Widening access to genetic services for ovarian cancer

Training oncologists and gynaecologists to provide cancer genetic services, which was previously offered by clinical geneticists only, improved access to genetic testing, according to the Mainstreaming Genetic Counselling for Genetic Testing of BRCA1 and BRCA2 in Malaysian Ovarian Cancer Patients (Magic) study by Cancer Research Malaysia (CRM).

APRIL 27, 2019 HEALTH

BY STAR2.COM

With a drug to treat BRCA mutations available, genetic testing and counselling for ovarian cancer patients is essential. — 123rf.com

Lead researcher and CRM genetic counsellor Yoon Sook Yee said: “In the past, genetic testing in ovarian cancer was limited to a small number of patients with the aim of identifying relatives at risk.

“Now that there is a drug to treat cancer patients with BRCA mutations, genetic counselling and testing is recommended for all patients with epithelial ovarian cancer.

“This has increased the number of patients who qualify for testing and specialised centres may become overloaded.

“This is the first nationwide study for ovarian cancer, which we set up to assess if we can improve access to genetic counselling by training oncologists and gynaecologists to provide genetic information.”

“Mainstreaming genetic testing and counselling to local hospitals is a strategy to cope with the increased volume of patients,” said consultant gynae-oncologist and study co-lead Prof Dr Woo Yin Ling.

“This is ideal for a large country like Malaysia where specialised centres are concentrated in the capital, yet the majority of the population live elsewhere.

“Patients found to have a BRCA mutation still need to be referred to a specialised cancer genetic clinic, but it becomes a smaller group.”

Consultant clinical geneticist and study co-lead Prof Dr Thong Meow Keong added: “We were concerned whether oncologists and gynae-oncologists could offer these new services in busy clinics that usually focus on treatment, rather than management of cancer risk.

“This study shows that moving the genetic counselling process to the community may be feasible and could be rolled out across Malaysia.”

The Magic study began in 2016, and to date, 68 gynae-oncologists and oncologists from 23 hospitals across Malaysia have been trained to provide genetic counselling to newly-diagnosed ovarian cancer patients.

A total of 600 patients had been counselled two years into the study, and results show that one in eight (13%) have altered BRCA genes.

“Nearly half did not suspect that they had a genetic alteration because no one else in the family had developed cancer.

“Through the national study, we were able to provide each patient, no matter where they lived in Malaysia, with information that could help prevent future cancers in the family,” said Yoon.

While patients in the local and specialised counselling arms were equally satisfied with the counselling they received, the local arm had four times more participants.

Yoon said: “Patients seem to prefer local appointments, so if they are referred by their oncologist or gynaecologist to another centre for genetic counselling, they are less likely to go.”

Preliminary results show that most patients were satisfied with their counselling experience, felt informed about their choices, and found it easy to decide to go ahead with genetic testing.

Yoon said: “These are preliminary results, but mainstreaming of genetic counselling in Malaysia may be a feasible model to improve access to genetic testing services for patients with ovarian cancer.

“If successful, this model could be adopted for other cancers and in other parts of South-East Asia.”

She added: “Cancer is still a taboo subject in Malaysia and there is a fatalistic attitude to hereditary conditions.

“Genetic information can cause conflict in families and the data we are collecting on the psychosocial impact of genetic testing will provide insights into the psychosocial challenges.

“With this knowledge, we can focus on interventions to overcome these challenges.”

Read more at https://www.star2.com/health/2019/04/27/genetic-services-for-ovarian-cancer/

New blood test for advanced prostate cancer

A revolutionary three-in-one blood test could pave the way to precision-personalised treatment for advanced prostate cancer, say scientists.

By PA  19 Jun 2017, 0:15

Updated: 19 Jun 2017, 0:15

The test has the potential to transform the way the disease is tackled by targeting specific gene mutations, it is claimed.

By looking for cancer DNA in blood samples, researchers were able to identify men with defective BRCA genes who were likely to benefit from a class of drugs called PARP inhibitors.

They also used the test to monitor DNA in the blood after treatment started, so patients who were not responding could quickly be switched to an alternative therapy.

Finally, the same test was used to pick up signs of evolving cancer showing the first signs of drug resistance.

Professor Johann de Bono, who led the team at The Institute of Cancer Research in London, said: "We were able to develop a powerful, three-in-one test that could in future be used to help doctors select treatment, check whether it is working and monitor the cancer in the longer term.

"We think it could be used to make clinical decisions about whether a PARP inhibitor is working within as little as four to eight weeks of starting therapy.

"Not only could the test have a major impact on treatment of prostate cancer, but it could also be adapted to open up the possibility of precision medicine to patients with other types of cancer as well."

In future, the test could allow the PARP inhibitor olaparib to become a standard treatment for advanced prostate cancer, by targeting those most likely to benefit, picking up early signs that the drug might not be working, and monitoring for emerging resistance.

PARP inhibitors such as olaparib block an enzyme used by cancer cells with defective BRCA 1 and 2 genes to repair their DNA.

When PARP is disabled, the cells die. 

The drugs do not generally work on cancer cells with functioning BRCA genes, because these are primary DNA repair tools that make PARP unnecessary.

While some patients respond to the drugs for years, others either fail to respond at an early stage or develop resistant cancer.

The new test, described in the journal Cancer Discovery, was developed with the help of 49 patients enrolled in TOPARP-A, a Phase II clinical trial investigating the effectiveness of olaparib.

Men responding to the drug were found to experience an average drop in circulating cancer DNA of 49.6% after eight weeks of treatment. In contrast, cancer DNA levels rose by 2.1% in patients who did not respond.

Patients whose cancer DNA blood levels were lowered by olaparib survived an average of 17 months compared with 10.1 months for those whose levels remained high.

The scientists also conducted a detailed investigation of the genetic changes in cancer DNA among men who stopped responding to olaparib.

They found that the cells acquired genetic changes that cancelled out the DNA repair defects making them susceptible to the drug.

Professor Paul Workman, chief executive of the Institute of Cancer Research, said: "Blood tests for cancer promise to be truly revolutionary.

"They are cheap and simple to use, but most importantly, because they aren't invasive, they can be employed or applied to routinely monitor patients to spot early if treatment is failing - offering patients the best chance of surviving their disease.

"This test is particularly exciting because it is multi-purpose, designed for use both before and after treatment, and using both the absolute amounts of cancer DNA in the bloodstream and also a readout of the specific mutations within that genetic material.

"We believe it can usher in a new era of precision medicine for prostate cancer."

Each year, around 47,000 men in the UK are diagnosed with prostate cancer and more than 11,000 die from the disease.

Dr Matthew Hobbs, deputy director of research at the charity Prostate Cancer UK, which funded the research, said: "It's clear that we need to move away from the current one-size-fits-all approach to much more targeted treatment methods.

"The results from this study and others like it are crucial as they give an important understanding of the factors that drive certain prostate cancers, or make them vulnerable to specific treatments."

http://www.aol.co.uk/living/2017/06/18/new-blood-test-could-see-personalised-treatment-for-advanced-pr/

5lb weight loss cuts breast cancer death risk by two-thirds

By Laura Donnelly, Health Editor, San Antonio

11:41PM GMT 12 Dec 2014

This post is on Healthwise

A woman weighing herself on a set of scales Photo: Alamy

Losing less than half a stone could dramatically reduce the chance of dying from breast cancer, research suggests.

Trials on 2,400 women treated for breast cancer found that death rates a decade later were almost 70 per cent lower among those with some of the deadliest cancers who had lost weight.

Experts hailed the findings as “extraordinarily important” and said diet appeared to be as effective as any drug in tackling some forms of the disease.

The Women’s Intervention Nutrition Study tracked thousands of women for two decades after they were treated for breast cancer, to see if changes in diet could reduce the chance of disease recurrence.

Women were put into two groups, with half put on a low-fat diet. Findings presented to the San Antonio Breast Cancer Symposium show that those who achieved a modest weight loss – around 6lb – and maintained it for five years had lower death rates over the next two decades. The most significant differences were among the 20 per cent of women who had types of cancer that are not linked to hormones.

This group includes triple negative cancers and those which stem from faulty genes, such as BRCA1, which prompted the actress Angelina Jolie to undergo a double mastectomy last year.

Such cancers have the fewest treatment options, and the worst prognosis if not caught early.

Death rates among these women fell by 70 per cent in a decade for those who lost at least 5lb. Even 20 years on, death rates were halved, the study, led by Harbor-UCLA Medical Centre, found.

Dr Rowan Chlebowski, lead researcher and medical oncologist, said the findings were “a big signal” that diet had a far greater impact on cancer than previously thought.

He said the research did not establish the mechanism at work, but suggested that insulin might play a part in feeding tumours.

The trial set out to see if a low-fat diet helped women recovering from treatment from early stage breast cancer.

The women, who on average consumed 30 per cent of their calories from fat at the start of the trial, were given a goal to reduce this to 15 per cent.

However, as well as cutting calories from fat by around 9 per cent, those on the regime lost an average of 6lb, maintained for five years.

Earlier findings from the study showed that five years later, such women were 24 per cent less likely to have cancer recur.

Separate studies which cut fat intake but not overall calories showed no impact on death rates for breast cancer, leading researchers to conclude that losing weight was probably more important than reducing fat.

Professor Tony Howell, director of research at the Genesis breast cancer prevention charity, said the new findings were an “extraordinarily important result”.

“A 69 per cent reduction in deaths in a group with few alternative treatments – that’s as good as any drug,” he said.

“For 20 per cent of women, this is as effective as chemotherapy.”

http://www.telegraph.co.uk/health/healthnews/11291670/5lb-weight-loss-cuts-breast-cancer-death-risk-by-two-thirds.html

Go to Healthwise for more articles

Prophylactic Breast Removal by DR. RICHARD SCHULZE

COMMENTARY by DR. RICHARD SCHULZE

May 15, 2013

Friends, I am interrupting this week’s Video Blog with a special commentary.

Since Angelina Jolie’s voluntary breast removal story hit the press yesterday, my office has been flooded with calls and e-mails from friends and acquaintances regarding this subject, and what my opinion is on such a radical preventative surgery. Readers are also starting to flood my BLOG with similar questions so let me address this issue, yet once again.

What’s Going On?

It is common medical knowledge that we are all genetically predisposed to certain diseases. We are the genetic products of our mother and our father. Therefore we all have the predisposition to develop inherited strengths and weaknesses (or diseases), passed down by them. This does NOT mean that we will develop the same health problems or die from the same diseases that our parents did. It simply means that our chances may be elevated. I will explain more on this later, and more important, how YOU can AVOID manifesting any genetic family diseases.

But specifically, with breast cancer, scientists think that they have discovered a gene, they refer to as BRCA1, that is a genetic marker for the potential development of breast cancer. The reason I say “think” is simply because almost all this testing science is proven false or at least faulty a decade or so later, like the AIDS test, or the PSA test for prostate cancer (that has now been proven defective), or giving millions of mammograms to young women whose breast tissue was too dense to see anything, which caused breast cancer and so this practice is now condemned.

Regardless of the history of medical testing blunders, many women who test positive for this particular BRCA1 gene are now opting to have their healthy breasts removed, as did Angelina Jolie in February.

And I am telling you right now, that in a decade or two, surgically cutting off healthy breasts because someone tests positive for the BRCA1 gene will be seen as a huge horrific medical mistake.

Regarding Angelina’s decision, personally I think it is an ignorant mistake. We are all just doing the best we can with the information that we have. When faced with possible death, who knows what each of us will decide? On the other hand, she was not faced with death, she is currently healthy, and I do not believe that her doctors gave her the whole picture, the whole truth, and if they had, her decision may have been very different, and not based on fear, disease and death but instead focusing on getting really healthy and staying really healthy.

So I don’t mind her ignorance, but what I do mind is her preaching her ignorance, and being some spokeswoman for BRCA1 genes. FEAR, negativity, and being a spokeswoman for the trillion-dollar medical and pharmaceutical industry that is getting rich by exploiting women’s fears—now she is becoming a spokeswomen to convince other women to cut off their own healthy breasts.

There Is A Positive Side To Testing Positive

NOTE: A positive test for this BRCA1 gene DOES NOT MEAN that you will develop breast cancer in your lifetime. In fact, if you have no family history of breast cancer, your odds of developing it are only slightly increased over the general population, like 10%. Your odds are much higher to develop breast cancer by simply living on a farm than having this gene, which can cause a 20% to 40% increase in breast cancer, but no one is suggesting that all farmers’ daughters have their breasts chopped off are they?

It is common medical knowledge that when doctors say you have a family history, or a family tendency to develop a particular disease, or even a marker gene that can mutate, it is USUALLY NOT the genetic defect that causes the disease, but what the family ate and the environment that the family lived in, that caused this gene to mutate.

But doctors say if you have a relative who did have breast cancer, and you have the BRCA1 gene, then your chances are increased up to 80%. Again, more on how to NOT manifest genetic diseases later.

Bottom Line First

The only reason a woman would cut off her healthy breasts is FEAR. Fear often caused by watching a close relative or loved one die of cancer, or specifically breast cancer. FEAR promoted by medical doctors and cancer researchers who all know better. FEAR promoted by hospitals and medical doctors because they make billions of dollars annually using this fear to sell their horrific medical procedures.

The late President Franklin D. Roosevelt stated, “The only thing we have to fear, is fear itself…nameless, unjustified terror that paralyses us into retreating, instead of advancing”.

FEAR, darkness, negativity, disease, causing us to retreat instead of advance. Wow, what a great statement. This couldn’t be truer than in this instance. FEAR causing us to cut off healthy body parts instead of learning how to shut off bad genes and Creating Powerful Health.

Medical Doctors Should Be Ashamed

After all, it is their oath, not mine, that states, “Do No Harm”, and surgical removal of healthy body parts is definitely harmful, not just physically harmful and risky, as is any surgical procedure, but also harmful are all the drugs used for this type of surgery from anesthetics and antibiotics to the pain killers. Trust me, every single day patients all across America are dying from hospital contracted bacterial infections, cancer caused by x-rays and CT scans and lives are ruined by pain killing drugs and patients are killed by pharmaceutical drugs. There are 1,000 potential risks from undergoing any type of surgery. And I have not even mentioned the emotional and spiritual harm caused to a woman by having this type of surgery. I saw the negative aftermath of mastectomies in my clinic, one too many times.

How to AVOID Genetic Diseases

Don’t let medical doctors terrify you into making horrifying, life-changing decisions! And don’t let them talk you into cutting off healthy body parts.

All that genetic markers say is that you have the potential to develop a disease, like breast cancer. It simply means that you have genes in your body, that when stimulated, irritated or woken up, can mutate and develop into cancer. Well, what wakes these genes up is no mystery, and ALL medical and cancer researchers know exactly what turns these genes on, but they don’t want to touch this subject, simply because it’s unpopular. What turns these genes on and makes them mutate, is junk food, toxic chemicals, French fries, pharmaceutical drugs… the list is long; it’s the aftermath of the American Dream.

Studies in Israel and even worldwide have proven the direct link between cows’ milk consumption and breast cancer. The growth hormones and steroids naturally present in cows’ milk are genetically designed to create a COW, not a human, and consumption of these alien hormones has been associated with cancer. Worse, if the cows have been subjected to additional growth hormones and steroids, which almost all are in America, because the use is rampant in the dairy industry, well, your odds of developing cancer are much greater. But no one is talking about women not consuming cow dairy products.

And maybe the greatest known risk factor to cause breast cancer is the use of hormones, like taking birth control pills or the supplemental use of hormones for menopause. This can increase your risk of developing breast cancer much greater than if you have the BRCA1 gene and a mother who had breast cancer.

Taking hormones can increase your risk of cancer 15 TIMES (1,500%)!

Dr. Angela Lanfranchi, a breast surgical oncologist and cofounder of the Breast Cancer Prevention Institute, calls the contraceptive pill a “Molotov cocktail” for breast cancer!

Additionally, there are hundreds of environmental toxins that are known to cause breast cancer like heavy metals to toxic chemicals and pollutants, to numerous chemicals added to the food we eat or the water we drink, to even the containers the food and drink comes in. There are even negative emotions that are now known to cause cancer.

The bottom line is that what causes someone to develop cancer, specifically breast cancer, is not so much the genetic predisposition, as what your mother ate, drank and the environment she grew up in and was exposed to. And, if she developed breast cancer, and you continue to live, eat, drink and even think the same way she did, well, then you can certainly expect to have an increased breast cancer risk.

BUT…

Now here is the big ‘BUT’… If you CHANGE, and do not live like your mother, and don’t live in the same possibly toxic environment, and don’t eat the same food, and don’t drink the same drinks, and don’t take the same pharmaceutical drugs, and don’t wear the same clothes, and don’t expose yourself to the same household chemicals, and don’t breathe the same air, and don’t think the same thoughts, and don’t torture yourself physically, emotionally and spiritually like your mother did to herself, then why would your body develop cancer? The answer is simply that these genes would NOT be stimulated and you would NOT develop cancer!

Bottom, Bottom Line

From a blog I wrote a few years ago on this same subject...

"Remember, your level of health is determined by your GENETICS REACTING to your LIFESTYLE, meaning, that you may be genetically predisposed to reproductive cancer (and there is nothing that you can do about that, that's water under the bridge) but if you create a powerfully healthy lifestyle, again, not just physically, but also emotionally and spiritually, well, you simply WILL NOT develop reproductive cancer.

On the other hand, if you live in a similar way as your parents did, or even a lower quality or lower health lifestyle, well, you can expect a similar outcome, possibly creating Reproductive Cancer. For all of us, the best way to PREVENT genetic weaknesses (family diseases) from developing in our bodies, and the best way to pass on stronger genetic coding to our children, is to live a healthy life. I don’t want to sound like a German geneticist or Dr. "Adolph" Schulze here, but this is a very basic law of Nature. The weak become diseased and die out and the strong survive, and get stronger, and I want to make sure that you are strong, healthy, live long, and that we will all create stronger and healthier future generations."

Finally, and MOST IMPORTANT!!!

Remember one thing…

It is NOT what you inherit…

It is how you LIVE that can either turn on, or turn off, genes that are predisposed to disease. But let’s get our minds out of the negative medical gutter.

I ask you to STOP being medically negative for a moment and just imagine that we also have genes in our body that are predisposed to greatness—genes for powerful strength, powerful health, brilliance, genius and maybe even super powers, physically, emotionally and spiritually.

Let us STOP living in FEAR and dwelling about your genes that can possibly turn into a disease, and instead START THINKING about living a healthy lifestyle and a life that turns your other super-health genes and super-power-genes on! YES!!!

— Dr. Schulze
https://herbdocblog.com/article/Commentary/prophylacticbreast-removal/