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Hold your breath to protect your heart

Radiotherapy uses beams of radiation to damage cancer cells, and is highly effective against breast cancer — but it can raise the risk of heart attack.

The heart lies just behind the left breast and, when directed at a breast tumour, radiotherapy can also damage the heart, over time causing inflammation that may block blood supply and lead to heart disease or heart attack.

A technique called deep inspiration breath hold can protect patients from this side-effect.

Patients simply take a deep breath and hold it for around 20 seconds just before each radiotherapy dose. As the lungs expand, they push the heart back and down out of danger.

A study of 50 patients, published in the journal Practical Radiation Oncology in 2014, found it reduced the radiation dose to the heart by 75 per cent compared with those who breathed normally. It can also help in lung cancer or cancer of the lymphatic system.

A similar approach is also being introduced for tumours in the liver and pancreas, although here patients hold a deep exhaled breath before each radiotherapy dose to ‘immobilise’ the organ.

With the right guidance this technique can be used without needing expensive machines.

Dr Andy Gaya, a consultant oncologist based in London, says: ‘Deep inhalation is used now to protect the heart in breast cancer and lymphoma radiotherapy, and expiration breath hold is increasingly used for liver and pancreas radiotherapy.’

Availability: At some NHS units and privately

Milk supplement can save taste 

A metallic taste and altered sense of smell are common during chemotherapy.

Exactly why is not well understood, but these taste and smell abnormalities can last for weeks and lead to loss of appetite, weight loss, depression and poor nutrition, which can slow recovery.

But U.S. research, published in the journal Food & Function last year, suggests a protein found in milk, saliva and tears called lactoferrin — already available as a nutritional supplement on the High Street — could help.

Researchers from Virginia Tech College of Agriculture and Life Sciences in the U.S. asked 19 patients with taste and smell disturbances to take 250mg of lactoferrin three times a day for 30 days.

They found cancer patients’ saliva contained significantly reduced levels of some proteins known to play a role in immunity and taste. However, lactoferrin boosted these levels and, at the same time, reduced the iron content of saliva.

Professor Susan Duncan, who carried out the study, said: ‘By suggesting lactoferrin as a dietary supplement, cancer patients and their family and friends may again find comfort in enjoying a meal together.’

Dr Gaya says: ‘Metallic taste is a huge problem, leading to reduced appetite and weight loss. If proven, this is a welcome, easy and cheap way to overcome a debilitating issue.’

Availability: On the High Street, but seek medical advice first

Icy socks stop nerve damage 

Peripheral neuropathy or nerve damage causes pain and numbness in hands and feet, affecting three-quarters of patients given paclitaxel, used for ovarian, breast and lung cancers.

It occurs because this chemotherapy drug can destroy nerves as well as cancer cells.

But wearing gloves and socks stored at minus 30c can help, according to researchers from Kyoto University in Japan.

Reducing the temperature in hands and feet lowers blood flow to these areas and as a result the amount of chemotherapy reaching them.

Patients wear the gloves and socks 15 minutes before, throughout treatment and for 15 minutes afterwards (90 minutes in total).

A small study of 36 breast cancer patients undergoing 12 weekly cycles of chemotherapy, published in the Journal of the National Cancer Institute in 2017, found just 28 per cent of hands wearing the gloves lost sensitivity to touch (81 per cent without); and 25 per cent of feet lost some sensitivity when wearing the socks (64 per cent without).

‘Frozen gloves and socks are under-utilised in the UK to reduce the risk of chemotherapy induced peripheral neuropathy,’ says Kefah Mokbel, a breast cancer surgeon at The Princess Grace Hospital, and St George’s Hospital, in London. ‘They should be considered to improve patients’ quality of life.’

Availability: Available online

Half treatment with same result 

Halving the time breast cancer patients spend on the drug Herceptin significantly reduces side-effects — and is just as effective, suggests a major new trial.

Herceptin targets a protein called human epidermal growth factor receptor 2 (HER2) on the surface of cancer cells, stopping them growing and dividing.

However, it can affect the heart’s pumping ability (because there are HER2 receptors in heart muscle, too), causing breathlessness and palpitations.

In the new study, involving more than 4,000 women with early-stage HER2 positive breast cancer, six months of treatment was as effective as the standard 12-month course, The Lancet reported earlier this month.

It was also associated with significantly fewer side-effects.

But if you take Herceptin, don’t change anything without your doctor’s advice. ‘Other studies have not shown the same result, so standard duration of Herceptin should remain 12 months,’ says Professor Mokbel.

Availability: Herceptin is widely available, but more research is needed into this new approach

 Rose geranium oil for nasal pain

A spray of rose geranium oil may ease nasal vestibulitis, which causes the lining of the nostrils to become excessively tender, bleed and form scabs.

It can be caused by a class of cancer drugs called taxanes, which stifle tumour growth by stunting formation of new blood vessels.

A small study published in the journal BMJ Supportive & Palliative Care last year suggested rose geranium oil may help alleviate the pain. Doctors gave rose geranium oil spray to 40 women who had nasal vestibulitis and were having chemotherapy.

Those who responded to a survey afterwards said it had eased symptoms and, in two cases, cleared completely. Results of a further trial are expected next year.

 Availability: On the High Street, but ask your doctor first

 Anti-poison drug prevents deafness

Eighty per cent of children who develop liver cancer can be cured, however two-thirds will be left with hearing loss from the treatment that saves them.

It’s because cisplatin, the drug used to treat it, also permanently kills sensory cells in the ear.

Research led by Great Ormond Street Hospital and funded by Cancer Research UK has shown that adding sodium thiosulphate, better known as an antidote for cyanide, to treatment with cisplatin can reduce the chance of hearing loss by 50 per cent, reported the New England Journal of Medicine last year.

Dr Penelope Brock, a paediatric consultant who led the research, says: ‘With sodium thiosulphate, we have a real chance to reduce the incidence of hearing loss, preventing children needing a hearing aid for the rest of their lives.’

Dr Gaya says: ‘Hearing loss is a major problem with some chemotherapy drugs, leading to doctors having to reduce the dose and stop chemo early, so further results are eagerly awaited.’

Availability: Next year on the NHS and privately. Some patients can get it via their doctor for free on ‘compassionate grounds’

Sponge to mop up toxic chemo drugs

Hair loss, nausea, fatigue and infection are common side-effects caused by chemotherapy drugs affecting healthy tissue.

Researchers at the University of California, San Francisco, have designed a ‘sponge’ to catch chemotherapy drugs as they leak out of the treated organ, before they reach healthy tissue.

It has an absorbent mesh-like centre to soak excess toxic drugs, but lets blood flow unhindered. Made using a 3D printer, surgeons place it in the vein leading from the organ being treated, leave it in during chemotherapy (normally an hour or two) and remove it afterwards.

Results published in the journal ACS Central Science showed it intercepted 64 per cent of the drug. So far it has only been tested on pigs for liver cancer, but trials are due on kidney and brain cancer.

Steve Rannard, a professor of chemistry at the University of Liverpool, says: ‘This is an exciting new approach. We now need to build a greater body of evidence to ensure it is safe.’

Availability: Trials on patients will begin in the next few years


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