Chemo During Pregnancy Doesn't Seem to Harm Baby

THURSDAY, Feb. 9 (HealthDay News) -- A new study finds that the babies of women who had chemotherapy while pregnant aren't at higher risk for a variety of medical disorders, a sign that the treatment should be safe for the fetus in most instances.

There's a caveat: babies born to pregnant women who had chemotherapy were more likely to be born prematurely, potentially putting them at risk for impaired brain development, which can cause problems with memory, thinking and learning skills.

Still, the findings are "very good news," said maternal-fetal medicine specialist Dr. Elyce Cardonick, who wrote a commentary accompanying the study.

"No pregnant woman likes to choose between treating themselves and protecting the baby," said Cardonick, who works at Cooper Medical School of Rowan University in Camden, N.J. "They don't have to choose. By making themselves healthy, they're helping the baby."

An estimated one in 1,000 pregnant women have cancer, Cardonick said. In some cases, doctors recommend that the women undergo abortions. But chemotherapy is an option.

Typically, doctors only treat the women outside the early stages of pregnancy and use older drugs that are "tried and true," Cardonick said.

Could chemotherapy harm the developing fetus? Previous research has suggested it won't, but researchers led by Dr. Frederic Amant, a gynecologic oncologist and assistant professor at Katholieke Universiteit in Leuven, Belgium, sought to understand whether the cancer treatment might affect babies after they are born.

In the new study, the researchers examined medical records and test results of 70 children whose pregnant mothers underwent chemotherapy. The children were followed for an average of 22 months and up to 18 years.

"The study is unique since this is the first time children were extensively examined over the long term," Amant said.

The investigators found that the children weren't at higher risk of heart, hearing or nervous system disorders, or general health and growth problems.

As to why the chemotherapy drugs do not reach the fetus and cause harm, Amant said the placenta acts like a filter, keeping most of the medications away from the fetus. Also, doctors avoid chemotherapy in the first trimester, when organs are in the early stages of development and especially vulnerable, Amant added.

The study is one of a series of articles about pregnant women and cancer published online Feb. 10 in The Lancet Oncology.

The other articles published in this issue report that:

The current trend in medicine is to allow pregnancies to continue in women diagnosed with cervical or ovarian cancer. However, chemotherapy must not be used in the first eight weeks, and the pregnancies come with risks.Pregnant women with breast cancer can undergo both surgery and chemotherapy, all with the aim of a full-term pregnancy. The mother's disease outcome would not be improved by terminating the pregnancy.Blood cancer can cause complications in pregnant women, such as blood clots, that may lead to advice to terminate the pregnancy at an early stage to protect the health of the mother. But women in later stages of pregnancy may find it feasible to undergo cancer treatment while preserving the pregnancy.

More information

For more about pregnancy and cancer, visit the American Society of Clinical Oncology.

View the original article here

'Hunger hormone' could help chemo patients: study

NEW YORK (Reuters Health) - A synthetic version of the "hunger hormone" ghrelin might help limit the loss of appetite that can come with cancer chemotherapy, a small study from Japan suggests.

Ghrelin is a hormone secreted by the gut to boost appetite. Because of that, scientists have been studying it as a target in the obesity war, which has included work on an anti-obesity "vaccine" that inhibits ghrelin. But the research has met with little success so far.

Since the hormone spurs hunger, in theory, infusions of synthetic ghrelin could help prevent the sometimes severe appetite loss caused by cancer drugs.

In particular, a commonly used cancer drug called cisplatin often causes nausea, vomiting and appetite loss -- and cuts the body's natural ghrelin levels.

For the new study, Japanese researchers tested the effects of ghrelin infusions in 41 patients undergoing cisplatin treatment for advanced cancer of the esophagus.

Half of the patients were randomly assigned to have ghrelin infusions twice a day, before their meals, over one week of chemotherapy. The rest were given infusions of saline.

In the end, the ghrelin patients maintained better appetites and were able to take in almost 50 percent more calories per day than patients given saline.

Overall, more than half of the saline group had nausea, versus one in five ghrelin patients. And while half of the saline group had anorexia -- significant appetite loss -- during chemo, only one in six ghrelin patients did.

Dr. Yuichiro Hiura and colleagues at Osaka University report their findings in the journal Cancer. The study was funded by a grant from the Japanese government.

It appears to be the first to show that ghrelin may help cancer patients being treated with cisplatin, so further studies are needed, the researchers say.

There is already a medication -- one that decreases the activity of the hormone serotonin -- that eases nausea and vomiting in the first 24 hours of cisplatin treatment, Hiura's team notes.

But, they add, lingering nausea and appetite loss in the following days are still a challenge to control. So ghrelin could offer a way to help with those longer-term effects.

Intensive chemotherapy with multiple drugs, including cisplatin, is commonly used for advanced-stage cancer, Hiura's team writes. But side effects may keep many patients from completing their treatment.

Ultimately, the researchers say, the goal is to make chemotherapy easier for patients to get through -- and, it's hoped, improve the treatment's effectiveness.

SOURCE: http://bit.ly/wB771x Cancer, online January 26, 2012.

View the original article here

For pregnant women with cancer, chemo possible

LONDON (AP) — Researchers have encouraging news for women who find themselves in a very frightening situation: having cancer while pregnant. Studies suggest that these women can be treated almost the same as other cancer patients are, with minimal risk to the fetus.

Only about 1 in 1,000 pregnant women face this dilemma, but doctors fear that more will because the risk of cancer rises with age, and more women are delaying having children until they're older.

Doctors have long worried about how to balance treating a pregnant woman with cancer and the need to protect her fetus from the effects of toxic cancer drugs and radiation treatments, and whether it is safe to continue a pregnancy in certain situations. A series of papers in the journals Lancet and Lancet Oncology published Friday make several key contributions:

— A Belgian-led study of 70 children in Europe exposed to chemotherapy while they were in the womb found they developed just as well as other children, according to tests on their hearts, IQ and general health. They were assessed at birth, 18 months, and every few years until age 18.

— Chemotherapy after the first trimester is possible, using extra ultrasounds to ensure the baby is developing properly. Radiation therapy is best done in the first two trimesters, when the baby is small enough to be covered with a lead blanket, according to a review of previous studies, led by Belgian researchers.

— Ending the pregnancy doesn't improve chances for the mother, the same study found.

— The type of cancer seems to matter: An Israeli analysis of past research suggested pregnant women with blood cancers might want to terminate an early pregnancy when chemotherapy can't be delayed.

— Another review of previous studies by French and American researchers concluded doctors should aim to preserve pregnancy in women with cervical or ovarian cancers where possible.

"Many (doctors) aren't keen to give chemotherapy to pregnant women and may even recommend termination," said Dr. Frederic Amant of the Leuven Cancer Institute in Belgium, an author of two of the papers. "But treating a pregnant woman with cancer doesn't have to be so different from treating a cancer patient who isn't pregnant."

Amant, who led the study of 70 children, said most of the children with cognitive problems were born premature, and that was probably the primary cause of their delayed development.

"Doctors will often err on the side of caution and deliver a baby early to avoid the effects of chemotherapy," said Dr. Catherine Nelson-Piercy, an obstetric physician and spokeswoman for Britain's Royal College of Obstetricians and Gynaecologists.

"These data don't say that chemotherapy is completely safe, but the baby is better off being in (the mother) as long as possible," she said. Nelson-Piercy was not linked to the Lancet series and often works with pregnant women diagnosed with cancer or other illnesses.

Dr. Richard Theriault, a professor of medicine at the MD Anderson Cancer Center in Texas, said he hoped the papers would change how doctors treat pregnant cancer patients.

"Terminating a pregnancy is not always necessary," said Theriault, who heads a program to treat pregnant women with cancer. He said a minority of pregnant women with cancer still get abortions.

He said the placenta seems to act as a kind of filter for chemotherapy drugs, restricting their effects on the fetus. "There's the phenomenon of the bald mother who gives birth to a baby with a full head of hair," he said. "It seems to suggest not as much gets to the baby as we thought."

That was certainly Caroline Swain's experience, who was diagnosed with breast cancer while pregnant with her second son. She had her left breast and many lymph nodes removed and had to wait until her fetus was 12 weeks old before starting chemotherapy.

"I was just so grateful it was possible to have treatment and keep my baby," said Swain, 45, who lives near London. "I was scared that my child wouldn't remember me if something happened to me."

Her son Luke, now 9, weighed in at 7.4 pounds (3.35 kilograms) when he was born, only slightly lighter than his older brother Max a year earlier.

"We had celebrations all around when Luke came out absolutely fine," Swain said of her and her husband Rowland's relief at the birth. "Luke is no different from his brother," she said. "They both love Legos and X-Box."

View the original article here

For pregnant women with cancer, chemo possible

LONDON (AP) — Researchers have encouraging news for women who find themselves in a very frightening situation: having cancer while pregnant. Studies suggest that these women can be treated almost the same as other cancer patients are, with minimal risk to the fetus.

Only about 1 in 1,000 pregnant women face this dilemma, but doctors fear that more will because the risk of cancer rises with age, and more women are delaying having children until they're older.

Doctors have long worried about how to balance treating a pregnant woman with cancer and the need to protect her fetus from the effects of toxic cancer drugs and radiation treatments, and whether it is safe to continue a pregnancy in certain situations. A series of papers in the journals Lancet and Lancet Oncology published Friday make several key contributions:

— A Belgian-led study of 70 children in Europe exposed to chemotherapy while they were in the womb found they developed just as well as other children, according to tests on their hearts, IQ and general health. They were assessed at birth, 18 months, and every few years until age 18.

— Chemotherapy after the first trimester is possible, using extra ultrasounds to ensure the baby is developing properly. Radiation therapy is best done in the first two trimesters, when the baby is small enough to be covered with a lead blanket, according to a review of previous studies, led by Belgian researchers.

— Ending the pregnancy doesn't improve chances for the mother, the same study found.

— The type of cancer seems to matter: An Israeli analysis of past research suggested pregnant women with blood cancers might want to terminate an early pregnancy when chemotherapy can't be delayed.

— Another review of previous studies by French and American researchers concluded doctors should aim to preserve pregnancy in women with cervical or ovarian cancers where possible.

"Many (doctors) aren't keen to give chemotherapy to pregnant women and may even recommend termination," said Dr. Frederic Amant of the Leuven Cancer Institute in Belgium, an author of two of the papers. "But treating a pregnant woman with cancer doesn't have to be so different from treating a cancer patient who isn't pregnant."

Amant, who led the study of 70 children, said most of the children with cognitive problems were born premature, and that was probably the primary cause of their delayed development.

"Doctors will often err on the side of caution and deliver a baby early to avoid the effects of chemotherapy," said Dr. Catherine Nelson-Piercy, an obstetric physician and spokeswoman for Britain's Royal College of Obstetricians and Gynaecologists.

"These data don't say that chemotherapy is completely safe, but the baby is better off being in (the mother) as long as possible," she said. Nelson-Piercy was not linked to the Lancet series and often works with pregnant women diagnosed with cancer or other illnesses.

Dr. Richard Theriault, a professor of medicine at the MD Anderson Cancer Center in Texas, said he hoped the papers would change how doctors treat pregnant cancer patients.

"Terminating a pregnancy is not always necessary," said Theriault, who heads a program to treat pregnant women with cancer. He said a minority of pregnant women with cancer still get abortions.

He said the placenta seems to act as a kind of filter for chemotherapy drugs, restricting their effects on the fetus. "There's the phenomenon of the bald mother who gives birth to a baby with a full head of hair," he said. "It seems to suggest not as much gets to the baby as we thought."

That was certainly Caroline Swain's experience, who was diagnosed with breast cancer while pregnant with her second son. She had her left breast and many lymph nodes removed and had to wait until her fetus was 12 weeks old before starting chemotherapy.

"I was just so grateful it was possible to have treatment and keep my baby," said Swain, 45, who lives near London. "I was scared that my child wouldn't remember me if something happened to me."

Her son Luke, now 9, weighed in at 7.4 pounds (3.35 kilograms) when he was born, only slightly lighter than his older brother Max a year earlier.

"We had celebrations all around when Luke came out absolutely fine," Swain said of her and her husband Rowland's relief at the birth. "Luke is no different from his brother," she said. "They both love Legos and X-Box."

View the original article here

'Hunger hormone' could help chemo patients: study

NEW YORK (Reuters Health) - A synthetic version of the "hunger hormone" ghrelin might help limit the loss of appetite that can come with cancer chemotherapy, a small study from Japan suggests.

Ghrelin is a hormone secreted by the gut to boost appetite. Because of that, scientists have been studying it as a target in the obesity war, which has included work on an anti-obesity "vaccine" that inhibits ghrelin. But the research has met with little success so far.

Since the hormone spurs hunger, in theory, infusions of synthetic ghrelin could help prevent the sometimes severe appetite loss caused by cancer drugs.

In particular, a commonly used cancer drug called cisplatin often causes nausea, vomiting and appetite loss -- and cuts the body's natural ghrelin levels.

For the new study, Japanese researchers tested the effects of ghrelin infusions in 41 patients undergoing cisplatin treatment for advanced cancer of the esophagus.

Half of the patients were randomly assigned to have ghrelin infusions twice a day, before their meals, over one week of chemotherapy. The rest were given infusions of saline.

In the end, the ghrelin patients maintained better appetites and were able to take in almost 50 percent more calories per day than patients given saline.

Overall, more than half of the saline group had nausea, versus one in five ghrelin patients. And while half of the saline group had anorexia -- significant appetite loss -- during chemo, only one in six ghrelin patients did.

Dr. Yuichiro Hiura and colleagues at Osaka University report their findings in the journal Cancer. The study was funded by a grant from the Japanese government.

It appears to be the first to show that ghrelin may help cancer patients being treated with cisplatin, so further studies are needed, the researchers say.

There is already a medication -- one that decreases the activity of the hormone serotonin -- that eases nausea and vomiting in the first 24 hours of cisplatin treatment, Hiura's team notes.

But, they add, lingering nausea and appetite loss in the following days are still a challenge to control. So ghrelin could offer a way to help with those longer-term effects.

Intensive chemotherapy with multiple drugs, including cisplatin, is commonly used for advanced-stage cancer, Hiura's team writes. But side effects may keep many patients from completing their treatment.

Ultimately, the researchers say, the goal is to make chemotherapy easier for patients to get through -- and, it's hoped, improve the treatment's effectiveness.

SOURCE: http://bit.ly/wB771x Cancer, online January 26, 2012.

View the original article here

Chemo During Pregnancy Doesn't Seem to Harm Baby

THURSDAY, Feb. 9 (HealthDay News) -- A new study finds that the babies of women who had chemotherapy while pregnant aren't at higher risk for a variety of medical disorders, a sign that the treatment should be safe for the fetus in most instances.

There's a caveat: babies born to pregnant women who had chemotherapy were more likely to be born prematurely, potentially putting them at risk for impaired brain development, which can cause problems with memory, thinking and learning skills.

Still, the findings are "very good news," said maternal-fetal medicine specialist Dr. Elyce Cardonick, who wrote a commentary accompanying the study.

"No pregnant woman likes to choose between treating themselves and protecting the baby," said Cardonick, who works at Cooper Medical School of Rowan University in Camden, N.J. "They don't have to choose. By making themselves healthy, they're helping the baby."

An estimated one in 1,000 pregnant women have cancer, Cardonick said. In some cases, doctors recommend that the women undergo abortions. But chemotherapy is an option.

Typically, doctors only treat the women outside the early stages of pregnancy and use older drugs that are "tried and true," Cardonick said.

Could chemotherapy harm the developing fetus? Previous research has suggested it won't, but researchers led by Dr. Frederic Amant, a gynecologic oncologist and assistant professor at Katholieke Universiteit in Leuven, Belgium, sought to understand whether the cancer treatment might affect babies after they are born.

In the new study, the researchers examined medical records and test results of 70 children whose pregnant mothers underwent chemotherapy. The children were followed for an average of 22 months and up to 18 years.

"The study is unique since this is the first time children were extensively examined over the long term," Amant said.

The investigators found that the children weren't at higher risk of heart, hearing or nervous system disorders, or general health and growth problems.

As to why the chemotherapy drugs do not reach the fetus and cause harm, Amant said the placenta acts like a filter, keeping most of the medications away from the fetus. Also, doctors avoid chemotherapy in the first trimester, when organs are in the early stages of development and especially vulnerable, Amant added.

The study is one of a series of articles about pregnant women and cancer published online Feb. 10 in The Lancet Oncology.

The other articles published in this issue report that:

The current trend in medicine is to allow pregnancies to continue in women diagnosed with cervical or ovarian cancer. However, chemotherapy must not be used in the first eight weeks, and the pregnancies come with risks.Pregnant women with breast cancer can undergo both surgery and chemotherapy, all with the aim of a full-term pregnancy. The mother's disease outcome would not be improved by terminating the pregnancy.Blood cancer can cause complications in pregnant women, such as blood clots, that may lead to advice to terminate the pregnancy at an early stage to protect the health of the mother. But women in later stages of pregnancy may find it feasible to undergo cancer treatment while preserving the pregnancy.

More information

For more about pregnancy and cancer, visit the American Society of Clinical Oncology.

View the original article here

Fasting Plus Chemo May Help in Cancer Fight: Study

WEDNESDAY, Feb. 8 (HealthDay News) -- Fasting, especially when combined with chemotherapy, appears to slow the growth of cancerous tumors in mice, new research suggests.

Experts note that the results of animal studies often don't hold up when tried in humans.

However, researchers have started testing whether fasting can help human patients with breast, ovarian and urinary tract cancer.

In the mouse study, published in the current issue of Science Translational Medicine, researchers found that fasting slowed the growth of growth of breast cancer, melanoma, glioma and human neuroblastoma in mice.

In some cases, fasting was as effective as chemotherapy, according to the study.

"The combination of fasting cycles plus chemotherapy was either more or much more effective than chemo alone," senior study author Valter Longo, a professor of gerontology and biological sciences at the University of Southern California, said in a university news release.

Researchers said that normal cells deprived of nutrients during fasting enter a dormant state, whereas when studied in the lab, a type of cancer cell attempted to keep growing and dividing.

That, in turn, led to a "cascade of events" that damaged the cancer cells' DNA and led to cell death.

"A way to beat cancer cells may not be to try to find drugs that kill them specifically but to confuse them by generating extreme environments, such as fasting, that only normal cells can quickly respond to," Longo concluded.

The study authors noted that results from the initial phase of a clinical trial, which involved patients with breast, urinary tract and ovarian cancer conducted at the USC Norris Comprehensive Cancer Center, have been submitted for presentation at the annual meeting of the American Society of Cancer Oncologists. This trial tested the safety of short-term fasts two days before and one day after chemotherapy.

"We don't know whether in humans it's effective," Longo said. "It should be off limits to patients, but a patient should be able to go to their oncologist and say, 'What about fasting with chemotherapy or without' if chemotherapy was not recommended or considered?"

The researchers warned that fasting may not be safe for all cancer patients, particularly those who have already lost a significant amount of weight or have other conditions, such as diabetes. They added that fasting can cause headaches and a drop in blood pressure. The study also pointed out that cancer-free survival resulting from fasting may not extend to large tumors.

According to the American Cancer Society, "available scientific evidence does not support claims that fasting is effective for preventing or treating cancer. Even a short-term fast can have negative health effects, while fasting for a longer time could cause serious health problems."

More information

The American Cancer Society provides more information on fasting and cancer.

View the original article here