Male breast cancer

In July 2010, few people talked about male breast cancer. It was a rarity, accounting for less than 1% of breast cancer diagnoses worldwide. The most common treatment was mastectomy with or without radiation. Chemotherapy plus tamoxifen and other hormonal therapies were used for men with node-positive tumors.

Update The authors of a recent review cite the same incidence. Treatment recommendations continue to be adapted from trials for breast cancer in women; therefore, they call for more research on male breast cancer, including a multinational consortium approach, such as the International Male Breast Cancer Program, because so few patients would be eligible for clinical trials.5

Vitamin D and Prostate Cancer

In a 2015 interview, Bruce W. Hollis, PhD, discussed his study on the effects of high vitamin D intake on men with prostate cancer. Dr Hollis reported that the men in his study who were treated with vitamin D3 demonstrated biochemical and molecular changes consistent with a decrease in inflammatory processes 2 months after prostatectomy compared with men who did not receive vitamin D3


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Update A 2019 study reviewed the evidence of the effect of vitamin D supplementation on prostate cancer biomarkers and patient survival. According to the review, “current evidence suggests that vitamin D supplementation in conjunction with standard of care (eg, chemotherapy, radiation therapy) may confer clinical benefits such as a decrease in serum [prostate specific antigen] PSA levels and vitamin D receptor expression.” The authors call for further research to confirm the results.6

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Resection for Lung Cancer in the Elderly

A 2014 study from researchers at the University of Texas MD Anderson Cancer Center in Houston, Texas, conducted a study to determine which modalities would be best for treating lung cancer in elderly patients. The study was a retrospective population-based analysis that compared the often-used lobectomy (removal of the entire lobe of lung) with sublobar resection (removal of the part containing the tumor) and stereotactic ablative radiotherapy (SABR), a type of radiation therapy comprising 3 to 5 sessions. They concluded that lobectomy is the treatment of choice for early-stage lung cancer in the elderly. Those who cannot tolerate surgery should be treated with SABR.

Update The choice of which method to use in the elderly patient with lung cancer is still controversial. A review paper published in 2019 found that “propensity-matched analysis showed significant association of sublobar resection with less blood loss, shorter operation time, chest drainage, and hospital stay, while with less lymph node removal when compared with lobectomy.”7 However the decision must consider patient selection, management, and accurate lymph node staging.

References

1. Cronin KA, Lake AJ, Scott S, et al. Annual report to the nation on the status of cancer, part I: national cancer statistics. Cancer. 2018;124(13):2785‐2800.

2. Ebede CC, Jang Y, Escalante CP. Cancer-related fatigue in cancer survivorshipMed Clin North Am. 2017;101(6):1085-1097.

3. Ostuzzi G, Matcham F, Dauchy S, Barbui C, Hotopf M. Antidepressants for the treatment of depression in people with cancer. Cochrane Database Syst Rev. 2018;4(4):CD011006.

4. Bloomquist K, Adamsen L, Hayes SC, et al. Heavy-load resistance exercise during chemotherapy in physically inactive breast cancer survivors at risk for lymphedema: a randomized trial. Acta Oncol, 2019;58(12):1667-1675.

5. Gucalp A, Traina TA, Eisner JR, et al. Male breast cancer: a disease distinct from female breast cancer. Breast Cancer Res Treat. 2019;173(1):37‐48.

6. Petrou S, Mamais I, Lavranos G, et al. Effect of vitamin D supplementation in prostate cancer: a systematic review of randomized control trials. Int J Vitam Nutr Res. 2018;88(1-2):100‐112.

7. Zhang Z, Feng H, Zhao H, et al. Sublobar resection is associated with better perioperative outcomes in elderly patients with clinical stage I non-small cell lung cancer: a multicenter retrospective cohort study. J Thorac Dis. 2019;11(5):1838‐1848.