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CANCER

‘Vitamin supplements speed up cancer’: study

Swedish researchers have warned smokers and lung cancer patients that taking vitamins may help the growth of tumours, a study published Wednesday revealed.

'Vitamin supplements speed up cancer': study

People who smoke or have lung cancer should think twice about taking vitamin supplements, according to a Swedish study Wednesday that showed certain antioxidants may make tumors grow faster.

Lab mice that already had cancer were given vitamin E and a drug called acetylcysteine, which sped the growth of their tumors and made them die faster than mice that did not ingest supplements.

"Antioxidants caused a three-fold increase in the number of tumors and also tumor aggressiveness, and the antioxidants caused the mice to die twice as fast," said study author Martin Bergo of the University of Gothenburg in Sweden.

"If we gave a low dose, tumors increased a little bit. And if we gave a high dose, tumors increased a lot."

Research on human lung cancer cells growing in a lab dish also showed that the antioxidants caused the cells to multiply faster than they would have alone, suggesting the same might happen in human patients. While more work needs to be done to confirm the effect in people, Bergo urged those with lung cancer, chronic obstructive pulmonary disease and smokers to take caution.

"You can walk around with an undiagnosed lung tumor for a long time," he said. "If you are in this patient group, then taking extra antioxidants might be harmful and it could speed up the growth of that tumor."

The body produces its own antioxidants to prevent DNA damage from chemicals known as free radicals, but needs more from healthy foods like leafy greens, vegetables and fruits to stay healthy. However, a large body of research on antioxidant supplements in humans has returned mixed results.

Some studies have suggested that people who take antioxidant supplements actually face a higher risk of cancer than those who do not.

One such study of nearly 30,000 men in Finland, which concluded in 1993, found that smokers who took the antioxidant beta carotene had a higher rate of cancer and greater risk of dying. Other studies, such as the SELECT trial which enrolled 35,000 US and Canadian men beginning in 2001, found that men who took vitamin E were more likely to get prostate cancer.

"We haven't completely ironed out which vitamins, if any, may prevent cancer and which may cause cancer development or growth," said Benjamin Levy, director of thoracic medical oncology at Mount Sinai Beth Israel Hospital in New York.

"This study may help explain the negative findings from prior clinical lung cancer studies, including the ATBC and SELECT studies," said Levy, who was not involved in the research.

Researchers said their findings suggest antioxidants help tumors cut down on harmful free radicals, just as they do in normal cells, allowing the tumors to grow faster. Free radicals can damage cells and possibly lead to cancer. But free radicals exist in cancer cells, too, explained Bergo.

"So it is also in the tumor's interest to suppress free radicals, and that is what we are doing when we take extra antioxidants, or give it to the mice in this case," he told reporters.

A protein called p53 can sense when DNA has been damaged by the buildup of molecules called reactive oxygen species (ROS). P53 can stop the growth of the cell and thereby stop the cancer. When extra antioxidants reduce the level of ROS, this "allows the cancer cells to escape their own defense system," said co-author Per Lindahl from the University of Gothenburg.

Of particular concern is the finding that acetylcysteine increased tumor growth, since the drug is often given to patients with chronic obstructive pulmonary disease (COPD) as a way to help them breathe better and clear mucus from their lungs.

"We think that the use of acetylcysteine in this patient group should probably be carefully evaluated," said Bergo.

He added that researchers are now combing through data registries to find out if COPD patients — including people with chronic bronchitis and emphysema — have higher cancer rates after taking the drug. The research appears in the journal Science Translational Medicine.

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HEALTH

Why cancer patients in Spain are changing address to stay alive

Almost half of all oncologists in Spain are reporting huge disparities between different regions in terms of patient access to the latest life-saving cancer treatments, spurring many patients to pack up and move (at least on paper).

Why cancer patients in Spain are changing address to stay alive
Photos: AFP

Time is of the essence when it comes to cancer and stopping it in its tracks.

But in Spain, a country where bureaucratic holdups are part and parcel of daily life, the repercussions attached to slow public service delivery in the health sector can prove lethal for some.

Spain’s Society of Oncology (SEOM) has just released a study that highlights the huge disparity in waiting times for newly approved cancer medications between the country’s different autonomous communities.

The timeframe from which a groundbreaking treatment is green lighted by Spain’s Ministry of Health to the moment it reaches a cancer patient in hospital varies between 5 to 17 months on average.

The wait is influenced by factors such as where the hospital is located in Spain, whether or not the regional health department has decided to incorporate the new medication into its cancer treatment and even the individual hospital’s modus operandi.

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With a one and half-year wait obviously not an option for anyone with the disease, especially those which are particularly aggressive, patients are preferring to pack their bags and move to an address where the holdups are far less.

For this they need to be registered (empadronados) at a municipality that falls within the catchment area of the hospital that can get them the drugs faster.

Technically their names will have to be on a rental contract or title deeds in the desired location to be able to do so, although this can also be achieved in many regions if a person living at said address authorises that they be included in the ‘padrón’.

A total of 84 public hospitals from all of Spain’s 17 autonomous communities (as well as the autonomous city of Ceuta) took part in the study, with 11 new cancer medications and 5 cancer biomarkers (a substance or process that helps to diagnose cancer) used as the basis of the research.

A total of 43 percent of oncologists surveyed told SEOM they had patients who were having to wait excessively long to receive the most cutting-edge treatment and diagnosis methods theoretically available to them through the public system, with some practitioners citing three-year-long holdups for prescriptions that have already been approved by medical authorities.

In fact, the study initially encompassed 146 hospitals across Spain, but 42 percent of them failed to get back to SEOM with the relevant information.

The same confusion that envelops many bureaucratic processes in Spain has seeped into the country’s health system, the research reveals.

In this case, there’s no homogenous nationwide policy or body to call on or complain to. Sometimes it’s the hospital that decides, in other cases it’s the region’s health department, making it unclear for people who can’t afford the wait.

Perhaps for this reason SEOM hasn’t revealed where exactly cancer patients can get the latest treatment fast and easy, as it can vary enormously even within the same city or town.

Even though Spain’s public health system is highly regarded worldwide (9th best internationally in 2015, 19th in 2018 according to The Lancet), the evidence suggests these cancer treatment holdups are nothing new.

Cancer sufferers have been ‘fudging’ their address for years as the only solution available to them for the currently inefficient system, other than actually moving to another part of Spain to sidestep the bureaucratic wait.

Begoña Barragán, president of the Spanish Group of Cancer Patients (GEPAC) told online daily Público she had at one point had 17 patients registered at her home address in order for them to gain access to her local hospital, which offered far shorter waiting periods than on average in Spain.

Her organization encompasses 70 associations across the country which have helped other cancer patients do the same.

“I remember one local minister once warning me ‘I don’t want to find out that you’ve been doing this in our region’, to which I replied ‘don’t worry, you won’t find out,” Barragán told Público.

“None of this has anything to do with medical reasons, it’s all due to administrational and financial causes. Doctors themselves will always offer up the best treatment if it’s up to them.

“This is a post code lottery, a game of chance”.

With this strand of unequal health service delivery increasingly under scrutiny, Spain’s Ministry of Health has shifted responsibility to the country’s autonomous communities, saying it’s up to them to find a solution.

But cancer groups and Spain’s health patient ombudsman are calling instead for a system that is as systematic as paying taxes.

“The rights to health service access, to be cured, to save lives cannot be determined by the place where you live, says the president of Defensor del Paciente Carmen Flores.

“That’s serious discrimination.

“Therefore, Spain’s Ministry of Health must create some order among the autonomous communities, that’s why they’re given funds from the national budget after all”.
 

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