Cancer Doctors Don't Discuss Herbs, Supplements With Patients

Many physicians cite a lack of knowledge as a primary reason, survey finds

By Mary Elizabeth Dallas

HealthDay Reporter

MONDAY, Jan. 5, 2015 (HealthDay News) -- Despite concerns about potentially dangerous interactions between cancer treatments and herbs and other supplements, most cancer doctors don't talk to their patients about these products, new research found.

Fewer than half of cancer doctors -- oncologists -- bring up the subject of herbs or supplements with their patients, the researchers found. Many doctors cited their own lack of information as a major reason why they skip that conversation.

"Lack of knowledge about herbs and supplements, and awareness of that lack of knowledge is probably one of the reasons why oncologists don't initiate the discussion," said the study's author, Dr. Richard Lee, medical director of the Integrative Medicine Program at the University of Texas MD Anderson Cancer Center in Houston.

"It's really about getting more research out there and more education so oncologists can feel comfortable having these conversations," Lee said.

The study was published recently in the Journal of Clinical Oncology.

People with cancer often turn to herbs and other dietary supplements in an attempt to improve their health and cope with their symptoms, according to background information in the study.

Although herbs and supplements are often viewed as "natural," they contain active ingredients that might cause harmful interactions with standard cancer treatments. Some supplements can cause skin reactions when taken by patients receiving radiation treatment, according to the American Cancer Society (ACS). Herbs and supplements can also affect how chemotherapy drugs are absorbed and metabolized by the body, according to the ACS.

St. John's wort, Panax ginseng and green tea supplements are among those that can produce potentially dangerous interactions with chemotherapy, according to the study.

For the current survey, the researchers asked almost 400 oncologists about their views and knowledge of supplements. The average age of those who responded was 48 years. About three-quarters of them were men, and about three-quarters were white, the study noted.

The specialists polled talked about supplements with 41 percent of their patients. However, doctors initiated only 26 percent of these discussions, the researchers found.

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Rotating Night Shift Work May Raise Risks of Heart Disease, Lung Cancer: Study

Research can't prove cause-and-effect, but does suggest a link

By Robert Preidt

HealthDay Reporter

MONDAY, Jan. 5, 2015 (HealthDay News) -- Working rotating night shifts may pose a threat to your health, a new study suggests.

The study defined rotating shift work as at least three nights spent working each month, in addition to days and evenings worked in the month.

In the new study, researchers led by Dr. Eva Schernhammer of Harvard Medical School tracked 22 years of data from about 75,000 nurses across the United States.

While the study couldn't prove cause-and-effect, it found that people who worked rotating night shifts for more than five years had an 11 percent increased risk of death from all causes.

The risk of death from heart disease was 19 percent higher among those who worked such shifts for six to 14 years, and 23 percent higher for those who worked such shifts for 15 or more years, Schernhammer's group found.

Nurses who worked rotating night shifts for 15 or more years also had a 25 percent higher risk of death from lung cancer, according to the study.

The findings are to be published in the March issue of the American Journal of Preventive Medicine.

According to the study authors, prior research has shown that night shift work is linked with an increased risk of cardiovascular disease and cancer.

"These results add to prior evidence of a potentially detrimental relation of rotating night shift work and health and longevity," Schernhammer, an associate professor of medicine at Harvard and associate epidemiologist at Brigham and Women's Hospital in Boston, said in a journal news release.

Further research is needed to learn how individual traits might interact with rotating night shift work to harm health, she added.

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Random Mutations Responsible for About Two-Thirds of Cancer Risk: Study

Cancer often linked to 'bad luck,' Hopkins researchers say

By Mary Elizabeth Dallas

HealthDay Reporter

THURSDAY, Jan. 1, 2015 (HealthDay News) -- Although about one-third of cancers can be linked to environmental factors or inherited genes, new research suggests the remaining two-thirds may be caused by random mutations.

These mutations take place when stem cells divide, according to the study by researchers at Johns Hopkins Kimmel Cancer Center. Stem cells regenerate and replace cells that die off. If stem cells make random mistakes and mutate during this cell division, cancer can develop. The more of these mistakes that happen, the greater a person's risk that cells will grow out of control and develop into cancer, the study authors explained in a Hopkins news release.

Although unhealthy lifestyle choices, such as smoking, are a contributing factor, the researchers concluded that the "bad luck" of random mutations plays a key role in the development of many forms of cancer.

"All cancers are caused by a combination of bad luck, the environment and heredity, and we've created a model that may help quantify how much of these three factors contribute to cancer development," said Dr. Bert Vogelstein, professor of oncology at the Johns Hopkins University School of Medicine.

"Cancer-free longevity in people exposed to cancer-causing agents, such as tobacco, is often attributed to their 'good genes,' but the truth is that most of them simply had good luck," added Vogelstein, who is also co-director of the Ludwig Center at Johns Hopkins and an investigator at the Howard Hughes Medical Institute.

The researchers said their findings might not only change the way people perceive their risk for cancer, but also funding for cancer research.

Cristian Tomasetti is a biomathematician and assistant professor of oncology at the Johns Hopkins University School of Medicine and Bloomberg School of Public Health. "If two-thirds of cancer incidence across tissues is explained by random DNA mutations that occur when stem cells divide, then changing our lifestyle and habits will be a huge help in preventing certain cancers, but this may not be as effective for a variety of others," Tomasetti said in the news release.

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Herceptin May Benefit Some Women With Early Breast Cancer

Drug-chemo combo yields low rate of recurrence after three years, study says

By Amy Norton

HealthDay Reporter

WEDNESDAY, Jan. 7, 2015 (HealthDay News) -- For some women with early breast tumors, lower-dose chemotherapy and the drug Herceptin may help ward off a cancer recurrence, a new study suggests.

Experts said the findings, published in the Jan. 8 New England Journal of Medicine, could offer the first standard treatment approach for women in the early stages of HER2-positive breast cancer.

HER2 is a protein that helps breast cancer cells grow and spread, and about 15 to 20 percent of breast cancers are HER2-positive, according to the U.S. National Cancer Institute.

Herceptin (trastuzumab) -- one of the newer, so-called "targeted" cancer drugs -- inhibits HER2. But while Herceptin is a standard treatment for later-stage cancer, it wasn't clear whether it helps women with small, stage 1 breast tumors that have not spread to the lymph nodes.

Women with those cancers have a relatively low risk of recurrence after surgery and radiation -- but it's high enough that doctors often offer chemotherapy and Herceptin as an "adjuvant," or additional, therapy, explained Dr. Sara Tolaney, of the Dana-Farber Cancer Institute in Boston.

The challenge, Tolaney said, is balancing the potential benefits against the side effects. So for the new study, her team tested a low-intensity chemo regimen -- 12 weeks of a single drug, called paclitaxel -- plus Herceptin for one year.

The researchers found that women who received the drugs were highly unlikely to see their breast cancer come back over the next three years. Of the 406 study patients, less than 2 percent had a recurrence.

There was no control group that did not receive chemo and Herceptin for comparison. But the results are "better than expected," said Dr. Charles Shapiro, co-director of the Dubin Breast Center at Mount Sinai Hospital in New York City.

Shapiro, who was not involved in the study, said it's still not clear what the benefits could be in the longer term.

"Three years of follow-up is short," he said. "Time will tell if there are late recurrences."

In other studies of women with small breast tumors (up to 1 inch across), recurrence rates over five years have ranged widely -- from 5 to 30 percent, Tolaney said.

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