When Cancer Spreads to the Brain: New Treatments Offer Hope

Some patients are living up to seven times longer than before. Here’s how…

Nduka Amankulor, MD, a neurosurgeon and neuro-oncologist at UPMC Hillman Cancer Center and assistant professor of neurological surgery at University of Pittsburgh School of Medicine.

CANCER

Published Date: October 1, 2019

Publication: Bottom Line Health

CANCER

When Cancer Spreads to the Brain: New Treatments Offer Hope

When melanoma or some other cancer spreads to the brain, the prognosis used to be grim. Now, treatment advances are dramatically improving outcomes…

An astounding 20% to 30% of people with cancer develop metastatic brain cancer (MBC)—cancer that has spread from another organ to the brain.

Breast cancer, lung cancer, kidney cancer and melanoma are the main types of cancer that invade the brain. But almost any cancer can produce brain metastases, with an estimated 170,000 new cases every year. 

Until recently, the prognosis for people with MBC was grim—only 8% of patients were alive two years after diagnosis, and 2% after five years. But those sad statistics are changing.

Now: The treatment of MBC is being revolutionized by targeted drug therapies that attack genetic mutations driving cancer…immunotherapies that stimulate the body’s own immune system to fight cancer…and precisely focused radiation.

Immunotherapy more than doubled the average survival time of melanoma­ patients with MBC—from 5.2 months to 12.4 months, according to a study published in Cancer Immunology Research. The effects are even better for melanoma patients with MBC but no other metastases—research found that those who received immunotherapy had an average survival rate of 56 months, compared with 7.7 months for those receiving standard treatment, such as chemotherapy. In other words, MBC patients treated with immunotherapy lived about seven times longer!  

What cancer patients and their families need to know…

Early Detection

Many oncologists don’t recommend screening for brain metastases, except for certain tumor types that have a significant predilection for spreading to the brain. Of course, if the patient develops neurological symptoms, such as headaches, numbness, blurred vision, balance difficulties, cognitive decline and/or seizures, then brain screening for a brain tumor is recommended, regardless of the type of cancer. 

New thinking: Early detection can extend survival time in patients without neurological symptoms who are at high risk of developing MBC. 

My advice for who should get screened… 

• Any patient with a new diagnosis of stage II to stage IV lung cancer, whether it’s non-small cell (the most common type) or small cell. 

• A melanoma patient with metastatic disease elsewhere in the body—because two out of three of these patients will also develop MBC. 

• A breast cancer patient who is positive for HER2 (a gene that plays a role in the development of breast cancer)…or whose tumor lacks hormone receptors (estrogen and progesterone receptors)…or lacks any markers at all (triple-negative breast cancer). The rate of MBC is significantly higher (10% to 15%) in all these breast cancer patients.

The gold standard for early detection is a brain MRI with contrast dye, which can detect brain tumors as small as 2 millimeters in diameter (less than one-tenth of an inch). Especially in patients who are at high risk of developing MBC, insurance may cover the MRI even if there are no neurological symptoms, but be sure to check first. Once MBC is diagnosed, MRIs are obtained roughly every two to four months.

Targeted Therapies

Targeted therapies are drugs (oral or IV) that block or alter specific genes and/or proteins that drive cancer. There have been dozens of clinical trials of targeted therapy in patients with brain metastases—with some remarkable results. For example…

Researchers from the MD Anderson Cancer Center at University of Texas studied melanoma patients with MBC who had the BRAF mutation, which occurs in about half of patients with this disease. The patients received two drugs—dabrafenib (Tafinlar), which targets BRAF…and trametinib (Mekinist), which targets MEK, a mutation similar to BRAF. In a group of 76 patients with BRAF who had never been treated for MBC and whose neurological symptoms were under control, 58% had significant shrinking of their brain tumors—and in four patients the tumors vanished, according to the research, which was published in The Lancet Oncology. The response lasted, on average, six to seven months. 

Immunotherapy

Immunotherapy drugs are a class of drugs that stimulate a patient’s immune system, essentially calling it into action. The most widely used immunotherapies are drugs that block checkpoint proteins, such as PD-1 or PD-L1, which suppress inflammatory responses in the immune system.

Scientific evidence: Impressive results with combined drug therapy—ipilimumab (Yervoy) and nivolumab (Opdivo)—were cited in a study published in The New England Journal of Medicine. In that research, when 94 melanoma patients with MBC took both drugs, 81% were alive after one year and 70% after two years—a dramatic increase over the typical survival rate of four to five months before the introduction of immunotherapy. 

Focused Radiation

In the past, the standard radiation treatment for MBC was whole-brain radiation—multiple treatments of the entire brain with low-dose radiation. 

However, whole-brain radiation has significant side effects, such as a marked decrease in memory and other cognitive abilities. Doctors are now using highly focused radiation therapies called stereotactic radiosurgery. Employing a flexible robotic arm to deliver radiation (CyberKnife), or using a helmet with built-in radiation sources (Gamma Knife), this treatment delivers less total radiation…faster…and more accurately. And its cancer-killing efficacy is as good as whole-brain radiation —with less severe side effects.

Your Plan of Action

To take advantage of the breakthrough treatments for MBC, you need a plan of action. Here are four steps to follow…

STEP  #1: Treat the primary cancer. The key in treating cancer is always minimizing your overall cancer burden using the full range of treatments available—such as chemotherapy, radiation, surgery, targeted therapies and immunotherapy. Controlling the primary malignancy reduces the risk of the cancer spreading to the brain. 

STEP #2: Ask your oncologist, “Has my tumor been sufficiently molecularly characterized?” Sophisticated genetic tests will show if you’re a candidate for targeted therapy or immunotherapy.

For example, if such testing shows that you have the ALK mutation, treatments for the primary tumor may include targeted therapies such as alectinib (Alecensa), brigatinib (Alunbrig) or lorlatinib (Lorbrena)—all of which also help prevent and/or treat brain metastases.

If a tumor biopsy shows that you have high levels of PD-1 or PD-L1, then you may be a candidate for an immunotherapy drug such as pembrolizumab (Keytruda), nivolumab (Opdivo) or atezolizumab (Tecentriq).  

STEP #3: Ask your oncologist, “Are there effective therapies that treat the molecular pathways affecting my cancer—and should we use those therapies to treat my brain cancer?” Once your tumor has been tested for molecular mutations, talk with your oncologist about the targeted and immunological therapies available to treat those problems. You and your doctor should develop a complete list of the targeted therapies and immunotherapies (see examples above) that may be right for you—and then decide which to use.

STEP #4: Demand a multidisciplinary team approach. The best treatment for primary cancer and for MBC is a team approach, typically involving a medical oncologist, a radiation oncologist and a cancer surgeon. The best treatment decisions are made when the entire team talks to one another, face-to-face. This type of multidisciplinary approach is typical of cancer centers that are designated by the National Cancer Institute for offering cutting-edge treatments. To find such an NCI-designated cancer center near you, go to: Cancer.gov/research/nci-role/cancer-­centers/find.

https://bottomlineinc.com/health/cancer/when-cancer-spreads-to-the-brain-new-treatments-offer-hope

7 Proven Ways Matcha Tea Improves Your Health

Studies of matcha and its components have unearthed a variety of benefits, showing that it can help protect the liver, promote heart health and even aid in weight loss.

Written by Rachael Link, MS, RD on October 10, 2017

Matcha has skyrocketed in popularity lately, with matcha shots, lattes, teas and even desserts appearing everywhere from health stores to coffee shops.

Like green tea, matcha comes from the Camellia sinensis plant. However, it is grown differently and has a unique nutrient profile.

Farmers grow matcha by covering their tea plants 20–30 days before harvest to avoid direct sunlight. This increases chlorophyll production, boosts the amino acid content and gives the plant a darker green hue.

Once the tea leaves are harvested, the stems and veins are removed and the leaves are ground up into a fine powder known as matcha.

Matcha contains the nutrients from the entire tea leaf, which results in a greater amount of caffeine and antioxidants than are typically found in green tea.

Studies of matcha and its components have unearthed a variety of benefits, showing that it can help protect the liver, promote heart health and even aid in weight loss.

Here are 7 health benefits of matcha tea, all based on science.

1. High In Antioxidants

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Matcha is rich in catechins, a class of plant compounds in tea that act as natural antioxidants.

Antioxidants help stabilize harmful free radicals, which are compounds that can damage cells and cause chronic disease.

When you add matcha powder to hot water to make tea, the tea contains all the nutrients from the entire leaf. It will tend to have more catechins and antioxidants than simply steeping green tea leaves in water.

In fact, by one estimate, the number of certain catechins in matcha is up to 137 times greater than in other types of green tea (1Trusted Source).

One study showed that giving mice matcha supplements reduced damage caused by free radicals and enhanced antioxidant activity (2Trusted Source).

Including matcha in your diet could increase your antioxidant intake, which may help prevent cell damage and even lower your risk of several chronic diseases (3Trusted Source).

SUMMARYMatcha contains a concentrated amount of antioxidants, which may reduce cell damage and prevent chronic disease.

2. Protects the Liver

The liver is vital to health and plays a central role in flushing out toxins, metabolizing drugs and processing nutrients.

Some studies have found that matcha may help protect the health of your liver.

One study gave diabetic rats matcha for 16 weeks and found that it helped prevent damage to both the kidneys and liver (4Trusted Source).

Another study gave 80 people with non-alcoholic fatty liver disease either a placebo or 500 mg of green tea extract daily for 90 days.

After 12 weeks, green tea extract significantly reduced liver enzyme levels. Elevated levels of these enzymes are a marker of liver damage (5Trusted Source).

Furthermore, an analysis of 15 studies found that drinking green tea was associated with a decreased risk of liver disease (6Trusted Source).

However, it's important to remember that there may be other factors involved in this association.

More research is needed to look at the effects of matcha on the general population, since most research is limited to studies examining the effects of green tea extract in animals.

SUMMARYSome studies have shown that matcha could prevent liver damage and decrease the risk of liver disease. However, additional studies are needed to look at the effects on humans in the general population.

3. Boosts Brain Function

Some research shows that several of the components in matcha could help enhance brain function.

One study in 23 people looked at how people performed on a series of tasks designed to measure brain performance. Some participants consumed either matcha tea or a bar containing 4 grams of matcha, while the control group consumed a placebo tea or bar.

The researchers found that matcha caused improvements in attention, reaction time and memory, compared to the placebo (7Trusted Source).

Another small study showed that consuming 2 grams of green tea powder daily for two months helped improve brain function in elderly people (8Trusted Source).

Additionally, matcha contains a more concentrated amount of caffeine than green tea, packing in 35 mg of caffeine per half teaspoon (about 1 gram) of matcha powder.

Multiple studies have linked caffeine consumption to improvements in brain function, citing faster reaction times, increased attention and enhanced memory (9Trusted Source, 10Trusted Source, 11Trusted Source).

Matcha also contains a compound called L-theanine, which alters the effects of caffeine, promoting alertness and helping avoid the crash in energy levels that can follow caffeine consumption (12Trusted Source).

L-theanine has also been shown to increase alpha wave activity in the brain, which may help induce relaxation and decrease stress levels (13Trusted Source).

SUMMARYMatcha has been shown to improve attention, memory and reaction time. It also contains caffeine and L-theanine, which can improve several aspects of brain function.

4. Helps Prevent Cancer

Matcha is jam-packed with health-promoting compounds, including some that have been linked to cancer prevention in test-tube and animal studies.

In one study, green tea extract decreased tumor size and slowed the growth of breast cancer cells in rats (14Trusted Source).

Matcha is especially high in epigallocatechin-3-gallate (EGCG), a type of catechin that has been shown to have powerful anti-cancer properties.

One test-tube study found that the EGCG in matcha helped kill off prostate cancer cells (15Trusted Source).

Other test-tube studies have shown that EGCG is effective against skin, lung and liver cancer (16Trusted Source, 17Trusted Source, 18Trusted Source).

Keep in mind that these were test-tube and animal studies looking at specific compounds found in matcha. Further research is needed to determine how these results may translate to humans.

SUMMARY:Test-tube and animal studies have found that the compounds in matcha may inhibit the growth of cancer cells.

5. Protects Your Heart

Heart disease is the leading cause of death worldwide, accounting for an estimated one-third of all deaths in people over the age of 35 (19Trusted Source).

Some studies have shown that drinking green tea, which has a similar nutrient profile to matcha, may help protect against heart disease.

Green tea has been shown to reduce levels of total and “bad” LDL cholesterol, as well as triglycerides (20Trusted Source, 21Trusted Source).

It may also help prevent the oxidation of LDL cholesterol, another factor that may protect against heart disease (22Trusted Source).

Observational studies have also shown that drinking green tea is associated with a reduced risk of heart disease and stroke (23Trusted Source, 24Trusted Source).

When combined with a well-rounded diet and healthy lifestyle, drinking matcha may help keep your heart healthy and protect against disease.

SUMMARYStudies show that green tea and matcha can decrease several heart disease risk factors.

6. Helps You Lose Weight

Take a look at any weight loss supplement, and there's a good chance you'll see "green tea extract" listed in the ingredients.

Green tea is well known for its ability to enhance weight loss. In fact, studies show that it may help speed up metabolism to increase energy expenditure and boost fat burning.

One small study showed that taking green tea extract during moderate exercise increased fat burning by 17% (25Trusted Source).

Another study in 14 people found that taking a supplement containing green tea extract significantly boosted 24-hour energy expenditure, compared to a placebo (26Trusted Source).

A review of 11 studies also showed that green tea reduced body weight and helped maintain weight loss (27Trusted Source).

Although most of these studies focused on green tea extract, matcha comes from the same plant and should have the same effect.

SUMMARYSome studies show that green tea extract helps increase metabolism and fat burning, both of which may aid weight loss.

7. Matcha Tea Is Very Easy to Prepare

Taking advantage of the many health benefits of matcha is simple — and the tea tastes delicious.

You can make traditional matcha tea by sifting 1–2 teaspoons (2–4 grams) of matcha powder into your cup, adding 2 ounces (59 ml) of hot water and mixing it together with a bamboo whisk. You can find a bamboo whisk at a specialty tea or Japanese store.

You can also adjust the ratio of matcha powder to water based on your preferred consistency.

For a thinner tea, reduce the powder to a half teaspoon (1 gram) and mix with 3–4 ounces (89–118 ml) of hot water.

If you prefer a more concentrated version, combine 2 teaspoons (4 grams) of powder with just 1 ounce (30 ml) of water.

If you're feeling creative, you can even try whipping up matcha lattes, puddings or protein smoothies to boost the nutrient content of your favorite recipes.

As always, moderation is key. Although matcha is brimming with health benefits, more is not necessarily better.

In fact, liver problems have been reported in some people who drank six cups of green tea daily. This translates to about two cups of matcha tea, since it’s more concentrated than green tea (28Trusted Source).

Drinking matcha may also increase your exposure to contaminants like pesticides, chemicals and even arsenic found in the soil where the tea plants are grown (29Trusted Source, 30Trusted Source).

It's best to stick to one or two cups per day and look for certified organic varieties to take advantage of matcha's many health benefits without risking any side effects.

SUMMARYThere are many ways to prepare matcha, so you can choose the one you like best. It can also be incorporated into a range of different recipes.

The Bottom Line

Matcha comes from the same plant as green tea, but since it is made from the entire leaf, it packs in a more concentrated amount of antioxidants and beneficial plant compounds.

Studies have revealed a variety of health benefits associated with matcha and its components, ranging from enhancing weight loss to decreasing the risk of heart disease.

Best of all, the tea is simple to prepare, so you can incorporate it effortlessly into your diet and give your day a burst of extra flavor.

https://www.healthline.com/nutrition/7-benefits-of-matcha-tea#section8

Hong Kong research warns of sunscreen health risks

NEW research in Hong Kong has found that UV filters commonly used in sunscreen are polluting surrounding waters and could endanger human health, one of the city’s leading universities said .

OCTOBER 15, 2018 HEALTH

BY AGENCY

There is growing international concern over the polluting effects of sunscreen.

An “extensive amount” of seven common UV filter chemicals was found in Hong Kong seawater as well as in fish, shrimps and mussels on aqua-farms, scientists from Hong Kong Baptist University told reporters.

“The effect of these contaminants passing along the food chain to humans and the long-term impact on human fertility cannot be neglected,” said Dr Kelvin Leung, who led the research.

Tests performed on zebrafish, which share a similar genetic structure to humans, showed the polluted water caused abnormalities and a higher mortality rate in the fish’s embryos as the chemicals entered the food chain.

The university described the study as a world-first in identifying the harm caused by a combination of polluting chemicals in sunscreen. Researchers said they would conduct further tests to learn more about the effects of UV filters on the human body.

The chemicals tested on the zebrafish study included octocrylene (known as OC), benzophenone-3 (known as BP-3) and ethylhexyl methoxycinnamate (known as EHMC), which were found to be the most abundant types of chemical UV filters in Hong Kong waters.

The European Union’s International Chemical Secretariat has already established BP-3 as a threat to human health and called for it to be replaced with another, safer ingredient. Dr Leung added that these chemicals can accumulate in the human body and cannot be dissolved or diluted simply by drinking water.

There is growing international concern over the polluting effects of sunscreen. Hawaii signed a bill in July to ban sunscreens containing chemicals harmful to coral reefs, which will take effect from 2021. But the ban raised concerns that it may deter consumers from using sunscreen to protect their skin from cancer.

Leung called for more regulations on the use of chemicals in personal care products and recommended consumers use mineral-based sunscreens such as titanium dioxide and zinc oxide, or wear sun-protection clothing. – AFP Relaxnews

https://www.star2.com/health/2018/10/15/sunscreen-health-risks/

Scientists in Australia develop world-first blood test to detect skin cancer before it spreads through the body

Scientists in Australia have developed a world-first blood test to detect skin cancer before it spreads through the body. 

•  Jonathan Pearlman, in sydney

18 JULY 2018 • 5:33PM

Early stage melanoma can often be difficult to distinguish from a mole CREDIT:  CALLISTA IMAGES

The test could potentially allow early detection of melanoma, the most deadly form of skin cancer, and increase the prospects of treatment. It may also help to avoid invasive and costly biopsies.

Researchers said the test could prove more accurate than the current method of detection, which typically involves a doctor looking at the skin and assessing spots or changes to moles before removing a sample for further examination. But an early stage melanoma can often be difficult to distinguish from a mole.

“While clinicians do a fantastic job with the tools available, relying on biopsies alone can be problematic,” said Pauline Zaenker, from Edith Cowan University.

“The body starts producing these antibodies as soon as melanoma first develops which is how we have been able to detect the cancer in its very early stages with this blood test. No other type of biomarker appears to be capable of detecting the cancer in blood at these early stages.”

Melanoma, which are typically caused by exposure to the sun, can, if undetected, spread to other parts of the body such as the lungs, liver and brain. These secondary melanomas can be more dangerous and harder to treat.

A trial of the new blood test involving 209 people found the cancer during its early stages in 81.5 per cent of cases.


Actor Hugh Jackman recently revealed he had been treated for skin cancer - a basal cell carcinoma - after seeking advice for a mark on his nose. CREDIT: @REALHUGHJACKMAN / INSTAGRAM

Detection of melanoma before it spreads can result in a 90 to 99 per cent five-year survival rate but the survival rate for people with secondary forms is less than 50 per cent.

The researchers said the test could be used for routine screening of people with a higher risk of melanoma, such as those with a large number of moles, pale skin or a family history of the disease.

“It’s critical that melanoma is diagnosed more accurately and early,” said Professor Mel Ziman, from Edith Cowan University.

“So a blood test would help in that identification particularly at early stage melanoma, which is what is the most concerning and would be most beneficial for everybody if it was identified early.”

The researchers plan to conduct clinical trials and believe the test could be available in three to five years.

The World Health Organization says skin cancers are more common for Caucasians, particularly people with pale or freckled skin, fair or red hair, or blue eyes.

Australia has one of the world’s highest rates of melanoma, with 14,000 new diagnoses and almost 2000 deaths each year.

Professor Rodney Sinclair, from the University of Melbourne, said the test was not 100 per cent accurate and results would still need to be interpreted with caution, potentially with a check by a dermatologist.

The research findings were published in the journal Oncotarget.

0https://www.telegraph.co.uk/news/2018/07/18/scientists-australia-develop-world-first-blood-test-detect-skin/