Healthcare professionals can now order a number of Macmillan Cancer Support’s free, high-quality cancer information booklets in CD format.

Macmillan has produced 37 audio CDs for people living with cancer who have any disability or visual impairment which may make reading difficult, or who simply prefer information in audio format.

Sue Green, Senior Information Development Nurse at Macmillan Cancer Support, says:

“Following a diagnosis of cancer, people often feel confused, anxious and afraid. High-quality information can help people affected by cancer to feel more in control and able to plan their lives, and can take away some of the fear and isolation they may feel.

“People may struggle to take in everything they’re told about their treatment and the side-effects it may cause so information to have at home is really important. They can take information away and listen to it in their own time, in the comfort of their own home.”

The CDs give information and advice about specific types of cancer, different types of treatment and possible side-effects, and the emotional effects of cancer.

Cynthia Higgins, a retired nurse, has had difficulty reading since being treated for Ocular Melanoma in 1997. She says:

“Macmillan’s new CDs give people with visual impairment a degree of independence and a sense of privacy. It’s very difficult to ask, even a loving relative, to continually go over a passage they are reading to you, or to find a section you want to hear again. It also allows people the opportunity to react to the information in private.”

To order from Macmillan’s range of audio CDs, visit be.macmillan.org.uk

Source
Macmillan Cancer Support

PRINCETON, N.J., June 17 — Survivors of Hodgkin lymphoma who received radiation therapy were more than twice as likely to suffer from stroke later in life, according a retrospective study by Dutch researchers.

• Consider appropriate strategies to reduce stroke and transient ischemic attack in Hodgkin lymphoma patients, such as treatment of hypertension and lifestyle changes.
• Explain to patients the increased long-term risk of radiotherapy.
• Consider whether evidence supports the use of radiotherapy for treatment of Hodgkin lymphoma.

The incidence of stroke among Hodgkin lymphoma patients who received radiotherapy was 2.2 times higher than in the general population (95% CI 1.7 to 2.8) and the incidence of transient ischemic attack (TIA) was 3.1 times higher (95% CI 2.2 to 4.2), according to the study, published in the July 1 issue of the Journal of the National Cancer Institute.

Of the 2,201 patients in the study, 96 suffered from cerebrovascular disease after a median follow-up time of 17.5 years after treatment, Marie L. De Bruin, MD, of the Netherlands Cancer Institute in Amsterdam, and colleagues reported.

“For young survivors of Hodgkin lymphoma who are at especially increased risk of stroke and TIA, physicians should consider appropriate risk-reducing strategies, such as treatment of hypertension and lifestyle changes to reduce the risk of stroke and TIA,” they wrote.

In proposing possible mechanisms to explain the increased risk for cerebrovascular disease, the Dutch team noted that in patients who undergo mantle field irradiation, both carotid arteries and the heart are exposed to radiation.

They suggested that in relatively young patients radiotherapy could induce atherosclerosis, while it could accelerate already existing atherosclerotic lesions in older patients. They also suggested cardioembolisms following radiation-induced cardiac disease as another possibility.

In an accompanying editorial, Dan L. Longo, MD, of the National Institute on Aging in Bethesda, Md., argued that the new study adds to the evidence that the use of radiation therapy for Hodgkin lymphoma is “short sighted” and that chemotherapy alone is effective.

“Unfortunately, given the life-long increased risks of late effects that have been documented from the use of radiation therapy, we simply cannot keep exposing patients to risk without clear benefit while we wait for safety data to be produced,” he wrote.

The study did not included precise data on the administration radiation dose the patients received, a limitation that Dr. Longo noted in his editorial.

“It is hoped that lower doses of radiation therapy will reduce the risk of late fatal toxicities from radiation therapy, but long-term follow-up data documenting that hope do not yet exist,” he wrote. “So it seems that the political pressure to keep using radiation therapy has allowed hope to triumph over experience in our exercise of clinical judgment.”

Dr. De Bruin said the analysis was the first long-term cohort study to assess the incidence of clinically verified stroke and TIA in Hodgkin lymphoma survivors.

The patients in the study were diagnosed between 1965 and 1995, before the age of 50, and survived at least 5 years after treatment. Among the patients who developed cerebrovascular disease, 55 suffered strokes, 31 TIAs and 10 suffered both.

Most ischemic events were from larger artery atherosclerosis (36%) or cardioembolisms (24%).

While the median time to first stroke was 17.4 years, the risks remained elevated later into the patients’ lives. The cumulative incidence of ischemic stroke or TIA 30 years after Hodgkin lymphoma treatment was 7% (95% CI 5% to 8%).

Radiation treatment to the neck and mediastinum was the most important risk factor for ischemic cerebrovascular disease (HR 2.5, 95% CI 1.1 to 5.6 versus without radiotherapy).

Hypertension, diabetes, and high blood cholesterol were associated with ischemic cerebrovascular disease, but smoking, overweight, and treatment with chemotherapy were not, according to the study.

The study was supported by the Dutch Cancer Society, a nonprofit organization based on Amsterdam. Dr. DeBruin reported no financial disclosures regarding this research. Dr. Longo is an employee of the National Institute on Aging.

Primary source: Journal of the National Cancer Institute

Source reference:
De Bruin, et al “Increase risk of stroke and transient ischemic attack in 5-year survivors of Hodgkin lymphoma” J Natl Cancer Inst 2009; 101: 928-37.

A new study published by University of Leicester researchers has found “convincing evidence” that cannabis smoke damages DNA in ways that could potentially increase the risk of cancer development in humans.

Using a newly developed highly sensitive liquid chromatography-tandem mass spectrometry method, the University of Leicester scientists found clear indication that cannabis smoke damages DNA, under laboratory conditions.

They have now published the findings in the journal Chemical Research in Toxicology1.

The research was carried out by Rajinder Singh, Jatinderpal Sandhu, Balvinder Kaur, Tina Juren, William P. Steward, Dan Segerback and Peter B. Farmer from the Cancer Biomarkers and Prevention Group, Department of Cancer Studies and Molecular Medicine and Karolinska Institute, Sweden.

Raj Singh said: “Parts of the plant Cannabis sativa, also known as marijuana, ganja, and various street names, are commonly smoked as a recreational drug, although its use for such purposes is illegal in many countries.

“There have been many studies on the toxicity of tobacco smoke. It is known that tobacco smoke contains 4000 chemicals of which 60 are classed as carcinogens. Cannabis in contrast has not been so well studied. It is less combustible than tobacco and is often mixed with tobacco in use. Cannabis smoke contains 400 compounds including 60 cannabinoids. However, because of its lower combustibility it contains 50% more carcinogenic polycyclic aromatic hydrocarbons including naphthalene, benzanthracene, and benzopyrene, than tobacco smoke.”

Writing in the journal Chemical Research in Toxicology, the scientists describe the development of a mass spectrometry method that provides a clear indication that cannabis smoke damages DNA, under laboratory conditions.

The authors added: “It is well known that toxic substances in tobacco smoke can damage DNA and increase the risk of lung and other cancers. Scientists were unsure though whether cannabis smoke would have the same effect. Our research has focused on the toxicity of acetaldehyde, which is present in both tobacco and cannabis.”

The researchers add that the ability of cannabis smoke to damage DNA has significant human health implications especially as users tend to inhale more deeply than cigarette smokers, which increases respiratory burden. “The smoking of 3-4 cannabis cigarettes a day is associated with the same degree of damage to bronchial mucus membranes as 20 or more tobacco cigarettes a day,” the team adds.

“These results provide evidence for the DNA damaging potential of cannabis smoke,” the researchers conclude, “implying that the consumption of cannabis cigarettes may be detrimental to human health with the possibility to initiate cancer development.”

The study was funded by the European Union Network of Excellence ECNIS, the Medical Research Council and Cancer Research UK.

1. Rajinder Singh, Jatinderpal Sandhu, Balvinder Kaur, Tina Juren, William P. Steward, Dan Segerback and Peter B. Farmer (2009) Evaluation of the DNA Damaging Potential of Cannabis Cigarette Smoke by the Determination of Acetaldehyde Derived N2-Ethyl-2?-deoxyguanosine Adducts. Chemical Research in Toxicology, 22, 1181-1188.

Source
University of Leicester