Information and Resources from the U-M Comprehensive Cancer Center

Research Roundup

U-M study finds women under-represented in cancer research

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Radiation therapy is common after breast conserving surgery. But a new University of Michigan Comprehensive Cancer Center study has found that it's much less frequent after mastectomy, even among women for whom it would have a clear lifesaving benefit.

The study looked at 2,260 women treated for breast cancer and assessed whether they would be strong candidates for radiation therapy. Radiation after mastectomy is generally recommended for women who have particularly large tumors, or cancer in four or more of their nearby lymph nodes.

The study found that among patients who should receive radiation therapy according to medical guidelines, 95% of those who had lumpectomy went on to receive radiation, but only 78% of those who had mastectomy received radiation. Among women for whom radiation is less clearly beneficial, 80% of lumpectomy patients had radiation while only 46% of mastectomy patients did.

"A substantial number of breast cancer patients are being under-treated. One in five women with strong indications for radiation after mastectomy failed to receive it. Radiation can be a lifesaving treatment," said study author Reshma Jagsi, M.D., D.Phil., assistant professor of radiation oncology at the U-M Medical School.

Results of the study appear in the Journal of Clinical Oncology.

The study also found that patients who reported their surgeon was involved in the decision to receive radiation were more likely to receive radiation than patients whose doctor was less involved.

"Even patients who wanted to avoid radiation therapy were very likely to receive it if their surgeons were highly involved in the decision process. We need to do a better job of educating both patients and physicians regarding the benefits of radiation after mastectomy in certain circumstances, and we need to encourage physicians to help their patients as they make these important decisions," Jagsi says.

In patients with strong indications for radiation after mastectomy, their risk of the cancer coming back in the chest wall or surrounding areas can exceed 30%. This is reduced by two-thirds if the patient undergoes radiation treatments, and overall survival is improved.

 

Gene Test Shows Who Could Benefit from Statins to Reduce Colon Cancer Risk

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A University of Michigan Comprehensive Cancer Center study found that a genetic test can determine which patients might benefit from receiving cholesterol lowering statin drugs to reduce the risk of colorectal cancer.

The researchers had previously shown that statins -- which 25 million people worldwide take each day to reduce their risk of cardiovascular disease -- can cut the risk of colorectal cancer by 50%. But statins do not appear to work equally well for everyone in reducing either colorectal cancer or cardiovascular disease risk.

The new study, which appeared in a recent issue of Cancer Prevention Research, found a genetic variant affects how statins control both colorectal cancer and cardiovascular disease risk.

"Our research is the first step toward personalized prevention. Now we have identified a genetic test that can show who's likely to benefit most from this drug," said senior study author Stephen Gruber, M.D., Ph.D., M.P.H., associate director of cancer prevention and control at the U-M Comprehensive Cancer Center.

The study looked at 2,138 people in Northern Israel who were diagnosed with colon cancer and 2,049 similar people without colon cancer. All participants were asked about statin use for controlling cholesterol. Statins are not currently used to prevent colorectal cancer.

In addition, the researchers took blood samples from all study participants and analyzed the genes. They found that the gene targeted by statins, HMGCR, is the same gene that predicts the drug's benefit for preventing colorectal cancer. Further, there are two versions of HMGCR-a long version and a short version. The researchers found that statins have more benefit for reducing both colorectal cancer risk and cholesterol in people with the gene's long version.

"The gene test by itself doesn't predict whether you're at an increased risk of colon cancer; it predicts only how well statins lower the risk," Gruber said.

The researchers point out that it's easy to know if statins are successfully lowering cholesterol, but their effect on colorectal cancer prevention is not as apparent. That's where a gene test would come in.

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