology’s website.

Use of complementary and alternative medicines (CAMs) in radiation oncology patients

Researchers in the United States have surveyed 153 cancer patients (the majority being breast cancer patients) in order to identify the most commonly used CAMs. The most popular treatments and techniques used were prayer/spiritual healing (61.9%), exercise (19.6%) and listening to music (17.6%). Multivitamins (48.1%), calcium (37.3%) and vitamins with minerals (21.5%) were the most popular vitamins used by those who participated in the research. Fish oil (19%), flaxseed, glucosamine and green tea (all 15%) were the most popular herbs and supplements used.

Previous use of vitamins and their doctor’s recommendation to use CAMs were the most common reasons patients took them. The researchers also found that 42% of those who said that they took vitamins, herbs or supplements did not discuss this with their clinicians.

To read the abstract of the research visit the website of Supportive Care in Cancer.

Patients’ thoughts regarding CAMs

The issue of CAMs has also been discussed in the Clinical Oncological Society of Australia journal Cancer Forum, with research from the Cancer Council New South Wales examining patients’ perceptions of CAMs. The researchers found that younger women and those who have a university degree were more likely to use CAMs. Patients, who had a longer length of time since their original cancer diagnosis, were also more likely to use CAMs.

To read the full version of the paper visit the Cancer Forum’s website.

To find out more information about complementary therapies visit the Complementary & alternative therapies page.

Skin toxicity amongst breast cancer radiotherapy patients

Research in the United States has examined the impact of skin toxicity on the quality of life of breast cancer patients undergoing radiotherapy. Researchers interviewed 20 women who were undergoing their last radiotherapy treatment and found that skin changes affected their levels of physical discomfort, body image, emotional distress, day-to-day activities and their overall satisfaction with their treatment. Younger women, those who weren’t in a relationship, women who were treated in summer, and women who were concerned about their body image prior to their treatment, were all more likely to be distressed by skin toxicity and changes.

Symptom management by those women in the study included self-medication, complementary and alternative therapies, and psychological strategies. The researchers concluded that when undertaking treatment education the women’s individual circumstances should be considered and women should be encouraged to seek different ways to address skin toxicity.

To read the abstract of the article visit the journal of Psycho-Oncology’s website.

Communicating with oncology nurses via email

Research from Norway has examined the content of email messages that breast and prostate cancer survivors sent to oncology nurses to see a snapshot of their everyday lives after treatment. The researchers found that survivors used email to seek advice and ask questions of oncology nurses. When analysing the emails, the most common themes included living with the symptoms and side effects of their treatments, living with a fear of relapse, concern for their everyday lives, and feeling that they had unmet information needs.

The researchers concluded that, if they are given the opportunity, email communication with oncology nurses can help survivors, and could be used as another means of support for an individual.

For the full article download Living With Cancer as Expressed Through E-mail Communications.

March 2011

Women’s preferences for survivorship follow up

Research from Australia, involving members of BCNA’s Review & Survey Group has examined women’s experience of follow up care, attitudes to different models of care and whether a survivorship care plan would be useful and acceptable. Results found that the majority of women were satisfied with their current level of care, needed more emotional support and information about menopausal symptoms and found the idea of a written care plan appealing.

When asked about different models of care, women saw the benefits of having a breast care nurse and general practitioners (GPs) involved in their follow up care however, there was concern that these health professionals would need some additional training. Women also expressed confidence about a model of shared care between GPs and specialists as a way to help reduce the specialist’s workload and to increase the ability of GPs in managing follow up care for women.

To read the abstract of the article, please visit the website of the journal, The Breast.

If you would like to read the summary of the research visit the Research reports page.

If you would like to be involved in breast cancer research opportunities and visit the Review & Survey Group information section.

Long term benefits of Herceptin for women with HER-2 positive breast cancer

Research from a clinical trial, has found that women with HER-2 positive breast cancer who were treated with Herceptin for one year following chemotherapy are at less risk of the cancer returning and the effect is long lasting. Unfortunately the researchers did not highlight what they meant by long lasting.

The clinical trial was designed to examine if Herceptin could increase disease free survival (a specific length of time after treatment, when there is no cancer in the body) and overall survival (a percentage of people who survive their treatment during a specific time period).

Results found that those women who received Herceptin compared to chemotherapy alone were more likely to have better disease free survival and reduced chances of the cancer returning. For women in this study, the rate of heart failure did remain low during the follow period. Previous research has shown that treatment with Herceptin can cause heart failure in some women. The researchers concluded that Herceptin given to women following their initial dose of chemotherapy provides benefits and is an appropriate treatment for women with HER-2 positive early breast cancer.

To read a summary of the article, please visit Medical News Today’s website.

Treatment plans for breast cancer in older women

Research from the US has found that, for women who are diagnosed with breast cancer over the age of 65, their treatment plans need to consider any health problems that the woman may have, their current lifestyle and any other issues. These factors should be considered by health professionals to determine whether a woman can undertake chemotherapy without excessive risk to her health, rather than her biological age.

To assist health professionals in determining, who is the best candidate for chemotherapy; researchers are looking at identifying potential biomarkers (a molecule which can be targeted to deliver a specific response to different treatment options) that could help them to do this.

To read the abstract of this article, please visit The Oncologist’s website.

If you would like to find information and stories about the issues affecting older women with breast cancer, please refer to the current edition of The Beacon.

Results of volunteers undertaking face-to-face peer support at an Australian Cancer Centre.

An evaluation of volunteers involved in assisting cancer support nurses at the Peter MacCallum Patient Information and Support Centre has found that a comprehensive training program has helped them to provide peer support to patients, families and their careers. The three day training program covered aspects of the role, communication skills training, boundaries for volunteers, de-briefing, the importance of self-care, support services, complementary and alternative medicine and information from the internet. To ensure that all the volunteers were prepared, role playing scenarios with actors were used to develop and refine these skills.

Results from the training found that role playing helped the volunteers develop their communication skills and that there was an increase of knowledge in all areas, including the importance of self-care. All those who completed the training remain actively involved with the Patient Information and Support Centre, with planned educational updates including the needs highlighted by the volunteers.

To read the abstract of this article visit the website of Supportive Care in Cancer.

If from reading this article, you would like to become more involved in the work of BCNA please visit the Get Involved page.

February 2011

The expectations of women undergoing implant breast reconstruction

Researchers in the United States have found that health professionals involved in the pre-operative stage of breast reconstruction need to explore a women's expectations regarding the appearance, sensation and movement of their new breast. The results found that women who underwent implant breast reconstruction were unclear about how their breast(s) would look and were unprepared for the unnatural appearance. Women specifically reported being unprepared for the flatness of their breast, loss of sensation, firmness and a lack of movement in their reconstructed breasts.

More information can be found on the US-based PubMed website.

Information sources of lymphoedema risk reduction for women recently diagnosed with breast cancer

Researchers from New South Wales have found that exposing women to lymphoedema risk reducing information at the time of their diagnosis, increases the awareness and likelihood that they will be involved in such activities. Results found that those who participated in the study had good knowledge about lymphoedema and that knowledge continued to grow as they received more information. The researchers highlighted that nursing staff play a key role in providing information and informing women to perform the risk reducing activities.

More information can be found on the Oncology Nursing Society website.

Breast cancer beliefs and behaviour changes

Research in the United States has found that understanding a women's breast cancer belief, such as why they were diagnosed can assist health professionals to develop programs to improve the wellbeing of breast cancer survivors. The results found that after being diagnosed women made changes to their physical, emotional and spiritual wellbeing, with these changes being related to their opinions about the cause of their cancer. For those who believed that their diagnosis was severe or related to stress, they were more likely to make changes to their diet, physical activity levels and alcohol intake.

More information about the research can be found on the US-based PubMed website.

Chemobrain - the effect is real

Researchers undertaking a review of the medical literature regarding chemobrain have found that it is poorly defined and it remains under diagnosed, thus affecting the quality of life of those people. Results found that there are limited pharmaceutical interventions and management strategies to assist those who suffer from chemobrain. The researchers highlighted that there needs to be multidisciplinary care and management of those with chemobrain.

More information can be found on the Oncology Stat website.

December 2010

Weightlifting reduces lymphoedema risk

Researchers from Pennsylvania have found that weightlifting can play a role in preventing lymphoedema. Researchers followed 154 breast cancer survivors who did not have lymphoedema and had been diagnosed in the past five years. The results found that slow progressive weightlifting did not increase the women’s chances of developing lymphoedema, but decreased their risk by 35%. Women who had five or more lymph nodes removed during surgery, and undertook weightlifting, had a 70% decrease in their risk of developing lymphoedema.

The researchers highlighted the importance of women who have lymphoedema, or are at risk for developing it, talking with their doctor about exercise, and discussing possible exercise weightlifting programs with a certified fitness professional before starting any new weightlifting program. The researchers also noted that women need to learn safe weightlifting techniques and the importance of wearing a well-fitting compression garment during any exercise.

To find out more about this research visit The University of Pennsylvania’s website.

The positive effect of exercise on cancer fatigue

Researchers in the United States have undertaken a meta analysis (a search of all information published on one topic in an effort to provide an answer to a question) to see if exercise can help reduce cancer-related fatigue in adult cancer survivors.

The results found that survivors who participated in exercise interventions had reduced levels of cancer-related fatigue and the reduction of their fatigue was in direct proportion to the intensity of the exercise. The researchers also found that the best results were seen when the exercise intervention was based on an evidence based and tailored to the individuals’ cancer type and the benefits they wanted to receive.

To find out more about this research visit the Cancer Epidemiology, Biomarkers and Prevention website.

Trial finds anastrozole better than tamoxifen for some women

Ten year results from have found that the drug anastrozole (an aromatase inhibitor) is safer than tamoxifen for postmenopausal women with hormone sensitivite early breast cancer. The study found that anastrozole was significantly better than tamoxifen for disease free survival and time to recurrence.

A side effect of anastrozole can be loss of bone density, and the trial found that, fractures were more common for women taking anastrozole than tamoxifen. However once treatment was finished, the risk of fractures was similar with both drugs.

To find out more about this research visit The Lancet Oncology website.

Better methods for reporting breast reconstruction outcomes needed

Researchers from the United Kingdom have found that there are no clear procedures for surgeons to report breast reconstruction outcomes. Researchers reviewed 134 different studies and found that there are inconsistencies in data reporting outcomes of breast reconstruction. The results found that less than 20% of the studies reported complications of surgery; half reported adverse (poor) outcomes and items excluded from the studies included the severity of complications, the duration of follow-up and overall complication rates.

The researchers concluded that there needs to be standard approach in assessing the outcomes of breast reconstruction that includes non-clinical factors, such as women’s satisfaction, body image and cosmetic outcomes.

An accompanying editorial for this article by Monica Morrow (a US breast cancer surgeon) and Andrea Pusic (a plastic surgeon who specialises in reconstruction) highlighted that improved standards for breast reconstruction outcome reporting could potentially improve the quality of life of a large number of women.

To find out more about this research visit the Medical News Today website

Benefits of radiotherapy for women with ductal carcinoma in situ (DCIS)

Results from a ten year trial have found that women diagnosed with DCIS, are less likely to develop early breast cancer if they undertake radiotherapy after surgery. The results found that radiotherapy after surgery also reduced the risk of a recurrence of DCIS in the same breast by over 60%. Treatment with radiotherapy did not decrease the risk of cancer developing in the other breast, however.

The trial also found that women who received treatment with the drug tamoxifen after radiotherapy had a further reduced risk of developing early breast cancer or DCIS. Tamoxifen reduced the risk of recurrence of DCIS in the same breast by 30% and reduced the risk of a new cancer in the other breast by over 65%. However tamoxifen was found to have no effect on the development of early breast cancer in the same breast as the initial DCIS.

To find out more about this research visit the Medical News Today website.

Attitudes of cancer patients regarding participation in clinical trials

Researchers in the United Kingdom have found that the majority of cancer patients in Wales are happy to participate in randomised clinical trials. Randomised clinical trials are research trials in which patients are randomly allocated to one of two treatments, either a new drug or treatment, or the current standard care for the patient’s condition. Researchers then compare the outcomes of patients on the new treatment with the current treatment, to see if the new treatment is a better option.

Researchers in this study surveyed 1146 patients about their attitudes to medical research and the likelihood that they would participate in a hypothetical randomised clinical trial. Results found that the prospect of randomisation (ie, not knowing if they would receive the new treatment being trialled or the current treatment) initially deterred patients from wanting to participate, but once more information about the trial, the voluntary nature of clinical trials, treatment details and the patient’s right to withdraw at any time, was explained more interest from patients was seen.

Researchers found that people who had previously participated in clinical trials, who were male and/or who were younger were more likely to participate. People aged over 70 were less likely to participate. The authors concluded that clear communication and information from health professionals needs to be provided to patients to help them consider the benefits of participating in randomised clinical trials.

To find out more about this research visit the British Journal of Cancer website.

November 2010

The lessons learnt from Herceptin – heart monitoring

Researchers in the United States have found that the increased risk of cardiac problems for some women who take Herceptin can be reduced, if health professionals undertake simple steps. This includes evaluating women for risk factors such as high blood pressure and prior congestive heart failure, and assessing a women’s heart function, before, during and after her treatment for any changes.

The researchers found that in most cases, if any changes in the heart functioning are detected, early intervention can help women to continue their Herceptin treatment. The authors highlighted that for women who have heart conditions, the use of non-anthracycline chemotherapies are recommended.

In Australia, women with early breast cancer who are taking Herceptin are required to undergo heart monitoring prior to starting treatment and throughout. BCNA recently surveyed women to see if they were receiving heart monitoring. We found that 99% of the women who completed our survey underwent some form of heart monitoring. To read more about BCNA’s survey please visit our website.

For more information about the US research visit the Oncology Nursing Society website.

Imaging confirms chemobrain in women treated with chemotherapy

Researchers in the United States have demonstrated that changes in the brain tissue do happen in women who undergo chemotherapy for breast cancer. Researchers took images of 47 women (those who had chemotherapy, those who didn’t have chemotherapy and women who were not diagnosed with breast cancer) and found that changes were seen in the cognitive function of women undergoing chemotherapy. Results found that in most women, cognitive function improved a year after they finished chemotherapy but for some women the effects were so severe that they were unable to return to work.

For more information about the research visit the Indiana University website.

Cancer concerns of spouses of women diagnosed with breast cancer

Researchers in the United States have examined the cancer related concerns of spouses of women with early breast cancer. Results from the research found that a diagnosis of breast cancer led spouses to question themselves, their mortality, to feel the need to change life priorities, feelings that they were unprepared for the challenges that lay ahead and to wonder when their life would return to normal.

Specific concerns of spouses included wanting more information about their wife’s treatment, worry that the cancer could spread, and concern about the emotional impact on their family and children. Other concerns included the impact on their sex life with their partner, the need to protect their partner from stress, and being unsure about what they could do to help.

The results highlight the need for programs and support for spouses. To find out more information about the research visit the Psycho-Oncology website.

Sexual issues a major concern for cancer patients taking new targeted drugs

Researchers from France have examined the impact of targeted therapies on the sexual functioning of 51 cancer patients, who had been taking the treatments for three months or longer. Results found that sexual wellbeing had reduced in terms of quality and intensity. The majority of those involved wished for a satisfying sexual life but found it hard to discuss this with their physicians.

The researchers highlighted that the impact on a patient’s sexual wellbeing is poorly understood by their treating team, and that this side effect it is not often considered in clinical trials. Oncologists can help address these side effects by including them in clinical trials and talking to their patients to see if there have been any changes in their sexual wellbeing. Suggestions for addressing these side effects include; offering patients an assessment for sexual wellbeing, establishing an outpatient clinic to address sexual wellbeing and referring patients to specialists.

To find out more information about the research visit the Medical News Today website.

Fertility concerns of cancer survivors inadequately addressed

Researchers from Australia have found that those diagnosed with cancer feel that their sexuality and fertility concerns are often not adequately addressed by their health professionals. The researchers interviewed 25 cancer survivors (19 women and 6 men) and found that fertility concerns were an issue of concern for those women who had completed their family, as well as for those who had decided not to have any more children.

Results of the research found that fertility was important for a patient’s sense of identity, their body image and their concerns regarding sexual needs. The researchers highlighted that sexual wellbeing and fertility issues need to be raised with health professionals, and information and training provided, so they can better assist their patients.