Internet Use and Dissatisfaction With Care
Cancer survivors who are dissatisfied with their care are more likely to search for health-related information on the internet than those who are satisfied with their care, according to a study published in the November 2020 issue of the Journal of the National Comprehensive Cancer Network. Researchers analyzed data on 12,970 people with a history of cancer who were included in the National Health Interview Survey between 2013 and 2018. During this period, the rate of cancer survivors who reported searching for health-specific information increased from 46.8% to 52.2%. While 48% of people who were very satisfied with their care reported using the internet for health-related reasons, 59.5% of those were very dissatisfied said they made health-related searches. It is unclear whether people are more likely to become dissatisfied due to searching the internet for health-related information, or whether people search for health-related information on the internet because they are dissatisfied with their care. “Given the overall high prevalence of internet use to obtain health information among cancer survivors, physicians, health care organizations, and other cancer advocacy groups should participate in efforts to produce high-quality, reliable online health-related materials,” the authors write.
Coronavirus Infection Persists in Immunocompromised Patient
The Centers for Disease Control and Prevention (CDC) recommends that asymptomatic people infected with the coronavirus isolate for 10 days following a positive test. A study published Nov. 4 in Cell, finds that an immunocompromised woman with chronic lymphocytic leukemia (CLL) and an asymptomatic infection shed virus that was capable of replicating for at least 70 days. The woman was unable to make sufficient amounts of a type of immune protein called immunoglobulin due to an immune deficiency that is common among people with CLL. The woman, who was treated in Washington, tested positive for the coronavirus in March; she was tested while hospitalized because she had previously been in a rehabilitation facility with an outbreak. She never developed COVID-19 symptoms, but she continued to repeatedly test positive. Virus isolated from samples taken on day 49 and day 70 after her original positive test was able to infect cells and replicate in the lab. The patient last tested positive for the coronavirus 105 days after the original test, but the researchers were no longer able to grow virus from samples taken on day 77 and beyond. “Although it is difficult to extrapolate from a single patient, our data suggest that long-term shedding of infectious virus may be a concern in certain immunocompromised patients,” the researchers write.
Liquid Biopsy Has Limitations in Prostate Cancer
Tests looking at fragments of tumor DNA or cancer cells in the blood, sometimes called liquid biopsies, are increasingly used to guide treatment with targeted therapies. A study published Nov. 5 in JAMA Oncology urges caution in interpreting liquid biopsy tests in patients with advanced prostate cancer. Using liquid biopsy is increasingly attractive for advanced prostate cancer patients because there are now two targeted therapies, called PARP inhibitors, approved for patients with certain tumor mutations. Many of these tests look at DNA fragments floating in the plasma, which is the liquid component of blood. The researchers reviewed data on 69 prostate cancer patients who received a liquid biopsy test. While plasma testing uncovered 23 mutations that appeared to make patients eligible for treatment with PARP inhibitors, the researchers concluded based on further testing that seven of these mutations should not in fact make patients eligible. Instead of being present in tumor cells, the mutations were present in blood cells and had arisen via a phenomenon called clonal hematopoiesis of indeterminate potential (CHIP), in which immature blood cells give rise to lineages of mutated cells. CHIP grows more common with age, as does prostate cancer.
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