Wednesday, September 25, 2013

The test that could spare HALF of breast cancer patients from chemotherapy - by judging how far the tumour may spread

  • Nice has approved the Oncotype DX test for use on the NHS
  • It examines genes taken from the tumour to establish if it will spread
  • It could prevent thousands of women being over treated
  • Doctors will use the test with other information, such as the size and grade of the tumour, to work out if chemotherapy could be beneficial




  • Thousands of women with breast cancer could be spared chemotherapy every year thanks to a test which has been approved for use on the NHS.
    The genetic test could benefit those with early-stage breast cancer facing the intensive treatment, which has side effects include nausea, vomiting, insomnia, hair loss and fatigue.
    Studies have suggested that half of women with the most common form of early breast cancer could be spared chemotherapy if they have the test.
    Thousands of women with breast cancer could be spared chemotherapy every year thanks to a test which has been approved for use on the NHS
    Thousands of women with breast cancer could be spared chemotherapy every year thanks to a test which has been approved for use on the NHS

    The Oncotype DX test involves the examination of genes taken from a sample of a tumour removed during surgery.
    It can help doctors decide whether chemotherapy would actually benefit patients and the risk of cancer returning.
    Almost 50,000 people are diagnosed with breast cancer every year in the UK and most of these have early-stage disease.
     

    Doctors will use the test in combination with other information, such as the size and grade of the tumour, to work out if chemotherapy could be beneficial.
    Current evidence suggests some people are over or under treated because of uncertainties about whether their cancer will actually spread.
    The National Institute for Health and Clinical Excellence (Nice) has approved the Oncotype DX test for people with oestrogen receptor positive (ER+), lymph node negative (LN-) and human epidermal growth factor receptor 2 negative (HER2-) early breast cancer who are at intermediate risk of the cancer spreading.
    The genetic test could benefit those with early-stage breast cancer facing the intensive treatment, which has side effects include nausea, vomiting, insomnia, hair loss and fatigue
    The genetic test could benefit those with early-stage breast cancer facing the intensive treatment, which has side effects include nausea, vomiting, insomnia, hair loss and fatigue

    Professor Carole Longson, Nice health technology evaluation centre director, said: ‘Breast cancer patients face significant emotional and psychological strain when considering chemotherapy. 
    ‘A test that can help to predict better the risk of the breast cancer spreading, and therefore the potential likely benefit of additional chemotherapy, represents a significant step forward for patients.’
    Some 15 studies on more than 6,000 patients worldwide have taken place using Oncotype DX, showing that around one third of treatment plans are changed as a result of the test.
    A 2011 UK study on Oncotype DX found that 46 per cent of patients with early stage disease could be spared unnecessary chemotherapy.
    Studies have suggested that half of women with the most common form of early breast cancer could be spared chemotherapy
    Studies have suggested that half of women with the most common form of early breast cancer could be spared chemotherapy. Image shows breast cancer cells

    The research was carried out by Simon Holt, a breast surgeon at the Hywel Dda Local Health Board in Wales, on 142 NHS patients with oestrogen receptor positive breast cancer, the most common type.
    Commenting on the Nice announcement, Kathi Apostolidis, vice president of the European Cancer Patient Coalition based in Brussels, said: ‘The decision of whether or not to undergo chemotherapy is an extremely important and difficult one for patients, not only due to the many side effects associated with treatment, but also due to the hardship for the patient and her family and the loss of income due to days off work.
    ‘Allowing patients and their physicians to make more personalised treatment decisions can help improve outcomes for the rising number of early-stage breast cancer patients in Europe.’
    Sally Greenbrook, Senior Policy Officer at Breakthrough Breast Cancer, said: ‘This is a good decision from Nice. 
    ‘We know that chemotherapy can have side effects such as sickness and hair loss and many patients find it to be extremely gruelling - so a test which enables patients to avoid it will be welcomed by many.
    ‘It’s important to remember that Oncotype DX is only suitable for certain types of breast cancer (ER+,HER2-) so some patients will still need chemotherapy. 
    ‘It’s also important to make sure that this test is made available to doctors and that systems are in place to ensure that patients are able to benefit from it.
    ‘Breakthrough Breast Cancer have developed a similar, much cheaper, test for this same purpose, known as IHC4, and Nice has recommended more research on this test to confirm whether it should be used in the clinic. We hope that this will be made available for routine use in the future as it could save the NHS money and benefit patients.’


    Read more: http://www.dailymail.co.uk/health/article-2431851/The-test-spare-HALF-breast-cancer-patients-chemotherapy--judging-far-tumour-spread.html#ixzz2fvYA1Z8I 
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