Secondary breast cancer treatment and managing fear - Highlights from the NCRI conference 2019

We're looking at key research themes covered at the annual National Cancer Research Institute’s (NCRI) Cancer Conference, and what they could mean for people affected by breast cancer.

We're looking at key research themes covered at the annual National Cancer Research Institute’s (NCRI) Cancer Conference, and what they could mean for people affected by breast cancer.

The NCRI’s Cancer Conference is attended by researchers, clinicians, people affected by cancer and industry representatives; the conference’s aim is to discuss recent progress in cancer research and find ways we can move forward with cancer treatment. We attended to establish what their findings could mean for people affected by breast cancer - both now and in the future.

Treatment for secondary breast cancer

Breast tumours can be very diverse, especially secondary breast cancer tumours. Some common features of breast cancer tumours can already be targeted with treatments, but many other rarer features also exist that could potentially be targeted too. In his conference session, Professor Nick Turner, a scientist at the Breast Cancer Now Toby Robins Research Centre at The Institute of Cancer Research, London, spoke about new ways to treat these diverse tumours.

Liquid biopsies are a new method being tested in trials tested to detect signs of cancer in the blood. For example, using a blood test, researchers can look for cancer DNA. Analysing this DNA holds lots of clues about what sort of treatment a cancer might respond to. Nick is developing this test further to study breast cancer DNA in the blood and make sure people with secondary breast cancer can get the most appropriate treatment based on what their tumours look like.

Nick is also trying to identify people most at risk of breast cancer returning following a diagnosis of primary breast cancer. He explained that in a recent trial of 80 people who were treated for primary breast cancer, 41 participants had cancer DNA in their blood after finishing treatment. These individuals were six times more likely to see their breast cancer return.

If we can identify people at higher risk of their breast cancer returning, then treatments could be started earlier and hopefully improve outcomes.

The link between obesity and cancer

For a long time, scientists have been trying to uncover the link between obesity and cancer. We know that tumours are often more resistant to chemotherapy treatment in people who are obese, and there’s a higher chance of their cancer spreading. However, we still don’t fully understand why. Professor Stephen Hursting, from the Department of Nutrition at the University of North Carolina, spoke about his research into this topic.

Currently, researchers think there are 15 types of cancer that can be linked to obesity. This is because obesity is linked to an increase in molecules which can help cancer cells grow.

A lot of research has investigated how obesity affects the immune system. Researchers think obesity may stop immune cells (called T cells) that fight disease from reaching tumours. Stephen described an ‘exclusion zone’ that exists around tumours in obese individuals and prevents immune cells from accessing and destroying these tumours.

A key focus of Stephen’s work is investigating whether obesity causes tumours to become more resistant to chemotherapy. He’s looking at whether it might be possible to deliver chemotherapy in a different way to avoid these tumours developing resistance.

In addition to this, Stephen thinks that certain diets may be able to alter the growth of cancer cells by changing the way these cells make energy. These diets could be prescribed to obese patients to lower the risks described.

Research is continuing in this area to understand how lifestyle factors affect cancer development. It will hopefully help us to learn more about how we can prevent cancer progressing through improved treatment.

Managing fear in cancer

An important discussion at the conference focused on people living with incurable cancer and how we can better support them. Currently in the UK, it’s estimated that between 136,000 and 250,000 people are living with a secondary cancer diagnosis, where the cancer can be treated but not cured.

Professor Phyllis Butow, a leading health psychologist at the University of Sydney, is studying what causes fear of cancer returning or getting worse. She has developed tools aimed at relieving such fears to help people living with or beyond a cancer diagnosis maintain a good quality of life for as long as possible.

People living with cancer may have many worries that can cause feelings of stress and anxiety that, at times, could feel overwhelming. However, Phyllis explained that there is strong evidence that certain techniques can greatly help.

She recently led a trial called ConquerFear to help people manage their fears. One of the theories tested in the trial is called meta-cognitive theory which helps people accept that worries exist but not to engage with them, focusing on other things instead.

To explain how meta-cognitive theory works, Phyllis gave an example of green elephants. If someone tells you not to think about green elephants, the likelihood is that all you can think about are green elephants. However, if you’re asked to write down 10 things you can see and hear, suddenly your focus shifts and the green elephants are forgotten. She explained that it’s better to engage with other thoughts, rather than trying to suppress negative thoughts altogether.

Currently, not everyone who wishes to can access the recommended tools to help relieve their fears and improve their emotional health. Phyllis emphasised that we need to continue to explore ways to prevent, minimise and treat fears for people living with or recovering from cancer.

 

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