Cancer Research UK has made some amendments to its research funding policies. A brief outline of policies affected is as follows:
Open Access and UKPMC: purpose and scope of the policy has been further defined;instructions on acknowledging Cancer Research UK funding has been refined;methods of ensuring availability of publications has been expanded and clarified;changes are effective from 1 March 2011.Applications from Post-retirement scientists: policy has been retired in conjunction with recent government legislation on default retirement age;retirement of this policy is effective 6 April 2011.Payment of Consultant Clinician Salaries This new policy has been written to clarify our current working practice and is relevant in any situation where Cancer Research UK pays part or all of the salary of a Consultant Clinician through a research grant.
See Terms and Conditions & Policies for further details of these changes.
In line with its five-year research strategy, Cancer Research UK is set to extend its drug discovery effort by investing up to £21 million over five years into two new small molecule drug discovery programmes as well as two programmes seeking novel antibody therapies.
Cancer Research UK has recently awarded £12 million to 10 exceptional researchers from across the country. The funding will help them develop their careers and generate exciting discoveries that will help more people beat cancer than ever before.
You can find out more about all the appointments on the latest funded awards web page.
The new investigators awards include three funding schemes:
We plan to make 10 more awards in 2012. You can now apply for this year's schemes. The deadline for preliminary applications is Thursday 28 July 2011.
If you have a strong track record of research, and your research relevant to understanding, preventing, diagnosing or treating cancer then these awards could help you to become a leader in your field. We are particularly keen to support new investigators in population research.
Only one per cent of women know that older women - those 80 or older - have the greatest risk of developing breast cancer according to new research (Br J General Practice 2007; 57: 404-406) published today.
Worryingly, the research also found that 56 per cent of women wrongly believed that age does not affect breast cancer risk.
The strongest risk factor for breast cancer - after gender - is age. The older the woman, the higher her risk. About one in 70 women will develop breast cancer between 40 and 50 years old but for women from 80 to 90 the figure is one in 25.
The study, funded by Cancer Research UK and the NHS Breast Screening Programme, surveyed 1,496 women who were asked "When is a woman most likely to get breast cancer?". Respondents were given a series of ten year age bands and 'age doesn't matter' from which to select their answer. Of those surveyed, 99 per cent answered incorrectly.
Cancer Research UK is participating in the International Cancer Genome Consortium (ICGC), helping to build the largest ever map of the genomic changes that drive 50 different tumour and/or subtypes types.
ICGC will produce vast amounts of genetic information, and this 'blueprint for cancer' will fuel the search for better, more personalised treatments for the millions of people worldwide who are diagnosed with the disease every year.
Cancer Research UK is leading on a project to map the faults in oesophageal cancer, and jointly leading on a prostate cancer project with the Ontario Institute of Cancer Research and Prostate Cancer Canada.
Understanding the genetic faults that drive these cancers will give clues for new, more targeted ways to treat patients and save more lives.
See Strategic initiatives for more information about Cancer Research UK's involvement in ICGC. Alternatively, read our Science Update Blog for the plain English version.
Cancer Research UK has awarded its prestigious 2012 Lifetime Achievement in Cancer Research Prize to David Lane.
The selection panel, comprising international cancer experts were unanimous in their decision to award the prize, in recognition of David Lane's outstanding contributions and achievements in cancer research.
The Lifetime Achievement in Cancer Research Prize is awarded by Cancer Research UK each year to honour the achievements of scientists and clinicians in the cancer research community. The prize recognises individuals who have produced exceptional research throughout their career, specifically contributing towards furthering the understanding of cancer.
David Lane will be presented with the award at the NCRI Conference on 4 November - he will also give a plenary lecture at the conference.
The Cancer Research UK Cambridge (CRI) and London Research (LRI) institutes are offering several competitive PhD studentships.
Applications are invited from talented and motivated recent graduates or final year undergraduates who hold or expect to gain a first/upper second class honours degree or equivalent.
The closing date for applications to the LRI's PhD programme is 19 November 2010 while the application deadline for the CRI's studentship is 30 November 2010.
See the Institutes' websites for eligibility criteria, available studentship projects and online application:
Cancer Research UK is committed to developing the next generation of leaders in cancer research. The New Investigator Awards are for outstanding scientists or clinicians who wish to establish or develop their independence.
We invite applications from those with interests in any area of basic, biomedical science (including biology, chemistry, physics and maths) and population research, as long as the work is relevant to cancer.
The Career Establishment Award offers core support for the best investigators who are newly appointed to a Higher Education Funding Council-supported post to develop a career in cancer research.
The Career Development Fellowship provides the opportunity for promising scientists with three to eight years of post-doctoral research experience to set up, for the first time, an independent research group.
The Senior Cancer Research Fellowship supports exceptional scientists with six to twelve years of post-PhD research experience to establish or develop a world-leading research group.
Preliminary application deadline: WEDNESDAY 17TH JULY 2013.
For any queries please contact Dr Matt Kaiser by email or phone (020 3469 5337).
Women who take hormone replacement therapy are more likely to be diagnosed with ovarian cancer and to die of the disease, according to a study published in the Lancet (doi.10.1016/S0140-6736(07)60534-0) today.
Results from the Million Women Study, which is the biggest study of its kind in the world, show that over five years there is one extra case of ovarian cancer in every 2,500 women who take HRT. And for every 3,300 women who take HRT, there will be one additional death from ovarian cancer.
The researchers, who are largely funded by Cancer Research UK, estimate that use of HRT since 1991 has resulted in an extra 1,300 cases and 1,000 deaths from ovarian cancer.
The study also suggests that a woman's risk of ovarian cancer returns to a normal level within a few years of stopping HRT.
In the last three years, Cancer Research UK has defined a compelling vision, ambitious goals and clear purpose statements. To complement this we have developed a Research Strategy which sets out how we intend to work towards achieving our 2020 goals over the next five years. The Research Strategy is directed at reducing mortality from cancer and will guide our decision-making and investment and funding plans over the years 2009-2014.
The Research Strategy was largely developed through the Science Plan, an extensive programme of work in which our Trustees, Scientific Executive Board and Research Strategy Unit reviewed the entire spectrum of our research portfolio. The Science Plan involved in-depth consultation over several years with the national and international research community, other funders, industry, government and our funding committees.
The Research Strategy has three themes:
Over the next five years, we believe that we can make the greatest impact on cancer by ensuring that research discoveries are translated into advances in prevention, detection and treatment for cancer. Our strategy will lead us into important new areas such as early detection, while building on current strengths in epidemiology, basic science, drug discovery and clinical research. We also aim to address key areas of unmet medical and research needs.
By developing an overarching strategy for our five Institutes, together with more strategic and coordinated research funding in universities and hospitals through our Cancer Research UK Centres, we will be in a position to take on tougher scientific challenges and to develop world class cancer researchers for the future.
It is through this Strategy that Cancer Research UK expects to make major strides towards achieving the 2020 Goals of the Charity.
Cancer is our greatest fear, a Cancer Research UK survey reveals today. Over a quarter of Brits say cancer is the thing they most fear, topping the list over Alzheimer's, heart attack and terrorism.
But the survey of 4,000 people also shows that the majority don't realise approximately how many cases of cancer could be prevented by lifestyle factors. While two thirds of people underestimated the proportion of cancers that can be prevented, only 1 in 5 correctly said that half of all cancers could be prevented by lifestyle changes.
The news comes on the day that Cancer Research UK launches its Cancer Awareness Roadshows - two mobile information units which will be touring the UK over the next 12 months to raise awareness of how we can reduce the risk of cancer and spot the signs of it at an early stage. The Roadshows are fronted by pop icon Ronan Keating and are a partnership with the Marie Keating Foundation.
By Salynn Boyles, Contributing Writer, MedPage Today Reviewed by F. Perry Wilson, MD, MSCE; Instructor of Medicine, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse PlannerNote that this double-blind randomized trial demonstrated that treatment with escitalopram prevented depression in patients undergoing treatment for head and neck cancer.Be aware that the study was not powered to detect differences in treatment or mortality-associated endpoints between the two groups.
Prophylactic escitalopram cut the incidence of depression in head and neck cancer patients by more than 50% and improved quality of life, a clinical trial showed.
Significantly fewer patients taking the antidepressant developed depression, when compared with those on placebo (10% vs 24.6%; stratified log-rank test, P=.04), according to a study in the June 20 issue of JAMA Otolaryngology Head and Neck Surgery.
"Depression is very common among patients with this disease, but it is not easy to predict who will become depressed at the beginning of treatment," University of Nebraska Medical Center professor of head and neck oncology William Lydiatt, MD, told MedPage Today. "That's why the prevention paradigm may offer considerable benefit at an acceptable risk."
As many as half of head and neck cancer patients develop clinical depression within months of their diagnosis and suicide rates are among the highest in patients with a medical illness, Lydiatt noted.
"The burden of treatment is extensive and frequently includes dysphagia, disfigurement, voice alterations, mucositis, need for tracheostomy and feeding tubes, fatigue and depression," the researchers wrote.
They chose the generic version of the popular SSRI Lexapro for the trial to give patients an affordable treatment option that's well tolerated in the elderly.
The randomized, double-blind trial included 148 newly diagnosed head and neck cancer patients entering treatment who did not yet have a diagnosis of depression. The patients were stratified by sex, site of disease, stage, and primary modality of treatment (surgery versus radiation).
Half were treated with escitalopram at a dosage of 10 mg/d for the first week (one tablet) followed by 20 mg/d (two tablets) until week 16, followed by an additional week of 10 mg/d. During the acute phase of the study, dosage was reduced to 10 mg/d when adverse events occurred. Patients not treated with the antidepressant received matching placebo pills.
Among the study's major findings: Patients undergoing radiation as their initial therapy were significantly more likely than those who had surgery to develop depression (hazard ratio, 3.6; 95% CI ,1.38-9.40; P=.009).A Cox progression hazards regression model comparing the two groups, after controlling for age, smoking status, and other variables, demonstrated an advantage for escitalopram (hazard ratio, 0.37; 95% CI, 0.14-0.96: P=.04).Patients who took escitalopram and who completed the study without developing depression rated their overall quality of life as significantly better than those in the placebo group for 3 consecutive months after ending treatment with the antidepressant (overall quality of life, good or outstanding at weeks 20, 24 and 28 - escitalopram group = 96%, 100%, 96%, respectively; placebo group = 77%, 86%, 85%).
Lydiatt said the finding that radiotherapy patients had a higher risk for depression than surgery patients is a big surprise with important potential clinical implications.
"The higher incidence of depression in the cohort receiving radiation suggests that radiation represents a greater and longer duration stress event than surgery," the researchers wrote. "Radiation may also generate greater inflammatory cytokines during treatment, which could contribute to the higher rate (of depression)."
Although overall treatment success and survival were not study endpoints, Lydiatt said he hopes to conduct further research with these outcomes in mind.
"I would not be surprised to see a survival advantage associated with this approach," he said. "Depression is associated with so many negative manifestations in these patients. Depressed patients don't comply with their treatments to the same degree as patients who aren't depressed and they don't take care of themselves as well. They often lose their spark to live.
This study was funded by a grant from the National Institute of Mental Health. Additional support was provided by a research fund grand from the Nebraska Medical Center and the University of Nebraska Medical Center.
Register TodayEarn Free CME Credits by reading the latest medical news in your specialty.Sign Up By Charles Bankhead, Staff Writer, MedPage Today Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San FranciscoObservation topped initial treatment for low-risk prostate cancer in terms of cost and effectiveness.Note that initial treatment came out ahead of observation only under circumstances when it reduced prostate cancer mortality by more than 50%.
Observation topped initial treatment for low-risk prostate cancer in terms of cost and effectiveness, according to a decision-analysis study.
Both active surveillance and watchful waiting proved more effective and less expensive than immediate treatment. In a comparison of the two observation strategies, watchful waiting added 2 months of quality-adjusted life expectancy and saved $11,000 to $15,000 versus active surveillance, depending on the patient's age.
Initial treatment came out ahead of observation only under circumstances when it reduced prostate cancer mortality by more than 50%, as reported online in Annals of Internal Medicine.
"Using our results, we estimated that if the number of newly diagnosed men with low-risk prostate cancer who selected observation with watchful waiting increased from 10% to 50%, it would result in a cost savings of more than $1 billion," Julia Hayes, MD, of Harvard and Dana-Farber Cancer Institute in Boston, and co-authors concluded. "If one half of the men who chose observation opted for watchful waiting and one half for active surveillance, it would save $500 million.
"As we better classify men as low risk by adding molecular and imaging techniques currently in development to standard clinical parameters, prospective studies should determine whether less surveillance than is typically done on active surveillance is safe for men who select observation for low-risk prostate cancer. These findings provide further support for watchful waiting and active surveillance as reasonable and underused options for men with low-risk prostate cancer."
Optimal management of low-risk prostate cancer remains controversial. In the era of PSA screening for prostate cancers, low-risk comprises 70% of newly diagnosed cases. The men have <6% likelihood of dying of prostate cancer within 15 years; yet, 90% of them undergo definitive treatment in the form of radical prostatectomy or radiation therapy.
Recent evidence suggests as many as 60% of men who have initial treatment for low-risk prostate cancer might not have required any therapy in their lifetimes, the authors noted in their introduction. Most of these men will have at least one long-term adverse effect of treatment.
Of the two options for observation, active surveillance involves close follow-up after diagnosis, typically with serial PSA testing, digital rectal exam, and prostate biopsies. Mature data for the strategy suggest that 30% of men eventually require treatment for prostate cancer, and 10-year prostate cancer-specific survival is 97.2% (J Clin Oncol 2010; 28: 126-131).
Watchful waiting refers to a strategy of observing patients without monitoring and providing palliative care when prostate cancer becomes symptomatic. Historically reserved for men with <10 years' life expectancy or major comorbidities -- and not expected to die of prostate cancer -- watchful waiting demonstrated similar overall and prostate cancer-specific mortality in a large randomized trial versus radical prostatectomy (N Engl J Med 2012; 367 :203-213).
Previous decision-analysis studies have suggested that active surveillance improves quality-adjusted life expectancy (QALE) versus initial treatment and that observation is less costly than initial treatment. Hayes and colleagues continued the evaluation by performing a cost-effectiveness analysis of active surveillance and watchful waiting versus initial treatment for men with clinically localized, low-risk prostate cancer.
Key assumptions of the analysis included a hazard ratio of 1.48 for prostate cancer-specific death for initial treatment versus watchful waiting and 1.85 for initial treatment versus active surveillance. Within each strategy, the authors developed probabilities for various scenarios, including biochemical recurrence, progression to metastatic disease, progression of Gleason score (active surveillance), elective treatment (active surveillance), and progression to treatment (watchful waiting).
The investigators based costs on 2012 U.S. dollars for initial treatment of prostate cancer, ongoing treatment of erectile dysfunction and urinary symptoms that existed before treatment, surveillance, treatment of short-term (<90 days) and long-term (=90 days) adverse events, and patient time.
The analysis produced an estimated lifetime risk of prostate cancer death of 4.8% with active surveillance, 6% with watchful waiting, and 8.9% for initial treatment. Life expectancy was about 81 years across all three strategies. Among 65-year-old men, 78% on active surveillance received treatment (median of 6.8 years after diagnosis) as compared with 34% on watchful waiting (median of 12.4 years after diagnosis).
Overall, both observation strategies proved to be more effective and less costly as compared with initial treatment. Watchful waiting afforded the most QALE at the lowest cost for 65-year-old men (9.02 years versus 8.85 for active surveillance, which cost an additional $15,374). Active surveillance cost $4,520 more than brachytherapy and $1,714 more than radical prostatectomy.
For 75-year-old men, watchful waiting added 2 months to QALE as compared with active surveillance (6.14 years versus 5.98 QALE) at a savings for $11,746.
Brachytherapy was the most effective and least expensive of all options for initial treatment. Intensity-modulated radiation therapy was the most expensive initial treatment strategy, and radical prostatectomy was associated with the poorest QALE.
Initial treatment became more effective than observation only when the hazard ratio for prostate cancer-specific death declined to 0.47 versus watchful waiting and 0.64 versus active surveillance.
The study adds to a growing volume of data suggesting that "we have to start selecting patients for treatment or some sort of observation," Art Rastinehad, DO, of North Shore-LIJ Health System in New Hyde Park, N.Y., told MedPage Today.
"It also raised the question of how do we select patients for treatment versus not," said Rastinehad, who was not involved in the study. "We have been using the same ways to screen patients -- PSA testing and a 12-core biopsy. In this day and age, this information is really inadequate to assess these patients' cancer volume.
"At our institution we're working on different ways to screen and treat patients with prostate cancer, especially using imaging modalities as a first step toward determining a patient's actual volume of disease."
The study was suppoprted by the National Cancer Institute and the Blue Shield of California Foundation.
Hayes disclosed a relationship with UpToDate. One or more co-authors disclosed relationships with Informed Medical Decisions Foundation and Blue Shield of California Foundation.
Charles Bankhead
Staff Writer
Working from Houston, home to one of the world's largest medical complexes, Charles Bankhead has more than 20 years of experience as a medical writer and editor. His career began as a science and medical writer at an academic medical center. He later spent almost a decade as a writer and editor for Medical World News, one of the leading medical trade magazines of its era. His byline has appeared in medical publications that have included Cardio, Cosmetic Surgery Times, Dermatology Times, Diagnostic Imaging, Family Practice, Journal of the National Cancer Institute, Medscape, Oncology News International, Oncology Times, Ophthalmology Times, Patient Care, Renal and Urology News, The Medical Post, Urology Times, and the International Medical News Group newspapers. He has a BA in journalism and MA in mass communications, both from Texas Tech University.
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By Charles Bankhead, Staff Writer, MedPage Today Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San FranciscoObservation topped initial treatment for low-risk prostate cancer in terms of cost and effectiveness.Note that initial treatment came out ahead of observation only under circumstances when it reduced prostate cancer mortality by more than 50%.