Neoadjuvant Capecitabine Plus Temozolomide in Atypical Lung NETs

Steatotic Liver Disease Linked To Improved Survival In Patients With Liver Cancer

Steatotic liver disease was associated with better liver function, lower recurrence rates, and improved overall survival in patients with liver cancer who received radiofrequency ablation.

Steatotic liver disease (SLD) was linked to improved survival in patients with liver cancer who underwent radiofrequency ablation (RFA).

After a median follow up of 51 months, patients with both liver cancer and steatotic liver disease (SLD; excessive buildup of fat in the liver cells) who received curative radiofrequency ablation (RFA, treatment using electric generated heat) for liver cancer, demonstrated longer survival compared with those without steatotic liver disease, according to a retrospective analysis.

Specifically, the SLD group demonstrated significantly improved liver reserve (liver function), lower cumulative incidences of hepatocellular carcinoma (HCC) recurrence, liver-related mortality and all-cause (death from any cause) mortality rate, according to findings published in Cancer. Patients were further differentiated into groups based on a diagnosis of metabolic function (MD) or no diagnosis, where no association was seen. Of note, SLD was associated with lower all-cause mortality in patients with HCC even after accounting for metabolic dysfunction, liver reserve and HCC characteristics.

Among 598 patients evaluated with HCC, 139 and 459 were classified into SLD and non-SLD groups, respectively. Significantly, there were 31 deaths in the SLD group versus 188 deaths in the non-SLD group. At an average length of 20.9 months and 30.6 months, 99 patients in the SLD group and 345 patients in the non-SLD group developed recurrent HCC. Regarding reasons for death, 28 patients and 162 patients were classified as liver-related deaths in the SLD and non-SLD groups, respectively. One patient in the SLD group and seven in the non-SLD group were classified as CV-related deaths. Of significance, the SLD group exhibited fewer HCC recurrences after curative RFA, fewer liver-related deaths and a lower all-cause mortality rate, compared with those in non-SLD group.

"In conclusion, the present data suggest that concurrent SLD is protective against all‐cause mortality in patients with HCC receiving curative RFA," study authors wrote. "ALBI grade is an important predictor for mortality. Further research is needed to investigate the protective mechanism of SLD for HCC."

Patients with HCC who received a lower ALBI grade, indicating better liver function, had a lower risk of death, especially those with HCC does dependently.

Patients in the SLD group had better liver function, as indicated by lower FIB-4 (degree of hepatic fibrosis) and ALBI scores. They were also less likely to have cirrhosis or HCV infection. However, they were more likely to have metabolic dysfunction (MD), diabetes (DM), and a history of smoking or alcohol consumption.

SLD has been associated with an increased risk for hepatocellular carcinoma; a common type of cancer that begins in the liver cells. Authors noted that maintaining good liver function is imperative for prognostic factor survival.

RFA is often chosen for patients with poor liver function or other health problems that make surgery risky, researchers stated in Cancer, noting that It's possible that the older, more cirrhotic patients in the RFA group were more likely to benefit from SLD and its associated better liver health.

Supporting this trial's evidence, a previous study found that patients with fatty liver disease who had surgery for liver cancer lived longer and had a lower risk of the cancer coming back. The previous study highlights that this might be because these patients were less likely to have advanced liver damage. However, this benefit was only seen in people without severe liver scarring.

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'Quick' Cancer DNA Test Offers Hope For Thousands

In January, Philip Marks says his prognosis was so bad that his oncologist did not think he would live to see February

When his health deteriorated last winter, Phillip Marks doubted he would ever play another round of golf, let alone see his 62nd birthday.

"They all thought I was going to kick the bucket, but I won the sweepstake down the golf club."

Mr Marks, from Penarth, Vale of Glamorgan, is one of thousands of people with lung cancer who is likely to benefit from a new diagnostic blood test being rolled out across Wales.

The test checks for cancer DNA which means a quicker diagnosis and better treatment options for patients.

Lung cancer is often diagnosed in the latter stages and is the leading cause of cancer deaths in the UK and is also more prevalent in disadvantaged communities.

About 1,900 people in Wales die from the disease every year.

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"I couldn't eat, I said to my partner 'take me to hospital otherwise I'm not going to be here next week', that's how bad I felt," said Mr Marks.

Mr Marks had already been told he had incurable lung cancer but doctors were struggling to find out its exact type and decide on the best form of treatment.

That was until the results of the new blood test came through and showed he might respond well to two tablets.

Mr Marks said there was an immediate difference.

Phillip Marks says QuicDNA has given him more time with his family

"From not being able to eat half a plate of pasta, I woke up on Sunday morning and my partner asked me what I wanted to do, and I said to her 'how about a carvery?' She just burst into tears.

"I've had six months of what I can sunshine and roses with my son, granddaughter, mum, dad, brothers and sisters," he said.

How does the test work?

Usually doctors try to find out more about someone's condition by extracting tumour cells from the body.

But these biopsies can be very invasive and doctors may also struggle to get a sample.

As cancer cells grow and multiply they shed tiny fragments of their DNA into the bloodstream.

The "liquid biopsy" is a simple blood test that looks for these.

Samples are analysed to build a picture of the cancer's genetic code which can help determine the best course of treatment.

It can also be used to monitor how well treatment is working.

"It's not only important to know whether or not there's actually cancer there and what stage it is, it's important to know what biomarker this cancer has because there could initially be more than 10 treatment options," said Dr Magdelena Meissner, chief investigator of the QuicDNA study.

"This [test] means as soon as someone is diagnosed they can start treatment with a targeted therapy."

Craig Maxwell has raised money on behalf of the Valindre Cancer Centre with the help of a host of celebrities

Craig Maxwell's fundraising efforts have helped to rollout the test.

Shortly before his 40th birthday, doctors found a tumour in his lung but as it was so low down they struggled to get a sample.

It took almost three months for Mr Maxwell, from Penarth, to find out he had inoperable stage 4 non-smoking lung and bone cancer.

"We had to wait 78 days for diagnosis and you've got limited time left...

"If somebody said to me 'here's 50 days back to spend with my family' - I would give anything for those 50 days back," said Mr Maxwell.

Determined to help others, the former commercial director of rugby for the Six Nations and Welsh Rugby Union asked experts what could be done to help speed up diagnosis and that was when he learnt about the QuicDNA project.

Former rugby boss Craig Maxwell has stage 4 liver and bone cancer and has raised almost £1.5m for charity

Some money had already been raised for the project which is run by the Life Sciences Wales Hub as well as other health and industry partners, but a further £300,000 was needed to get it off the ground.

Mr Maxwell said: "I was making videos for my children, for their birthdays and weddings - all that stuff I will miss, but was thinking in the time I've got this is not enough."

He managed to raise the money needed, surpassing the target by raising almost £1.5m

"All I've done is run, cycle and climb mountains.

"But if that means that somebody like me walked into the hospital tomorrow and there was a test that could help them, and if I've been a small part of that, that would be the proudest thing I've ever achieved."

The extra funding will help experts explore how liquid biopsies might be used to detect and screen for other cancers.

But experts warn huge challenges remain.

Cancer survival rates in Wales and across the UK lag behind many developed countries.

Prof Tom Crosby, clinic director of cancer in Wales said: "Patients are waiting too long from the point of time when they are told they may have cancer to actually starting their first treatment.

"The demand is outstripping the capacity we have that's mostly about the workforce and the machines... And we need more of those, but we also need to do more with what we have."

Prof Crosby added that the new test was a positive step that could help Wales "get ahead of the game" and offer hope to many.

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Richmond Father Pushes Through Stage 4 Cancer For Family, Kids

A GoFundMe page was set up for a Richmond resident battling Stage 4 cholangiocarcinoma.

Richmond resident and father Kenneth Yih with his family.

"It's almost like you die when they tell you."

This was how Richmond resident Kenneth Yih, a father of two, described the moment a doctor told him there was a large cancerous mass in his abdomen area.

Just before his family trip to Japan, Yih began experiencing unusually sharp abdominal pain and had it checked at Richmond Hospital in March.

After tests and waiting almost a whole day, the doctor brought an X-ray scan that showed Yih the image of the large mass.

Medical professionals later confirmed it to be Stage 4 cholangiocarcinoma — an inoperable and rare cancer that targets the bile ducts connecting the liver to the gallbladder and small intestine.

"It was hard news. The first two weeks were extremely hard," said Yih.

"The doctors tell you you have so much time and everything kind of stops. All the plans that you had and all the things that you want to do."

Yih told the Richmond News he fell into depression right away, lost weight, and couldn't sleep.

With the support of his wife, kids, family and friends who flew in to surprise him, he felt encouragement to keep fighting, he explained.

"I opened the door and they surprised me. That gesture of friendship and kindness and love and support just kind of mentally clicked in me and brought me back," said Yih.

Cholangiocarcinoma is an aggressive and often silent form of cancer where prognosis and survival rates are described as "heartbreaking."

Yih began chemotherapy and immunotherapy under the direction of his oncologist with pain and difficulty sleeping being only a few of several side effects that treatment has on his body.

"For my family and kids, it's worth it," he said.

"When I'm able to, I just spend time with family and my kids as much as possible. We're trying to do things that we may not have time for."

Fundraising for treatment

Candace Wong, a friend of Yih's, set up a GoFundMe page the moment Yih's oncologist told him there was a drug called Ivosidenib, that could help him.

The fundraising page was created to raise $150,000 for Yih to pay for this medication; so far, $59,255 has been collected.

Humbling and gratefulness were two words Yih described the moment he saw the page being created.

"For someone to kind of think about somebody else in that way and see everyone's kindness and generosity, the people around you rallying for you is just amazing."

When Yih is not in treatment, he tries to stay active with his weekly recreational volleyball nights or play soccer with his kids.

He enjoys cooking for his family and continues to prepare feasts at Easter, Thanksgiving and Christmas.

Yih is reminding everyone to "take charge of your own health" and never hesitate to check out any discomfort they feel.

"If anyone is unfortunately in a position like mine, I'd want them to know they can lean on the people around them," he said.

"It can be family, friends, support groups because a positive attitude is enormous in trying to fight this disease and those are the people that are going to carry you through, whether it's a good day or a bad day.

"I'm just super thankful for the people around me and just for everyone to appreciate life and the time that they have with the people they love."

To read more about Yih's story, visit the GoFundMe page.

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