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Less Frequent Mammograms Safe for Breast Cancer Survivors
Oncologists advise breast cancer survivors to receive annual screenings to monitor for disease recurrence, but a study presented last week at the San Antonio Breast Cancer Symposium found survivors 50 and older may be able to safely receive less frequent mammograms. Researchers followed 5,235 women ages 50 and older who had undergone surgery to remove breast cancer and had no evidence of recurrence at least three years after treatment. Some participants were assigned annual mammography, while the others received less frequent screening. People in this group were screened every two years if they had breast-conserving surgery and every three years if they had a mastectomy. After a median follow-up of 5.4 years, breast cancer-specific and recurrence-free survival rates were similar between the two groups, the Associated Press reported. While more research is needed before updating screening guidelines, moving to less frequent mammograms could reduce costs and limit the anxiety people feel going into screening appointments. “It’s high time that we have a more personalized approach to screening, not just for women who’ve never had breast cancer, but for those who’ve had breast cancer,” Laura Esserman, a breast oncologist at the UCSF Carol Franc Buck Breast Care Center in San Francisco, who was not involved in the study, told the Associated Press.
Doctors Call Out Ableism in Cancer Care
Navigating the health care system and making treatment decisions is difficult for anyone diagnosed with cancer, but people with physical disabilities also must regularly contend with discrimination when trying to access the best cancer care. A commentary published last month in the Lancet Oncology highlights how people with physical disabilities often receive oncology care from providers who either have bias or lack knowledge on how to properly care for this population. Some providers might assume a person who uses a wheelchair is not sexually active so they do not need to be offered an HPV vaccine, while others may not consider that someone with cerebral palsy cannot hold their limbs steady during screening, STAT reported. These incorrect assumptions can lead to delayed cancer detection. The three authors—two of whom use wheelchairs—also wrote that many current oncology guidelines include ableist language. For instance, the criteria to determine if a patient can tolerate chemotherapy include the ability to walk. “There’s ableist language and assumptions about people who use a wheelchair, for example, not being strong enough when, in fact, some people who use wheelchairs are the strongest people around,” Sean Smith, a commentary author and a cancer rehabilitation physician at Michigan Medicine in Ann Arbor, told STAT. “There needs to be a better way to assess these patients consistently … a way that is patient-centered and ensures that people who could benefit from and who want treatment by chemotherapy can get it.”
Trial Results Find Skin Cancer Vaccine Reduces Risk of Recurrence
Adding a new skin cancer vaccine to immunotherapy lowers the risk of cancer recurrence among melanoma survivors, according to preliminary results of a clinical trial. In the phase II study, 157 people with stage III or IV melanoma who had their tumors surgically removed were randomized to receive either the new mRNA vaccine and the immunotherapy drug Keytruda (pembrolizumab) or Keytruda alone. An mRNA vaccine trains the immune system to recognize and attack proteins associated with cancer. The melanoma vaccine is personalized for each person based on their individual tumor characteristics. On Dec. 14, researchers reported the trial’s results after three years of follow-up. Participants who received the vaccine had a 49% lower risk of recurrence or death and a 62% lower risk of cancer spread compared with those in the Keytruda-only group, CNN reported. About 25% of people who received the vaccine experienced serious side effects, such as fatigue and chills, compared with 20% of those receiving Keytruda alone. A phase III trial testing the vaccine-immunotherapy combination began this July. Stephane Bancel, the CEO of Moderna, which is producing the vaccine along with Merck, told CNN the vaccine may be ready for accelerated approval from the Food and Drug Administration as early as 2025.
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