Medical developments and research from the world of breast cancer and cancer, for the week ending 19 September 2014.
After a year in which I’d had four Pet-CTs and was starting to glow in the dark, I asked my surgeon for an MRI instead of a Pet-CT and was told that he wasn’t familiar with this method of imaging for breast cancer. This week, a study shows that the combination of Pet plus MRI is more effective than Pet plus CT, which is vindication, to some extent. MRIs are also more effective than mammograms in diagnosing breast cancer, but of course, they are also more expensive, so for the time being, mammograms are going to rule.
The second item is about spontaneous remissions. According to wikipedia, a spontaneous remission
spontaneous healing or spontaneous regression, is an unexpected improvement or cure from a disease that appears to be progressing in its severity. These terms are commonly used for unexpected transient or final improvements in cancer.”
I’ve only met three people who had spontaneous remissions. One is
Anita Moorjani, another was a woman with inoperable breast cancer who used QiGong to heal her cancer [she still had her tumour, but it was indolent and she’s still hale and hearty 20 years on, at the age of 80!], and a third was a woman with stage 4 Non-Hodgkin’s lymphoma who used QiGong, nutrition and heavy supplementation and enemas. Kelly A. Turner has written a book about spontaneous remissions. She is not the first person to write about spontaneous remissions, but what’s handy about her book is how she categorises common lifestyle choices in people who experienced spontaneous remissions.
image credit: hjd.med.nyu.edu
1. PET/MRI improved detection of metastases in breast cancer
Whole-body PET/MRI improved the detection of metastases and reduced the occurrence of false positives compared with PET/CT imaging.
Scientists compared PET/CT with the new hybrid technology PET/MRI, which delivers less radiation.
When patients underwent PET/MRI imaging, researchers identified two bone, three liver, two lymph node and five brain metastases in 10 patients that were not detected by PET/CT. These included one liver and two brain metastases that were previously unknown.
“Our preliminary data suggest that PET/MRI outperformed PET/CT in detecting metastases in the liver, brain, lymph node and possibly bone. Prospective studies of PET/MRI are warranted to determine whether early detection of metastases, including occult brain metastases in HER-2–positive patients, impacts survival.”
For more information: American Society of Oncology 2014 Breast Cancer Symposium, Abstract 15,
Detection of metastases in breast cancer: Is whole body PET/MR better than PET/CT?
2. Spontaneous cancer remission rare, but worth study
In her 28-year career, Dr. Deborah Axelrod says she’s had just one patient whose advanced breast cancer inexplicably vanished.
The patient, Ann Fonfa, endured multiple surgeries to remove cancerous tumors that kept growing back. All the while, Fonfa refused the recommended treatments of chemotherapy and radiation, instead experimenting with unproven alternative therapies,
Fonfa, president and founder of the Annie Appleseed Project, a cancer patient advocacy group, was diagnosed with a slow-growing breast cancer in 1993. Though she underwent surgery, she declined chemotherapy and radiation because she said her body overreacts to chemical exposures.
Instead, Fonfa adopted a vegan diet, exercised more and took enzymes. “I concentrated on the joy of life,” said Fonfa, who lives in Delray Beach, Fla. “Serving in the advocacy world has been very valuable.”
Surgery temporarily eliminated the tumors, but each time they grew back. In 1997, after three lumpectomies and a mastectomy, she was diagnosed with stage 4 cancer.
Finally, Fonfa tried Chinese herbs. After the first dose, she said, she broke out in hives. But within 10 months, the remaining tumors had vanished, something Fonfa attributes to a change in her immune system. “I have friends who have done everything mainstream and conventional, and they die. No one really knows the luck of the draw,” she said.
Seven years after her original diagnosis, Fonfa received good news: The cancer was undetectable. Fonfa, 66, has been cancer-free for the last 14 years.
The phenomenon has been reported with virtually all kinds of cancer, more frequently in some types than others.
Kidney, brain, uterine and skin cancer (melanoma) were the four most common types, according to a review of 176 published cases from 1900 to 1960 by University of Illinois College of Medicine surgeons Tilden Everson and Warren Cole.
In cases of infant neuroblastoma, regression is so common that screening isn’t recommended, according to the National Cancer Institute.
In a follow-up study looking at incidence rates from 1900 to 1987, University of Calgary researchers found lymphoma and leukemia ranked among the most common remissions, along with melanoma and cancers of the brain and the retina. By contrast, the most common cancers overall were lung, colon and rectum and breast, according to the study.
Cases of spontaneous regression have fueled speculation that cancer may be vulnerable to sudden surges of the immune system, which can occur with a high fever, bacterial infection, blood transfusion, or major surgery or antibiotic usage.
The reaction may deprive the tumor of something it needs to survive — blood, lactic acid, thyroid hormones — and thus starve it until it collapses and dies.
Immune system theories are also weakened by the fact that thousands of cancer patients get fevers, antibiotics, blood transfusions and surgeries and only a few of them experience spontaneous regression.
Regression is rare in breast cancer, with just 32 reported cases, according to a 2008 study published in the Archives of Internal Medicine. However, the researchers noted that one factor behind the small numbers may be “the fact that these cancers are rarely allowed to follow their natural course.”
3. Breast cancer risk may be lower for women with diverse gut bacteria
Researchers analyzed samples from 60 postmenopausal women aged 55 to 69 without breast cancer.
They found that women with increased bacterial diversity had a more favorable ratio of estrogen metabolites to estrogen circulating in the body.
The findings suggest that changing one’s diet or taking medications to change the gut microbiome may decrease cancer risk.
For more information: Journal of Clinical Endocrinology and Metabolism, September 11, 2014, doi: 10.1210/ jc.2014-2222,
Associations of the Fecal Microbiome With Urinary Estrogens and Estrogen Metabolites in Postmenopausal Women
Chiku or chikoo or sapota – an intensely sickly-sweet fruit. Image credit: a1-vegetables.com
4. Eat chikoo to fight cancer
The sweet and succulent chikoo or Sapota fruit, a popular ingredient for desserts, could well be the answer to halt cancer from spreading, according to a study by Indian scientists.
Researchers have now shown methanolic (alcoholic) extracts of the whole fruit possess certain active phytochemicals (plant-derived compounds) that can trigger a sequence of orchestrated events in tumour cells leading to their death (a process called apoptosis).
“There was a preliminary study which had used two of the phytochemicals isolated from Sapota fruit on cancer cell lines. Ours is the first study using whole fruit methanolic extracts which explores anti-cancer properties of the same on different cancer cell lines and on animal models.
“Our results indicate that inclusion of Sapota fruit in our daily diet may protect from genesis and progression of cancer.”
For more information: Nature.com Scientific Reports, 4, Article number:6147doi:10.1038 /srep06147,
Sapodilla Plum ( Achras sapota) Induces Apoptosis in Cancer Cell Lines and Inhibits Tumor Progression in Mice 5. Chokeberry extract ‘boosts pancreas cancer chemo’
6. Adjuvant chemotherapy extended OS, DFS in luminal B breast cancer
Adjuvant chemotherapy significantly prolonged OS and DFS in patients with luminal B breast cancer regardless of HER-2 and PR status.
However, patients with HER-2–positive disease who were aged 60 years or older experienced shorter DFS.
For more information: American Society of Oncology 2014 Breast Cancer Symposium, Abstract 156,
The role of adjuvant chemotherapy in luminal B breast cancer
7. No benefit to endocrine therapy in elderly women with low risk hormone receptor positive breast cancer
Treatment with endocrine therapy and radiation therapy as part of breast conservation is the current standard of care for women with hormone-receptor positive (HR+) invasive breast cancer.
Results from recent phase III clinical trials have suggested that elderly women with low risk, early stage HR+ breast cancer can attain acceptable outcomes when treated with endocrine therapy alone, without radiation.
However, outcomes resulting from treating with radiation alone, without endocrine therapy, had not been similarly tested.
Ten years post-treatment, patients treated with radiation alone had an estimated disease-free progression rate of 92%.
That estimate compared favorably to the 91% of patients treated with radiation and endocrine therapy who adhered to their endocrine therapy regiment.
However, the disease-free progression rate among patients who did not adhere to endocrine therapy was considerably lower, 72%.
For more information: http://www.fccc.edu/information/news/press-releases/2014/2014-09-16-ASTRO-endocrine-therapy-benefit.html