Thursday 30th June 2016- The Guardian: Couple win legal battle against ruling on dead daughter’s eggs

‘A 60-year-old woman who wants to use her dead daughter’s frozen eggs to give birth to a grandchild has won a legal battle over what constitutes medical consent.

The court of appeal has ordered the Human Fertilisation and Embryology Authority (HFEA) to reconsider the application, opening the way for fertility treatment in the United States.

The woman, whose daughter died of bowel cancer in 2011, had asked three judges to allow her to carry out the dying wishes of her “much-loved and only child”. The family have remained anonymous; the court identified the mother as Mrs M.

Her daughter, who was 28 when she died, spent most of the last five years of her life in hospital. She wanted to have IVF treatment but became too ill. At one stage, she suggested having her ovaries transplanted into her mother. Three eggs were eventually removed and stored.

The legal problem the HFEA confronted, the judgment explained, “was that while [the daughter] consented to treatment for egg removal and storage (including storage after her death) and also to the use (other than for research purposes) of her eggs after her death, she never completed any form giving details of the precise use that is now proposed”.

Lawyers for the mother and her husband, referred to only as Mr M, said that if they did not overturn the refusal for treatment, the eggs would be allowed to perish.

Giving judgment, Sir James Munby, who is president of the family division of the high court, Lady Justice Arden and Lord Justice Burnett granted the parents’ appeal. Neither Mr or Mrs M were in court for the ruling.’

‘The judges heard that the daughter, referred to only as A, was desperate to have children and asked her mother to “carry my babies”. Her parents launched legal action against the HFEA’s refusal in September 2014 to allow them to take their daughter’s eggs to a US fertility treatment clinic to be used with donor sperm.’

‘The court’s role, however, was not to decide whether it would have permitted the mother to undergo fertility treatment using her deceased daughter’s eggs and donated sperm.

Its task was to determine whether Mr Justice Ouseley erred in concluding that the HFEA’s statutory approvals committee acted lawfully and rationally in exercising its broad discretion to refuse to authorise export of the frozen eggs.

Giving the court’s ruling, Lady Justice Arden said the challenge succeeded at three levels: “First, there was on the face of it the misstatement of certain of the evidence about [the daughter’s] consent by the [HFEA] committee.

“Second, even if what the committee meant was that there was a lack of effective consent because the appellants could not show that [the daughter] received information on certain matters, the decision was flawed because the committee pointed to the lack of certain evidence without explaining why [she] needed to receive that information and give that consent.

“The third level is that the committee did not ask the prior question of what information the Human Fertilisation and Embryology Act required to be given to [the daughter] in the circumstances of her case.”

The judge said the decision must be set aside and remitted to the statutory approvals committee of the HFEA for further consideration of the export application.’

Related Articles:

Couple win legal battle against ruling on dead daughter’s eggs- The Guardian

Woman wins appeal to use dead daughter’s eggs- BBC News

 

Thursday 25th February 2016- The Independent: Pancreatic cancer is four different diseases, study finds

‘A new study which has shown that pancreatic cancer is four separate diseases has been hailed as “incredibly exciting.”

The team at the University of Glasgow said the study was as a “launch pad” for finding new treatments for the disease.

Around 8,000 people in the UK are diagnosed with the cancer which affects the large gland in the digestive system each year. It is particularly difficult to diagnose as it does not show symptoms in the early stages.

The way in which pancreatic cancer is treated has not developed greatly for two decades, said Dr Peter Bailey, one of the study authors, and compared current methods to “hitting the disease with a mallet with your eyes closed.”

Around a fifth of those with the disease survive more than a year after being diagnosed, while less than 5 per cent living after five years, and 1 per cent after a decade.

The team at the University of Glasgow studied around 456 pancreatic cancer tumours for the research published in the journal ‘Nature’.

Scientists were able to categorise the disease into four different sub-types: squamous, pancreatic progenitor, immunogenic and ADEX.

Professor Sean Grimmond, who led the study, said: “This study demonstrates that pancreatic cancer is better considered as four separate diseases, with different survival rates, treatments and underlying genetics.”

“Knowing which sub-type a patient has would allow a doctor to provide a more accurate prognosis and treatment recommendations.

He explained that cancer drugs that doctors use or are in development can target the disease which are similar to other forms of cancer.

For example, some types of pancreatic cancer are associated with mutations normally found in colon cancer or leukaemia, he said.

Pancreatic Cancer UK described the findings as “incredibly exciting”.

Leanne Reynolds, head of research at the charity, said the findings meant that in the future “the right patients can be given the right treatment at the right time”.’

Related Articles:

Pancreatic cancer is four different diseases, study finds

Major insight into killer pancreatic cancer- BBC News

Scientists discover pancreatic cancer is four separate diseases- The Guardian

Wednesday 24th February 2016- The Guardian: Radical cancer treatment seeks to control rather than destroy tumours

‘A radical approach to cancer treatment which keeps tumours under control rather than destroying them completely may be more effective than conventional therapies, scientists say.

The idea draws on Charles Darwin’s 150-year-old theory of evolution and recasts tumours as diverse ecosystems of cells which can be manipulated to prevent them from growing out of control.

The strategy is highly experimental and has only been tested in mice, but successful trials in humans could usher in a transformation in cancer care, where patients live healthy lives with tumours that are constantly kept in check by low doses of medicine.

Routine cancer treatment assumes that patients do best when a therapy kills off the maximum number of malignant cells in their bodies. But tumours are collections of different cells and some are more resistant to drugs than others. A dose of chemotherapy will typically leave drug-resistant cells behind. Unencumbered by their neighbours, they can rapidly grow back when the treatment stops.

Scientists in the US wondered what would happen if anticancer drugs were used to shrink tumours without destroying the diversity of cells inside them. They hoped that the surviving cancer cells would stop more aggressive, drug-resistant ones from taking over, just as grass can prevent moss running wild in a garden.

Writing in the journal Science Translational Medicine, Robert Gatenby at the H. Lee Moffitt Cancer Center in Tampa, Florida, describes how his team tested the idea with the chemotherapy drug paclitaxel (or taxol) in mice with two different forms of breast cancer.

When the mice were given standard chemotherapy, their tumours shrank, but grew back as soon as the treatment ended. For the new therapy, mice were given initially high doses of drugs followed by ever lower doses. The strategy appeared to be more effective than standard treatment. Giannoula Klement, a cancer specialist at Tufts University School of Medicine in Boston, who was not involved in the work, said that in about 60% of the mice, the cancer treatment could be withdrawn completely with no further growth of the tumours.

In an accompanying article, Klement argues that to beat cancer, it must be considered as an ecosystem of different cells. “The likelihood that a ‘magic bullet’ against cancer is going to be found is nil. If we have learned anything from the eco-evolutionary model it is that unless we respect these eco-evolutionary laws, we will continue to play a cat and mouse game with cancer,” she writes.

Instead of eradicating cancer, the new goal for doctors needs to be prevention of cancer disease, she adds. “We need to stabilise tumour growth and enable gradual, controlled regression over time.”’

Related Articles:

Radical cancer treatment seeks to control rather than destroy tumours

Don’t kill cancer, learn to live with it, say scientists- The Telegraph

Thursday 4th February 2016- The Independent: World Cancer Day: Deaths caused by disease fall but number of cases rise

‘Cancer death rates in the UK have fallen by almost 10 per cent in the last decade, although the number of cases is still going up, new figures show.

Analysis by Cancer Research UK found that 284 out of every 100,000 people in the UK died from cancer in 2013 (around 162,000 people), down from 312 in every 100,000 a decade ago.

The slump is largely due to improvements in the detection, diagnosis and treatment of cancer.

A breakdown of the sexes shows men’s death rates have fallen by 12 per cent over the period, while the drop among women is 8 per cent.

This equates to around 85,000 men and 77,000 women dying from cancer each year in the UK.’

‘Cancers of the lung, bowel, breast and prostate account for almost half of all cancer deaths in the UK. These four cancers saw an 11 per cent drop in death rates for the period studied.

But some cancers – such as liver and pancreatic – have seen a rise in the rates of people dying, by 60 per cent over the last 10 years for liver cancer and by 8 per cent for pancreatic cancer.

Experts have predicted that, mostly due to the fact people are living longer, one in two people in the UK will be diagnosed with cancer at some point in their lives.

However, some cases could be prevented, with at least a third of cancer cases each year in the UK linked to unhealthy lifestyles, obesity, smoking and diet.’

‘Figures from Cancer Research UK also show the total number of cancer cases is still going up.

Almost 346,000 people were diagnosed with cancer in the UK in 2012, up from 282,000 in 2002 and 249,000 in 1992.

Around 162,000 people died from cancer in the UK in 2012, up from just over 155,000 in 2002, but a very similar figure to 1992.

Around 80 per cent of cancer deaths occur in people aged 65 and over, and more than half occur in those aged 75 and older.’

Related Articles:

World Cancer Day: Deaths caused by disease fall but number of cases rise

Cancer death rates down by 10% in 10 years- BBC News

UK cancer death rates after diagnosis drop 10% in ten years- The Guardian

 

Saturday 23rd January 2016- The Telegraph: New ‘sat nav’ operating technique could double chance of survival from brain cancer

‘A new ‘sat nav’ operating technique for surgeons could double the chance of survival of brain cancer patients by removing tumours which were thought to be inoperable.

Sheffield Children’s Hospital has launched new surgical suite which includes an MRI scanner which can precisely monitor the brain during an operation.

It allows surgeons to work out whether they have managed to remove all of a brain tumour while still in theatre.’

‘”The MRI images mean that we can be sure the tumour has been completely removed and nothing has been left behind before we finish the operation.”

Dr Hesham Zaki, Sheffield Children’s Hospital’

‘They can also work out precisely where a tumour is, thereby ensuring surrounding healthy tissue is not damaged.

Around 10,000 people are diagnosed with brain cancer each year and half will die. If a tumour is completely removed the chance of survival is up to 80 per cent. But if cancerous cells are left behind that falls to just 40 per cent.

Surgeons have already used the suite to carry out operations on two children and they hope to soon offer adults the benefit.’

‘Hesham Zaki, head of the department of paediatric neurosurgery, said the equipment puts the Sheffield hospital at the forefront of increasing survival rates from brain tumours in the UK and worldwide.

He said: “The fact we can use the MRI scanner during the surgery is a real step-change. “Just like a sat nav, it tells me where I need to go.

“We scan the patient that we are operating on with their skull still open and the operation still ongoing.

“The MRI images mean that we can be sure the tumour has been completely removed and nothing has been left behind before we finish the operation.

“This is important because some types of brain tumour can look like normal brain. This is a sea-change. Tumours that were inoperable can now be operated on.”‘

See:

New ‘sat nav’ operating technique could double chance of survival from brain cancer

Thursday 21st January 2016- BBC News: Sisters help launch cancer study aiming to end chemotherapy

‘The first patients have had their DNA analysed in a massive study that aims to help replace chemotherapy.

They include three sisters who developed breast tumours within 15 months of each other.

The 100,000 Genomes Project in England will look at their DNA, and that of thousands of other patients, to help the search for precision treatments and understand how tumours develop.

Cancer Research UK said the project was “very exciting”.

In November 2013, Mary Lloyd was diagnosed with breast cancer, as was her younger sister Kerry two months later. In February the following year their sister Sandra was diagnosed too.

Mary, 61 and from Northampton, told the BBC News website: “It was really unbelievable.

“I had just retired and made plans, then to find out Kerry also had breast cancer – she’s got two children still at school – it was just awful.

“Sandra had almost prepared herself [for her diagnosis] and she was devastated as well.

“But because we’re sisters together we’ve been able to support one another. That’s really important as the treatment is horrendous.”‘

‘The sisters are taking part in the 100,000 Genomes Project, run within the NHS, which is trying to understand the mutations that cause or increase the risk of cancer.

It will also determine the drugs that can target tumours. Herceptin works only in patients with specific mutations.

“It’s classed as the beginning of the end of chemotherapy,” said Dr Julian Barwell, a consultant in clinical genetics at the the University Hospitals of Leicester NHS Trust.

He told the BBC: “This is the first step for the NHS into genomic medicine. If successful it will give individual tumour profiles and identify which drugs are likely to benefit you. It’s hugely exciting.”‘

See:

Sisters help launch cancer study aiming to end chemotherapy

Thursday 14th January 2016- The Telegraph: Scientists hope tissue bank will hold key to combat pancreatic cancer

‘Scientists hope that a newly established tissue bank will hold the key to properly understanding pancreatic cancer.

The cancer has the worst ten-year survival rate of any cancer, with most patients being told they may have less than 12 months to live.’

‘Researchers will accumulate samples from six hospitals in England and Wales which it is hoped will lead to better treatments and earlier diagnosis.

There are 8,875 new cases of pancreatic cancer a year in the UK, with almost the same number of people dying from it annually.

Only one in 100 sufferers survive ten years after their diagnosis, a survival rate that has remained stubbornly unchanged for 40 years.

A little-known charity,the Pancreatic Cancer Research Fund (PCRF), raised £2m to fund the bank with little fanfare.

But the bank will store actual tumour samples – as well as blood, saliva and urine in which proteins indicating cancer can be found – from about 1,000 patients a year, which the fund hopes will in time reverse the tide of deaths from pancreatic cancer.

Prof Hemant Kocher, from Barts Cancer Institute, told the BBC: “Surgery is possible in only about 10-15% of patients with pancreas cancer at the moment.’

Related Articles:

Scientists hope tissue bank will hold key to combat pancreatic cancer

‘New research hope’ from pancreatic cancer tissue bank- BBC News

Wednesday 18th November 2015- The Independent: Breast cancer drug too expensive to be routinely available on NHS, watchdog rules

‘A pioneering breast cancer treatment will not be routinely available on the NHS because its price is “too high”, a watchdog has ruled.

The National Institute for Health and Care Excellence published final draft guidance saying Kadcyla – which can give women dying from an aggressive form of breast cancer extra months of life – was not set at an affordable price.

The manufacturer Roche offered a discount, but it was not enough to sway Nice to recommend the drug across England.

The drug will still be available in England through the Cancer Drugs Fund for some patients.

In Scotland, the organisation that decides which medicines should be routinely available on the NHS chose not to approve the drug last year.

Nice said Roche had agreed a “significant” discount with NHS England to stop the drug being removed from the CDF, but a smaller discount had been offered to Nice for the drug’s more widespread use.

This means women will need to ask their oncologist to apply to the CDF for funding for Kadcyla.

It is licensed for HER2-positive breast cancer and has been shown to extend life by almost six months on average in women who have tried other treatments, although some patients live much longer. ‘

Related Articles:

Breast cancer drug too expensive to be routinely available on NHS, watchdog rules

Breast cancer drug Kadcyla ‘too expensive’ for NHS- BBC News

Wednesday 18th November 2015- The Telegraph: Blood test detects ovarian cancer in nine out of 10 patients

‘A screening test with a 90 per cent accuracy rate for detecting potentially fatal ovarian cancer early is a major step closer.

Studying blood serum compounds led scientists to a set of biomarkers that may enable development of a highly accurate screening test for early-stage ovarian cancer. Early diagnosis is vital for treatment of ovarian cancer.

Researchers, using liquid chromatography and mass spectrometry techniques coupled with machine learning computer algorithms, have identified 16 metabolite compounds that provided unprecedented accuracy in distinguishing 46 women with early-stage ovarian cancer from a control group of 49 women who did not have the disease.

Blood samples for the study were collected from Canada and the United States, but the researchers – whose findings were published in the journal Scientific Reports – say more extensive testing across a larger population will be needed to determine if the high diagnostic accuracy will be maintained across a larger group of women.’

See:

Blood test detects ovarian cancer in nine out of 10 patients

Friday 13th November 2015- The Guardian: AstraZeneca lung cancer drug given green light in US

‘FDA approval of Tagrisso offers major boost for British company, seeking to release six new cancer medicines by 2020’.

‘A new lung cancer pill from AstraZeneca has been approved by US regulators, in a major boost for the British drugmaker.

AZD9291, which will be sold as Tagrisso, is for advanced non-small-cell lung cancer, the most common form of lung cancer. Tagrisso targets a genetic mutation, known as T790M, that helps tumours evade current lung cancer pills. The drug will be made available to patients in the US as soon as possible and its price will be “comparable to other oral cancer therapies,” a spokeswoman said. AstraZeneca will reveal the price early next week.

Lung cancer is the leading cause of cancer death among men and women, accounting for a third of cancer deaths, more than breast, prostate and colorectal cancers combined.

The treatment, developed in Cheshire, is  ione of several highlighted by AstraZeneca chief executive Pascal Soriot in his defence against a £69bn takeover approach from American rival Pfizer, the maker of Viagra, last year. AstraZeneca estimates that Tagrisso could bring in sales of $3bn (£2bn) a year but analysts are more cautious, forecasting sales of $1.1bn in 2020. The company needs new blockbuster medicines to make up for sales losses on older drugs that are losing patent protection.

The once-daily Tagrisso tablet had a “significant effect on reducing tumour size in over half of patients who were treated,” said Richard Pazdur of the FDA’s centre for drug evaluation and research.’

See:

AstraZeneca lung cancer drug given green light in US