The above picture comes from the Macmillan website. It doesn't relate directly to this post but might tease the mind to figure out some controllable causes of cancer. 

Whether a patient, family member or friend, finding a perspective on cancer is always going to be difficult and the reams of stories, updates, advice and analyses probably don’t help.

The lead article below from the Economist offers one of the few `world view’ summations around and is worth a quick read through.


#The first piece of a puzzle is always correctly placed.
# Home is where you know which light switch to press.
# Jury duty is really the only time it is socially acceptable to judge someone as a group.

Closing in on cancer, Economist

(U.S.) THE numbers are stark. Cancer claimed the lives of 8.8m people in 2015; only heart disease caused more deaths. Around 40% of Americans will be told they have cancer during their lifetimes. It is now a bigger killer of Africans than malaria.

But the statistics do not begin to capture the fear inspired by cancer’s silent and implacable cellular mutiny. Only Alzheimer’s exerts a similar grip on the imagination.

Confronted with this sort of enemy, people understandably focus on the potential for scientific breakthroughs that will deliver a cure. Their hope is not misplaced. Cancer has become more and more survivable over recent decades owing to a host of advances, from genetic sequencing to targeted therapies. The five-year survival rate for leukaemia in America has almost doubled, from 34% in the mid-1970s to 63% in 2006-12. America is home to about 15.5m cancer survivors, a number that will grow to 20m in the next ten years. Developing countries have made big gains, too: in parts of Central and South America, survival rates for prostate and breast cancer have jumped by as much as a fifth in only a decade.

From a purely technical perspective, it is reasonable to expect that science will one day turn most cancers into either chronic diseases or curable ones. But cancer is not fought only in the lab. It is also fought in doctors’ surgeries, in schools, in public-health systems and in government departments. The dispatches from these battlefields are much less encouraging.

First, the good news. Caught early, many cancers are now highly treatable. Three out of four British men who received a prostate-cancer diagnosis in the early 1970s did not live for another ten years; today four out of five do. Other cancers, such as those of the lung, pancreas and brain, are harder to find and treat. But as our Technology Quarterly in this issue shows, progress is being made. Techniques to enable early diagnosis include a device designed to detect cancer on the breath; blood tests can track fragments of DNA shed from tumours. Genome sequencing makes it ever easier to identify new drug targets.

The established trio of 20th-century cancer treatments—surgery, radiation and chemotherapy—are all still improving. Radiotherapists can create webs of gamma rays, whose intersections deliver doses high enough to kill tumours but which do less damage to healthy tissue as they enter and leave the body. Some new drugs throttle the growth of blood vessels bringing nutrients to tumours; others attack cancer cells’ own DNA-repair kits.

Cancer may be relentless; so too is science.

The greatest excitement is reserved for immunotherapy, a new approach that has emerged in the past few years. The human immune system is equipped with a set of brakes that cancer cells are able to activate; the first immunotherapy treatment in effect disables the brakes, enabling white blood cells to attack the tumours. It is early days, but in a small subset of patients this mechanism has produced long-term remissions that are tantamount to cures. Well over 1,000 clinical trials of such treatments are under way, targeting a wide range of different cancers. It is even now possible to reprogram immune cells to fight cancer better by editing their genomes; the first such gene therapy was approved for use in America last month.

Yet cancer sufferers need not wait for the therapies of tomorrow to have a better chance of survival today. Across rich and poor countries, the survivability of cancer varies enormously. Men die at far higher rates than women in some countries; in other countries, at similar levels of development, they do comparably well. The five-year survival rate for a set of three common cancers in America and Canada is above 70%; Germany achieves 64%, whereas Britain manages a mere 52%. Disparities exist within countries, too. America does well in its treatment of cancer overall, but suffers extraordinary inequalities in outcomes. The death rate of black American men from all cancers is 24% higher than it is for white males; breast-cancer death rates among blacks are 42% higher than for whites. A diagnosis in rural America is deadlier than one in its cities.

Variations between countries are partly a reflection of health-care spending: more than half of patients requiring radiotherapy in low- and middle-income countries do not have access to treatment. But big budgets do not guarantee good outcomes. Iceland and Portugal do not outspend England and Denmark on health care as a proportion of GDP, but past studies show wide variation in survivability in all cancers.

Taxes and budgeting are a lot less exciting than tumour-zapping proton beams and antibodies with superpowers. But the decisions of technocrats are as important as the work of technicians. Cancer kills millions of people not simply for want of scientific advance, but also because of bad policy.

Full story:

 Labour (Ireland) wants the HPV vaccine to be rolled out to boys sooner rather than later

(Ireland) The plan was originally to roll the free vaccine out to boys – but this has yet to happen.

Labour’s Alan Kelly has said his party will table a motion calling for the HPV vaccine to be extended to boys.

Speaking at the party’s think-in in Athy in Kildare, Kelly said he has been working with Health Minister Simon Harris on the initiative.

From the years 2014 -2015, there was an 87% uptake in the HPV vaccine – the highest since the programme began in 2010. However, immunisation rates have now fallen below 50%.

The health minister, along with other politicians, have attributed the fall-off in the uptake to misinformation being circulated from anti-vaccine campaigners.

Full story:

 New Zealand has had free HPV vaccines for boys since January

New treatment for head and neck cancer gets approved
(U.K.)Scottish patients will be the first in the UK to benefit from potentially life-extending immunotherapy treatment for head and neck cancer on the NHS.

The Scottish Medicines Consortium (SMC) have approved nivolumab for these types of cancer that are difficult to treat and often require many invasive and complex therapies. Studies have shown that double the number of patients treated with nivolumab were still alive after one year, compared with those treated with standard chemotherapy.

Head and neck cancer was the sixth most common cancer diagnosis in Scotland in 2015 with 1,283 and was within the top ten cancer related deaths at 452 people.

Gregor McNie, Cancer Research UK’s senior public affairs manager in Scotland, said: “Head and neck cancer is very difficult to treat once it has relapsed or spread, and options, including surgery and radiotherapy, are limited. So it is fantastic news that nivolumab will be available for some patients in Scotland with this devastating disease.

“Around 1,300 patients are diagnosed with head and neck cancer in Scotland every year.

Full story:

Queenslanders in wealthy areas less likely to get head and neck cancer
(Australia)Wealth has been revealed to be a major driver in cases of head and neck cancer in Queensland with those in disadvantaged areas 1.7 times more likely to be diagnosed than affluent areas.

According to data from Cancer Council Queensland, living in remote areas was another factor, with 20 in every 100,000 people diagnosed with head and neck cancer, compared to 14 in every 100,000 in metro areas between 2010 and 2014.

Cancer Council Queensland chief executive Chris McMillan said this type of cancer often went undiagnosed because the symptoms were easy to miss.

“You think I’ve just got a sore throat because it’s hung around or I’ve just got a hoarse voice because it’s hung around and that could be early warning signs of cancer,” she said.

Distance to health services was another factor which contributed to the differences.

Full story:




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