Cancer News Review – Johns Hopkins Medicine Podcasts Johns Hopkins Medicine

Anchor lead: More people should now be screened for lung cancer, Elizabeth Tracey reports

More people now meet the criteria for lung cancer screening, if new guidelines from the United States Preventive Services Task Force are implemented. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the update.

Nelson: They have proposed to change the guidelines by dropping the age to start screening from 55 years old to 50 years old. That may be more beneficial to African Americans at risk for lung cancer because if you look at the age distribution when they develop the disease it is at a little bit younger age. And then they backed off on the pack year recommendation from 30 pack years to 20 pack years. That may actually benefit women. Women seem to be more likely to get lung cancer by smoking less than men do.   :31

Nelson reminds everyone that the single best strategy for avoiding lung cancer is not to smoke, or to stop as quickly as possible, since after 15 years your risk drops to that of a never-smoker. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Are people who have advanced cancer at high risk for opioid overdose? Elizabeth Tracey reports

People with advanced cancers are often on opioid medications. A new study examines whether they are at higher risk for overdose death as a result. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says the most recent data seems to conclude they are not.

Nelson: The opiate epidemic may be important in the care of cancer patients but the risk for death related to opiates is substantially less and of course we’re asking our oncologists and palliative care specialists to walk a very fine line in this space. No one wants anyone to have to suffer with cancer pain particularly if they’re nearing the end stages of their life where every moment is precious in order to interact with family members. You’d like them to be awake with the amount of dignity they can muster, free of pain and able to live out their life as best as they can.   :33

Nelson says federal agency oversight takes cancer diagnoses into account. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Shorter courses of radiation for cancer therapy will work for most, Elizabeth Tracey reports

Radiation therapy for cancer used to be given over weeks, but modifications to the technique have allowed the time course to be compressed for most patients. Now a Johns Hopkins study shows that many doctors aren’t using the shorter course. William Nelson, director of the Kimmel Cancer Center, explains the data.

Nelson: Now that they can aim better, damage to the normal tissues is stunningly less. They can deliver it over a week. with that in mind, this group looked at the Medicare database. What they found was that among 382 radiation oncologists a third of them still used the prolonged course of treatment, had not converted over to using the shorter term course. They were typically older, more likely to practice in the South, or the middle of the country. The rate of adoption of a new technology hasn’t been as rapid as I think many people think.  :34

Nelson says anyone who needs radiation therapy should ask their physician about the shorter course. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Should you resume routine cancer screening tests? Elizabeth Tracey reports

Since the COVID-19 pandemic began, routine screening tests for cancer have fallen dramatically, a study by medical records vender EPIC shows. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says surveys point to fear of infection.

Nelson: As we’re open for business there is still a little bit of reticence. The screening and early detection has not bounced back very quickly. There are some survey tools out that all say the same thing, that many people are reticent to visit healthcare facilities at all. They feel that this is the kind of place that you might be at high risk to catch a Sars-CoV2 infection. Nothing could be farther from the truth. Look, these are the risks here, these are the risks there, its time to pay attention to your cancer screening, and oh, by the way to your blood pressure checks, your cholesterol screening, and many other things that you may have deferred.  :34

Nelson notes that underserved populations also need to think about routine screenings to avoid some of the conditions that put them at high risk for COVID-19 infections. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: It’s time to resume routine cancer screenings, Elizabeth Tracey reports

Are you avoiding cancer screening tests because of the COVID-19 pandemic? A recent study shows that many people are. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says the numbers are startling.

Nelson: Clearly cancer is an illness that is not going to go away by having people stay at home. What this article dives into is what about the screening itself? The study itself came from a medical records vendor EPIC and they looked in their medical records database. What they saw is between March 19 and April 20 compared to steady state eleven or twelve weeks last year they saw a stunning in appointments for cancer screening. They were down at least 68% for cervical cancer, colonoscopy down 86% and mammography down 94%.  :34

Nelson notes that there’s no question that catching cancer early is most likely to result in good outcomes, so resuming screening is your best strategy. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Does it help to have a complete genetic assessment when it comes to lung cancer? Elizabeth Tracey reports

Lung cancer is often the result of known mutations abbreviated EGFR and ALK, and these are routinely tested for around the country. Now a new study suggests that a more complete genetic assessment really doesn’t add much and is much more expensive. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, comments.

Nelson: I think that it hints that there are things that are being used in the community the stuff that’s being used  is the meat and potatoes stuff that drives the drugs that we know about. I suspect that broad based genetic testing of cancers will become more and more common because it will be easier to do, more accessible. And the number of drugs that may be helpful will increase over time. I think the cost is going to go down. :20

Nelson notes that broad based testing is often a part of clinical trials.

Nelson: It’s clearly worth testing for the EGFR and ALK mutations. I think still for lung cancer it’s worthwhile thinking about participating in a clinical trial.  :09

At Johns Hopkins, I’m Elizabeth Tracey.