Sunday, 16 December, 2018

Uterine cancer on the rise, especially for black women

Body fat and breast cancer Uterine Cancer Is On The Rise, And Black Women Are Getting More Diagnosed With It
Celia Hoffman | 08 December, 2018, 21:56

Even with equivalent treatments in women with hormone receptor-positive, HER2-negative breast cancer, black women had significantly higher breast cancer recurrence and increased overall mortality compared to white women in a large phase III clinical trial, TAILORx, according to data presented at the 2018 San Antonio Breast Cancer Symposium, held December 4-8, News Medical says. "A major emphasis in these trials is refining treatments to provide more options for patients, such as shorter courses of radiation therapy", added Reshma Jagsi, MD, DPhil, FASTRO, Professor and Deputy Chair of the Department of Radiation Oncology at the University of MI.

Statistically, nine out of 100,000 black women die from uterine cancer as compared to four or five out of 100,000 women in other ethnic groups.

Black women were determined to be at the most risk of dying from uterine cancer. The disease claims the lives of about 40,000 people each year.

As a leading institution funded by the National Cancer Institute, Mayo Clinic Cancer Center conducts basic, clinical and population science research, translating discoveries into improved methods for prevention, diagnosis, prognosis and therapy. Findings released from the TAILORx study in June 2018 showed no benefit from chemotherapy for 70 percent of the women in the trial. They also observed no difference in use and type of adjuvant chemotherapy and endocrine therapy or in the duration of endocrine therapy. "Hot flashes not only impact a patient's quality of life, they are associated with patients prematurely discontinuing breast cancer treatment, which may increase the risk of breast cancer recurrence and mortality", says Dr. Leon-Ferre. Ethnically, 79 percent were non-Hispanic, 9 percent were Hispanic and 12 percent were of unknown ethnicity.

The association was even stronger for risk of estrogen receptor (ER)-positive breast cancer in women with the highest levels of whole-body fat (HR 2.21, 95% CI 1.23-3.67, P=0.002), percentage of whole-body fat (HR 2.17, 95% CI 1.29-3.66, P=0.01), and trunk fat mass (HR 1.98, 95% CI 1.18-3.31, P=0.003), the study found.

These marked outcome disparities were not explained by reported adherence to therapy, or by factors such as age or tumor size or aggression level, Albain said. "It's not any sort of racial bias, it's just a fact".

"Patients will tell me all the time they're taking their pills, and they're not taking their pills", Albain said. There were three arms in the trial with patients in two arms receiving different dosages of oxybutynin and patients in the third arm receiving a placebo.

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The researchers, from the Weill Cornell Medical College, set out to investigate the association between body fat and breast cancer risk in women with healthy BMI.

"We know that young people and African-Americans are less adherent with hormonal therapy - that's been shown over and over again", she said.

Black women, along with white women, were more likely to develop uterine cancer, too.

"There are many risk factors for developing uterine cancer", said Dr. Joseph Davis, an OB-GYN and medical director of the Cayman Fertility Center in the Caribbean who was not involved in the report.

"We have to chip away at it all, increase our understanding of disease differences and not lump [factors together] as much as we do", Partridge said.

This year's San Antonio Breast Cancer Symposium (SABCS) features a record number of radiation oncology trials among its oral presentations. Research presented at scientific conferences typically hasn't been peer-reviewed or published, and results are considered preliminary.

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