01:19am Saturday 21 October 2017

Nearly 1 in 4 Women Newly Diagnosed with Breast Cancer Report PTSD Symptoms

The research has been e-published ahead of print in the Journal of the National Cancer Institute.

“This study is one of the first to evaluate the course of PTSD after a diagnosis of breast cancer,” said lead author Alfred I. Neugut, MD, PhD, the Myron M. Studner Professor of Cancer Research, professor of medicine and epidemiology, at Columbia University’s College of Physicians & Surgeons and Mailman School of Public Health, and a member of the HICCC.

“We analyzed interview responses from more than 1,100 women,” said Dr. Neugut. “During the first two to three months after diagnosis, nearly a quarter of them met the criteria for PTSD, although the symptoms declined over the next three months. Younger women were more likely to develop symptoms of PTSD, and data suggest Asian and black women are at a more than 50 percent higher risk than white women.”

The 1,139 research participants were part of the Breast Cancer Quality of Care Study (BQUAL). Between 2006 and 2010, women with newly diagnosed breast cancer, stages I to III, over the age of 20 were recruited from NewYork-Presbyterian/Columbia University Medical Center and Mount Sinai School of Medicine in New York City; the Henry Ford Health System in Detroit; and Kaiser-Permanente in Northern California. Each participant completed three phone interviews. The first was two to three months after diagnosis and before the third chemotherapy cycle, if the patient was receiving chemotherapy. The second interview was four months after diagnosis, and the third was six months after diagnosis.

“The ultimate outcome of this research is to find ways to improve the quality of patients’ lives,” said Dr. Neugut, who is also an oncologist at NewYork-Presbyterian Hospital/Columbia. “If we can identify potential risk factors for PTSD, when women are diagnosed with breast cancer, we could provide early prevention and intervention to minimize PTSD symptoms. This approach might also have an indirect impact on the observed racial disparity in breast cancer survival.”

The research team believes that these findings may apply to patients with other cancer diagnoses as well. Dr. Neugut noted that in previous research, symptoms of PTSD have been reported following prostate cancer and lymphoma diagnoses.

The paper is titled “Racial Disparities in Posttraumatic Stress after Diagnosis of Localized Breast Cancer: The BQUAL Study.” Additional contributors are Neomi Vin-Raviv, Grace Clarke Hillyer, Dawn Hershman, Sandro Galea, Nicole Leoce, and Wei-Yann Tsai (CUMC); Dana Bovbjerg (University of Pittsburgh); Lawrence Kushi, and Candyce Kroenke (Kaiser-Permanente); Lois Lamerato (Henry Ford Health System); Christine Ambrosone (Roswell Park Cancer Institute); Heiddis Valdimarsdottir, and Lina Jandorf (Mt. Sinai); and Jeanne Mandelblatt (Georgetown). In addition to Dr. Neugut, Drs. Hershman and Tsai are members of the HICCC.

The study was supported by the Department of Defense, the National Cancer Institute, Breast Cancer Foundation and Environmental Health Foundation fellowship (grant numbers: NCI R01 (CA100598), NCI R01 (CA124924 and 127617), U10 (CA84131) and KO5 (CA96940)).

The authors declare no financial or other conflicts of interest.

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The Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia University Medical Center encompasses pre-clinical and clinical research, treatment, prevention, and population-based education efforts in cancer. The Cancer Center was initially funded by the NCI in 1972 and became a National Cancer Institute (NCI)–designated comprehensive cancer center in 1979. Cancer Center researchers and physicians are dedicated to understanding the biology of cancer and to applying that knowledge to the design of cancer therapies and prevention strategies that reduce its incidence and progression and improve the quality of the lives of those affected by cancer. For more information, visit www.hiccc.columbia.edu.

Columbia University Medical Center provides international leadership in basic, pre-clinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians and Surgeons was the first institution in the United States to grant the MD degree and is among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest in the United States. Its physicians treat patients at multiple locations throughout the tri-state area, including the NewYork-Presbyterian/Columbia campus in Washington Heights, the new ColumbiaDoctors Midtown location at 51 W. 51st St. in Manhattan, and the new ColumbiaDoctors Riverdale practice. For more information, visit www.cumc.columbia.edu or columbiadoctors.org.

Media Contact: Elizabeth Streich, estreich@columbia.edu, 212-305-3689

Patient Benefits from ‘Immune System-Stimulating’ Experimental Drug

Pam Johnson smoked cigarettes for 45 years. She quit the day she had surgery for stage 3 lung cancer.

“I was anxious and worried,” says Johnson about the day she received her diagnosis in 2010. Her primary care physician had ordered routine blood work that came back abnormal. He ordered a chest x-ray as follow-up to rule out obvious causes of the abnormality. The chest X-ray revealed a suspicious spot in her right lung and a follow-up biopsy confirmed that it was cancerous.
 
Johnson says there was no question in her mind where she would go to get care: “UC and the Barrett Center—it’s the best institution in town for cancer care.”
She chose Sandra Starnes, MD, UC Health chest surgeon and chief of thoracic surgery at the UC College of Medicine, to perform her surgery at University of Cincinnati Medical Center (formerly University Hospital). Starnes and her team offer rib-sparing video-assisted thoracoscopic surgery (VATS). The technique requires only a few small incisions in the chest to insert the minimally invasive tools used to operate.
Johnson immediately began a three-month regimen of combined chemotherapy and radiation therapy to address residual cancer cells. Six months later, a follow-up PET/CT scan showed a mass in the liver, with blood work indicating abnormal liver function. A biopsy confirmed that the lung cancer had spread to her liver as well as to a pelvic bone and one rib.
 
After a standard second-line chemotherapy failed to reduce the liver tumor size, she consulted with John Morris, MD, director of the UC Cancer Institute’s Experimental Therapeutics/Phase 1 Program and lung cancer expert to talk about experimental treatments.
“It was pretty clear that the standard therapies weren’t going to be enough for me. I wanted to take the steps that would give me the best change at kicking the cancer’s butt. I trust Dr. Morris and he said this phase I study was my best shot,” recalls Johnson.
In March 2012, she began treatment on a phase 1 study, sponsored by Bristol Myers Squibb, to test an immune system-stimulating agent known as MDX-1105. About 200 patients will enroll in the trial nationwide.
“This experimental drug does not act directly on the tumor, but rather blocks an ‘off-switch’ in the immune system allow the immune system to activate against cancer,” explains Morris, who serves as UC’s principal investigator of the trial.
By June 2012—after two cycles of the experimental therapy—Johnson’s liver tumor had shrunk 80 percent, the pelvic bone regenerated and the rib remained stable. As of February 2013, Ms. Johnson’s tumors continue to shrink and are almost unmeasurable on x-rays.
“I’m living a good quality of life, despite the cancer. I trust my Dr. Morris. He gets me and what I want from this experience. I’m very hopeful and focused on living my life,” adds Johnson.
Cancer Experimental Therapeutics
Patients who have not responded to standard treatment options may qualify to participate in experimental treatment options only available through phase I “first-in-human” clinical research studies. The UC Cancer Institute is the only organization within a 100-mile radius of Cincinnati to offer a comprehensive phase I clinical trial program.
Phase 1 studies are the first step in testing an investigational drug in humans. The purpose of a phase 1 study is to find the safest way to give a new drug (for example, by mouth, IV infusion or injection) and the most effective dosage.

Learn more about the UC Cancer Institute Experimental Therapeutics Program at uccancer.com/phase1 or by calling 866-724-CURE (2873).

– See more at: http://healthnews.uc.edu/news/?/22006/#sthash.wbR2vfTZ.dpuf


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