Every day cancer scientists around the
globe make progress in our understanding of the basis of cancer, how to prevent
the disease, and how to treat the disease.
Canada plays an important part in this progress.
The Canadian Cancer Society recently
released its top Canadian Cancer Society funded research stories of 2015. The projects range from new tools to study
cancer, new understanding of biological basis disease to new tools to diagnose
and treat cancer to quality of life issues for cancer patients. Check out all
their stories here!
All of the 10 stories are amazing and
intriguing. But today I will highlight one
from our own backyard at the NCIC Cancer Clinical Trials Group in Kingston,
Ontario.
As a scientist, I think of cancer research
in terms of novel treatments and improving patient survival. But there’s another area of cancer research
that physicians and cancer patients care a lot about: cancer pain. As a patient, having to undergo radical
therapy and alter your lifestyle is hard enough. Understanding pain associated with cancer and
managing symptoms is just as an essential component of cancer research.
Dr. Edward Chow and the NCIC Clinical
Trials Group recently completed a phase 3 clinical trial assessing how the
well-established drug dexamethasone might be used to alleviate bone pain after
radiotherapy in cancer patients suffering from bone metastases.
Metastasis is a common complication of
advanced cancer. Cancer cells from the
primary tumor move to distant sites in the body. One such site is the bone. The resulting bone lesion is often quite
painful for the patients. Currently,
radiotherapy is used to treat the metastases and the pain. However, an estimated 30-40% of patients
report experiencing “pain flares”, defined as a temporary worsening of the pain
in the treated site.
Dexamethasone that has been in use since
the 1960’s is a steroid that has anti-inflammatory properties. It is used for the treatment of
arthritis. Some previous studies have
suggested it may also have a use in the treatment of cancer pain. The current study is the largest study to
date that assessed how dexamethasone may be used to reduce bone pain in
response to radiation.
In this study, 298 patients from across
Canada were enrolled: half of them
randomly allocated to receive dexamethasone and the other half allocated to
receive a placebo. The difference in
pain flare incidence was 8.9%, with lower pain flares in the dexamethasone
treated patients. Additionally, these
patients also experienced less nausea, reduced functional interference, and
increased appetite. In other words,
dexamethasone is efficacious in the preventative treatment of radiation-induced
pain flare. Dexamethasone, an old dog,
can learn new tricks and may have a new arena to play in: cancer care. This “old-ish” cancer scientist learned a
new, and important, aspect of cancer research.
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