These are some of the topics that have cropped up in the news, in the journals, and on our helpline recently. You can link to the article or abstract and read our summary. You can also link to relevant information we already have on the subject elsewhere on our website. The articles will be updated every couple of weeks and stored in the Hot topics archives.

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Although exposure to asbestos remains the main risk factor for mesothelioma a recently published research paper has highlighted a risk from chemoradiotherapy, especially to the chest area, for people with Hodgkin’s lymphoma.

The study, from The Netherlands, involved over 2500 people treated for Hodgkin’s lymphoma between 1965 and 1995. The patients were followed for an average of 18 years. Thirteen of the study population developed mesothelioma, which is nearly 26 times the rate expected in the general population. The risk for women – 85 times general population rate – was far greater than men at 18 times the general population rate.

The researchers found that those who were treated with chemotherapy alone weren’t at any greater risk of mesothelioma. Those who received only radiotherapy had a 5.8 fold increased risk, but those who had received both chemotherapy and radiotherapy were nearly 45 times more likely to develop mesothelioma than the general population. All but one of the cases of mesothelioma developed in the radiation field. Only seven had any documented exposure to asbestos.

The researchers conclude that mesothelioma should be considered in anyone who has previously been treated with radiotherapy and who presents with new symptoms.

Malignant mesothelioma following radiation treatment for Hodgkin's lymphoma
De Bruin ML et al. Blood 2009 Feb 20.
Read the abstract
 
Macmillan resources
Mesothelioma information centre
Hodgkin’s lymphoma information centre
Radiotherapy

It’s known that giving chemotherapy before surgery for cancer of the oesophagogastric junction can help to improve survival. Results from a recent trial suggest that adding radiotherapy to the preoperative regimen can be even more beneficial.

The study involved 126 patients with locally advanced adenocarcinoma of the lower oesophagus or gastric cardia. They were randomly assigned to one of two treatment groups either:

• 15 weeks of chemotherapy followed by surgery, or
• 12 weeks of chemotherapy,  then 3 weeks of chemoradiotherapy followed by surgery.

The addition of radiotherapy improved the 3 year survival rate from 27.7% to 47.4%. Although the target accrual was not achieved and the trial closed early before a statistical significance was achieved, the researchers feel the results suggest that preoperative chemoradiotherapy helps to improve survival for this group of patients.

Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction
Stahl M et al. J Clin Oncol 2009 Feb 20;27(6):851-6.
Read the abstract

Macmillan resources
Cancer of the gullet information centre

A number of studies have shown a link between alcohol consumption and an increased risk of breast cancer. New data from The Million Women Study has shown links between alcohol and other types of cancer in women.

The Million Women Study includes data from nearly 1.3 million women, recruited between 1996 and 2001. Using data about the women’s daily alcohol consumption the researchers calculated relative risk rates for 21 site specific cancers.

During an average follow-up of 7.2 years per woman, nearly 69,000 cancers occurred within the group of women. A quarter of the women never drank alcohol, and 98% consumed less than 21 drinks per week. Increasing alcohol intake was linked with an increased risk of cancers of the oral cavity, pharynx, oesophagus, larynx, liver, breast and rectum. The increased risk of upper respiratory cancers was confined to current smokers and little effect was seen among non-smokers. The type of alcohol taken didn’t seem to affect the results.

Interestingly, increasing alcohol intake was associated with a decreasing risk of thyroid cancer, NHL and renal cell carcinoma.

In conclusion the researchers suggest that low to moderate amounts of alcohol can increase the risk of certain cancers. They calculate that for every additional alcoholic drink taken per day, the increase in incidence of cancer up to the age of 75 is 15 per 1000 women, 11 of which are breast cancers.

Moderate alcohol intake and increase in cancer in women
Allen NE et al. J Natl Cancer Inst 2009 Mar 4;101(5):296-305.
Read the abstract 

Macmillan resources
Causes of cancer: Diet and lifestyle
Be sensible with alcohol
Hot Topic – Alcohol and cancer (Feb 2006)

These summaries are for information only and do not necessarily reflect the views of Macmillan.