Cancer No. 1 Killer of Asian-Americans, Hawaiians, Pacific Islanders: Study

Cancer No. 1 Killer of Asian-Americans, Hawaiians, Pacific Islanders: Study

Cancer is the leading cause of death among Asian Americans, Native Hawaiians and Pacific Islanders, even though overall cancer incidence and death rates in these groups are lower than among white Americans, a new study finds. There will be about 57,740 new cancer cases and nearly 17,000 cancer deaths among Asian Americans, Native Hawaiians and Pacific Islanders in 2016, the American Cancer Society report estimated.
However, the three leading causes of cancer death among Asian American, Native Hawaiian and Pacific Islander men are lung (27 percent), liver (14 percent) and colon/rectum (11 percent). Among women, they are lung (21 percent), breast (14 percent) and colon/rectum (11 percent), the findings showed.
Even though Asian Americans, Native Hawaiians and Pacific Islanders have cancer incidence and death rates that are 30 percent to 40 percent lower for all cancers combined than whites, their rates of stomach and liver cancers are nearly double those of whites. And they also have higher rates of nasopharynx (upper throat behind the nose) cancers.
The researchers also found that Asian Americans, Native Hawaiians and Pacific Islanders are less likely than whites to be diagnosed with cancer before it has spread. Within Asian American, Native Hawaiian and Pacific Islander subgroups, there are also wide variations in cancer incidence rates.
Study co-author Lindsey Torre, an epidemiologist in the surveillance research group at the cancer society said that the variations they see in cancer rates in [these groups] are related to risk factors, including lifestyle factors, use of screening and preventive services, and exposure to cancer-causing infections.
Between 2006 and 2010, incidence rates per 100,000 men ranged from about 217 among Asian Indians/Pakistanis to almost 527 among Samoans. The rate among white men was 554. Among Asian American, Native Hawaiian and Pacific Islander women, rates ranged from 212 among Asian Indians/Pakistanis to almost 443 among Samoans. The rate among white women was about 445, according to the report.
Among both men and women in this population, the highest rates after Samoans were among Native Hawaiians and Japanese, the study authors said.
In addition, Torre concluded that cancer-control strategies among this population include improved use of vaccination and screening; interventions to increase physical activity and reduce excess body weight, tobacco use and alcohol consumption; and research to get a more detailed understanding of differences in the cancer burden and risk factors between subgroups.

Could We Be Winning the War on Cancer?

Could We Be Winning the War on Cancer?

Deaths from cancer continue to decline in the United States, according to a new report from the American Cancer Society. Since peaking in 1991, cancer death rates have dropped by 23 percent, the ACS said in the report released Thursday.
Study author Rebecca Siegel, strategic director for surveillance information services for the American Cancer Society said that cancer death rates are continuing to decline by about 1.5 percent per year. The 23 percent drop in death rates occurred from 1991 through 2012 and that translates to more than 1.7 million cancer deaths averted.
The findings are included in Cancer Statistics, 2016, the American Cancer Society’s latest annual report on cancer incidence, mortality, and survival. The report was published online Jan. 7 in CA: A Cancer Journal for Clinicians.
The data was collected from the U.S. National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program and other sources. Over the past decade, the rate of cancer deaths has dropped by 1.8 percent a year in men and 1.4 percent in women, according to the report. The decline in the past 20 years has been driven by the continuous drop in deaths for four major cancer types: breast, colon, lung, and prostate, the report noted.
For 2016, the ACS estimates that there will be about 1.6 million new cancer cases and nearly 600,000 deaths in the United States.
Despite the progress, death rates for certain cancers are increasing, Siegel and her colleagues found. These include cancers of the liver, pancreas, and uterus. Thyroid cancers are the most rapidly rising, increasing more than 5 percent yearly in both men and women, the research revealed. However, some of that increase stems from overdiagnosis due to advanced imaging techniques, the experts said.
Dr. Steven Rosen is director of the City of Hope Comprehensive Cancer Center and Beckman Research Institute in Duarte, Calif. While saying “there was nothing surprising” in the new report, he added that “we should be very proud of all our accomplishments.”
Among the cancers that may be linked to obesity are breast, colon, endometrial, esophagus, gallbladder, kidney, pancreas, prostate, and thyroid, he said. Siegel agreed that obesity must be addressed head-on as a cancer risk factor. “For many of the cancers that are increasing, it’s related to obesity,” she said. The link between obesity and cancer is not well-known by many people, she added.

Breast Cancer Survivors Could Have Increased Risk of Thyroid Cancer

Breast Cancer Survivors Could Have Increased Risk of Thyroid Cancer

Women who survive breast or thyroid cancer are linked to an increased risk for the other, according to a new analysis. University of Chicago researchers who reviewed 37 published studies found breast cancer survivors were 1.55 times more likely to develop thyroid cancer than women who hadn’t had breast cancer. And, female thyroid cancer survivors were 1.18 times more likely to get breast cancer than women who hadn’t had thyroid cancer, researchers said.
The study lead author Dr. Raymon Grogan, director of the university’s endocrine surgery research program said that this is a real risk. People who have had one of these cancers need to be aware that they are at higher risk for developing the other cancer.
Thyroid cancer cases have nearly tripled in the United States over the past 30 years, and breast cancer is the most common cancer among women, according to background notes with the study. Thanks to medical advances, more women are surviving each cancer, Grogan said. Moreover, Doctors need to be more aware of the link between the two cancers, he said.
“It should just become one of the common discussions between a patient and her doctor,” he said. “It doesn’t change the recommendations for screening, but people need to be aware and be screened at the appropriate time.”
The report was published Feb. 5 in the journal Cancer Epidemiology, Biomarkers and Prevention. Carol DeSantis, director of breast and gynecological cancer surveillance at the American Cancer Society, said the connection between thyroid and breast cancer is known.
She said her concern with this new report is that by lumping together so many studies that differ in their methods and findings, it’s impossible to come up with a single number that accurately reflects the risk of having one cancer after having had the other.
“The review of different studies is helpful to see that there is that link, but combining them all together, I am not sure who that would be applicable to,” DeSantis said.
Grogan said the research team tried to control for those differences as best they could. Nineteen of the studies analyzed breast cancer patients and their risk of thyroid cancer. Another 18 looked at thyroid cancer cases and their incidence of breast cancer. The researchers then combined these data and calculated the odds of a women having thyroid cancer after breast cancer and vice versa.
In addition, the researchers combed through the studies to find reasons why these cancers seemed related. One explanation was that women who survive either cancer were more likely to be screened and examined so that other cancers were found early.
Another possible connection was that breast and thyroid cancers share hormonal risk factors. There is some evidence that exposure to estrogens and to thyroid-stimulating hormones may contribute to both cancers, Grogan said.
A third theory points to radiation therapy, which has been shown to increase the risk for lung, esophageal, and blood cancers, and sarcomas. Also, earlier research found that radioactive iodine, used to treat thyroid cancer, may play a small role in the development of other cancers, including breast cancer, but that is not clear, Grogan said.
Finally, it is possible that a genetic mutation might be responsible for the connection, Grogan said. DeSantis said that cancer survivors should be aware of the increased risk of developing other cancers.
She said that generally, cancer survivors are at risk for developing a second cancer and breast cancer survivors are at risk for blood cancers, uterine cancer, ovarian cancer and other cancers. Likewise, thyroid cancer survivors are at risk for a number of other cancers, including breast cancer.

A Breast Cancer Diagnosis Checklist

A Breast Cancer Diagnosis Checklist

It is true that it is helpful to carry around a checklist of all the information you want to gather about your breast cancer diagnosis, because you’ll be seeing results from the various tests at different times. Although you may have already had a biopsy, for instance, your doctor might still need to remove lymph nodes to determine whether the cancer has spread. 

Mary McHugh, MD, a pathologist at Mount Carmel St. Ann's hospital in Westerville, Ohio, and a member of the College of American Pathologists, recommends finding out the following. What type of cancer is it? The most common form is IDC. Other common types include DCIS, ILC, and LCIS. Click here for a detailed explanation of each type. Is it invasive? Says Dr. McHugh: "If the cancer breaks through the wall of the breast duct, it's considered invasive. If it hasn't broken through, though, it's called in situ or noninvasive cancer." Invasive cancer is more serious.

What size is the tumor? This is measured in centimeters. What stage is it? Ductal carcinoma in situ (DCIS) is stage 0, the most curable; cancer that has spread to other parts of the body is stage IV. What is the histopathologic grade? This is a total score combining three different characteristics of the tumor as it appears under the microscope. Scores range from 3 to 9; a higher score indicates more aggressive cancer. Your report will include a histopathologic grade of 1 if your combined score is 3 to 5; 2 if your score is 6 to 7; and 3 if the score is 8 to 9.

After surgery: Are the margins clear (aka negative) or positive? The surgeon removing the tumor tries to take a rim of cancer-free tissue around the tumor. "We're trying to confirm that the surgeon got it all out," explains Dr. McHugh. If the margins are positive, that may mean scheduling more surgery to get the rest out.

Do the lymph nodes or blood vessels show cancer? Is the cancer hormone receptive? "Some cancer cells have a higher number of hormone receptors in the nucleus and that can promote the growth of the cells," Dr. McHugh says. Your report will say you're ER-positive, or estrogen receptor-positive, and/or PR-positive, progesterone receptor-positive, or negative for one or both. This helps doctors determine if you're a candidate for hormone therapy, such as tamoxifen, which blocks these receptors and can slow down or stop the growth of tumors.

And finally, what is the cancer's HER2/neu status? "If tumor cells are HER2-positive, it means they're associated with a more aggressive tumor," says Dr. McHugh. Your HER2/neu status tells your oncologist whether the drug Herceptin (trastuzumab), which targets the HER2 protein, should be part of your treatment plan.

Is Fat From Another Area of Body Safe for Breast Reconstruction?

Is Fat From Another Area of Body Safe for Breast Reconstruction?

Using women’s own fat cells to enhance breast reconstruction following cancer surgery doesn’t increase the risk they will experience a recurrence of their disease or develop a new cancer, research suggests.

The procedure is known as lipofilling. Fat is taken from the belly or another part of the body and injected into the breast to enhance appearance, the researchers explained. According to the report in the February issue of Plastic and Reconstructive Surgery, this technique can be safely used during breast reconstruction following a partial or total mastectomy.

The study’s lead author, Dr. Steven Kronowitz, of Kronowitz Plastic Surgery in Houston, said in a journal news release that their controlled study shows that, used as part of breast reconstruction, lipofilling is a safe procedure that does not increase the risk of recurrent or new breast cancers.
The study included more than 1,000 women who had lipofilling after cancer-related breast surgery. About one-third of these women had a high genetic risk for breast cancer and underwent a risk-reducing mastectomy.

Rates of new or recurrent breast cancers in these women were compared against a similar group of women who had cancer-related breast reconstructions without lipofilling. Women who’d had lipofilling after a mastectomy due to cancer were followed for about five years, the study said.

Overall, cancer recurrence rates were similar among the women who had lipofilling and those who didn’t. This was true for cancers that recurred in the breast or surrounding tissue as well as recurring systemic cancers that affect other parts of the body, the study authors said.

None of the women who had a preventive mastectomy developed breast cancer, the findings showed.  There was a slightly higher risk of cancer recurrence for women on hormone therapy who had lipofilling during breast reconstruction, the investigators found.

In addition, plastic surgeons are increasingly using lipofilling as part of breast reconstruction surgery. But the researchers said many doctors remain concerned that the procedure may affect women’s risk for new or recurring breast cancer.