Oncologic Hospital Readmissions

Cancer patients are at a higher risk of hospital readmissions than the general population. A recent study conducted by a team at the Boston University School of Medicine (Boston, MA) identified avoidable oncologic readmissions and their causes. The researchers conducted a retrospective chart review over a six-month period, during which 203 patients were discharged. While 68.7% of readmissions could not have been avoided, the authors found that 31.3% were potentially avoidable. Most of those potentially avoidable readmissions were due to ascitic or pleural fluid reaccumulation. Based on those findings, the researchers offer solutions such as performing supervised procedures in the outpatient setting. Addressing the issues could decrease readmissions in an oncology service. The study was published in JCO oncology practice.

Stress Linked to Cancer Recurrence, Lung Cancer Metastasis Management and More

  • Stress can re-ignite dormant tumor cells to cause cancer recurrence months or years after completing of successful treatment. A mixed animal and human study by an international group of researchers established that norepinephrine and cortisol, stress hormones released into the bloodstream when the level of stress is elevated, start a chain of biochemical events ultimately leading to reactivating the tumor cells. One of the findings in the human part of the study was the beta-blocker’ class of drugs ability to inhibit stress hormone signaling which prevented the reactivation of cancer cells. This finding opens up the possibility of beta-blockers use for cancer recurrence prevention. The study was published in Science Translational Medicine.
  • Harvard’s Wyss Institute for Biologically Inspired Engineering and John A. Paulson School for Engineering and Applied Sciences (SEAS) used an unconventional approach to managing hard to treat lung metastases. They delivered immune system stimulating chemicals directly into the lung metastasis via drug-filled nanoparticles attached to red blood cells thus sparing the healthy lung tissues otherwise damaged by chemotherapy. The scientists also established that this method could halt further lung cancer growth and also prevent cancer recurrence. This animal research paves the way to new therapeutic options for metastatic cancers. The study was published in Nature Biomedical Engineering.
  • Another team from Harvard’s Wyss Institute for Biologically Inspired Engineering and John A. Paulson School for Engineering and Applied Sciences (SEAS) developed a vaccine that combines chemo and immunotherapy in one injection. This animal research shows some promise even in difficult to treat cancers. The study was published in Nature Communications.
  • Researchers at the Centre for Genomic Regulation (CRG) in Barcelona and Columbia University in New York City found a way to produce more hematopoietic stem cells (HSCs) – self-renewing stem cells crucial for treating cancer, as well as other serious diseases. The scarcity of such cells has always presented a problem. While these cells are typically derived from bone marrow and circulating and cord blood this research established another way of getting them – by reprogramming other blood stem cells. The researchers used a special algorithm to identify a gene capable of reprogramming blood stem cells to acquire hematopoietic stem cell properties. This research boosts the opportunity for more patients to benefit from hematopoietic stem cell treatments. The study was published in Cell Reports.

Delaying Cancer Treatments and Impact on Mortality

In the unprecedented time of COVID-19, there is a dire need to understand the impact of delaying cancer treatment. A team from Canada and the United-Kingdom undertook a Systematic Review and Meta-Analysis of studies published from January 2000 to April 2020 to quantify the impact of delays in surgical interventions, systemic treatment (such as chemotherapy), or radiotherapy for seven types of cancer. These seven cancers represent “44% of all incident cancers globally”.

From analyzing studies included in the review, the authors concluded that every four-week delay in cancer treatment was associated with increased mortality. Delaying more than four weeks was associated with an even higher increase in the risk of death. For instance, delaying breast cancer surgery for eight weeks would increase the risk of death by 17%. This risk would be 26% with a twelve-week delay.

The study was published in November 2020 in the BMJ. The findings of this Systematic Review and Meta-Analysis will be instrumental in creating policies on cancer management priorities during a pandemic.

Hanna, T. P., King, W. D., Thibodeau, S., Jalink, M., Paulin, G. A., Harvey-Jones, E., O’Sullivan, D. E., Booth, C. M., Sullivan, R., & Aggarwal, A. (2020). Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ (Clinical research ed.), 371, m4087. https://doi.org/10.1136/bmj.m4087