AI Becomes Very Good at Diagnosing Breast Cancer

Artificial intelligence is becoming more of a hot topic, and people should remember more that AI can be used both to hurt humans and (as in this case) help humans.

A computer programme can identify breast cancer from routine scans with greater accuracy than human experts, researchers said in what they hoped could prove a breakthrough in the fight against the global killer.

Breast cancer is one of the most common cancers in women, with more than 2 million new diagnoses last year alone.

Regular screening is vital in detecting the earliest signs of the disease in patients who show no obvious symptoms.

In Britain, women over 50 are advised to get a mammogram every three years, the results of which are analysed by two independent experts.

But interpreting the scans leaves room for error, and a small percentage of all mammograms either return a false positive – misdiagnosing a healthy patient as having cancer – or false negative – missing the disease as it spreads.

Now researchers at Google Health have trained an artificial intelligence model to detect cancer in breast scans from thousands of women in Britain and the United States.

The images had already been reviewed by doctors in real life but unlike in a clinical setting, the machine had no patient history to inform its diagnoses.

The team found that their AI model could predict breast cancer from the scans with a similar accuracy level to expert radiographers.

Further, the AI showed a reduction in the proportion of cases where cancer was incorrectly identified – 5.7 percent in the US and 1.2 percent in Britain, respectively.

It also reduced the percentage of missed diagnoses by 9.4 percent among US patients and by 2.7 percent in Britain.

“The earlier you identify a breast cancer the better it is for the patient,” Dominic King, UK lead at Google Health, told AFP.

“We think about this technology in a way that supports and enables an expert, or a patient ultimately, to get the best outcome from whatever diagnostics they’ve had.”

Computer ‘second opinion’

In Britain all mammograms are reviewed by two radiologists, a necessary but labour-intensive process.

The team at Google Health also conducted experiments comparing the computer’s decision with that of the first human scan reader.​

If the two diagnoses agreed, the case was marked as resolved. Only with discordant outcomes was the machine then asked to compare with the second reader’s decision.

The study by King and his team, published in Nature, showed that using AI to verify the first human expert reviewer’s diagnosis could save up to 88 percent of the workload for the second clinician.

“Find me a country where you can find a nurse or doctor that isn’t busy,” said King.

“There’s the opportunity for this technology to support the existing excellent service of the (human) reviewers.”

Ken Young, a doctor who manages mammogram collection for Cancer Research UK, contributed to the study.

He said it was unique for its use of real-life diagnosis scenarios from nearly 30,000 scans.

“We have a sample that is representative of all the women that might come through breast screening,” he said.

“It includes easy cases, difficult cases and everything in between.”

The team said further research was needed but they hoped that the technology could one day act as a “second opinion” for cancer diagnoses.

Terrible — U.S. Asbestos Imports are Doubling in 2018

Asbestos is incredibly harmful to human health, and it’s extremely regressive that the U.S. not only hasn’t banned it, but is now increasing imports of it.

As President Donald Trump’s industry-friendly Environmental Protection Agency (EPA) takes steps to loosen restrictions on the commercial use of asbestos—which is known to cause cancer and lung disease—an analysis of federal data published Tuesday found that asbestos imports to the U.S. surged by nearly 2,000 percent between July and August of this year.

Conducted by the Asbestos Disease Awareness Organization (ADAO) and Environmental Working Group (EWG), the analysis found that “the U.S. imported more than 341 metric tons of asbestos” last year, with imports expected to double in 2018 thanks to the Trump administration’s aggressive and deeply harmful deregulatory agenda.

“It is appalling that unlike more than 60 nations around the world, the U.S. not only fails to ban asbestos, but allows imports to increase,” Linda Reinstein, president and co-founder of ADAO, said in a statement. “Americans cannot identify or manage the risks of asbestos. The time is now for the EPA to say no to the asbestos industry and finally ban asbestos without exemptions.”

“When most people learn that asbestos remains legal even after it’s claimed the lives of countless Americans, they’re shocked,” added EWG president Ken Cook. “And when the public finds out the Trump administration is actively working to keep it legal, they are furious.”

Good Immunotherapy is Amazing at Treating Cancer — And It’s Unnecessarily Expensive

Drugs are cheap to produce — it’s things like unjust government-granted patent monopolies that allow pharmaceutical companies to charge exorbitant prices that make drugs expensive.

To quote economist Dean Baker’s latest October 2018 paper:

“Many items that sell at high prices as a result of patent or copyright protection would be free or nearly free in the absence of these government granted monopolies. Perhaps the most notable example is prescription drugs where we will spend over $420 billion in 2018 in the United States for drugs that would almost certainly cost less than $105 billion in a free market. The difference is $315 billion annually or 1.6 percent of GDP. If we add in software, medical equipment, pesticides, fertilizer, and other areas where these protections account for a large percentage of the cost, the gap between protected prices and free market prices likely approaches $1 trillion annually, a sum that is more than 60 percent of after-tax corporate profits.”

On to the article though.

Last week, researchers James Allison and Tasuku Honjo were awarded this year’s Nobel Prize in medicine for their work on cancer immunotherapies, heralded by the Nobel committee as “seminal discoveries” that “constitute a landmark in our fight against cancer.”

Immunotherapies like those developed on the basis of Allison and Honjo’s work are indeed an important step towards a whole new way to treat cancer, as well as a host of other chronic diseases. However, this Nobel award should remind us that these innovative therapies are out of reach for so many patients in the United States due to the exorbitant prices drug companies charge for them.

Just weeks before the Nobel announcement, oncologist Ezekiel Emmanuel wrote in a Wall Street Journal essay, “We Can’t Afford the Drugs That Could Cure Cancer,” that “a cure for cancer has become possible, even probable” with immunotherapies, but that our health system cannot afford their price tag. Just after the Nobel announcement, Vox reporter Julia Belluz reminded us that “the average cost of cancer drugs today is four times the median household income” (emphasis added).

Immunotherapies constitute a part of the class of drugs called biologics (as opposed to chemical pharmaceuticals) that have shown very promising results in treating many previously intractable conditions, such as multiple sclerosis, asthma, chronic pain, and Crohn’s disease, due to their ability to more precisely target individual diseased cells. Therefore it’s no surprise that currently most of the top 10 best-selling drugs worldwide are biologics.

[…]

If biologics really are the future of medicine, we must change the way prescription drugs are priced in the United States, or millions of patients will be left behind. One way to do that is to invest in public pharmaceuticals that can assure an adequate supply of and equitable access to essential medications.

Developing Drug Impairs Process Cancer Cells Use for Growth

It looks like this will be useful later on.

A drug discovered and advanced by The University of Texas MD Anderson Cancer Center’s Institute for Applied Cancer Science (IACS) and the Center for Co-Clinical Trials (CCCT) inhibits a vital metabolic process required for cancer cells’ growth and survival.

IACS-10759 is the first small molecule drug to be developed from concept to clinical trial by MD Anderson’s Therapeutics Discovery team, which includes IACS and the CCCT. Therapeutics Discovery is a unique group of clinicians, researchers and drug development experts working collaboratively to create new treatment options, including small molecules, biologics, and cell-based therapies.

[…]

Metabolic reprogramming is an emerging hallmark of tumor biology where cancer cells evolve to rely on two key metabolic processes, glycolysis and oxidative phosphorylation (OXPHOS), to support their growth and survival. Extensive efforts have focused on therapeutic targeting of glycolysis, while OXPHOS has remained largely unexplored, partly due to an incomplete understanding of tumor contexts where OXPHOS is essential.

“Through a comprehensive translational effort enabled by collaboration across MD Anderson, we have identified multiple cancers that are highly dependent on OXPHOS,” said Marszalek.

This effort inspired the discovery and development of IACS-10759, a potent and selective inhibitor of OXPHOS. Its advancement to clinical trials was made possible by a multidisciplinary team of more than 25 scientists across Therapeutics Discovery.

“Through this collaborative, 18-month process, we identified and rapidly advanced IACS-10759 as the molecule for clinical development,” said Di Francesco. “We believe IACS-10759 will provide a promising new therapy for cancer patients.”

There’s No Amount of Alcohol, Sausage or Bacon That’s Safe, According to These Cancer Experts

It’s certainly something people should think more about.

No amount of alcohol, sausage or bacon is safe according to a new global blueprint on how to beat cancer.

Even small amounts of processed meats and booze increase the risk of a host of cancers outlined in World Cancer Research Fund (WCRF) guidelines updated every decade.

The respected global authority has unveiled a 10-point plan to cut your risk of getting cancer by up to 40%.

[…]

Processed meats also cause people to be overweight which can trigger many more cancers.

But UK experts have disagreed with the draconian advice insisting the odd bacon sandwich “isn’t anything to worry about”.

The WCRF found boozing is directly linked to increased risk of six cancers and for the first time recommended sticking to water or unsweetened drinks.

Innovative Immunotherapy Approach Eliminates Woman’s Breast Cancer

Immunotherapy is valuable at reversing cancer outcomes, as shown in the past months with the cancer “vaccine” that eliminated tumors in mice and now this immunotherapy that worked when other approaches didn’t.

“We’ve developed a high-throughput method to identify mutations present in a cancer that are recognized by the immune system,” Dr. Rosenberg said. “This research is experimental right now. But because this new approach to immunotherapy is dependent on mutations, not on cancer type, it is in a sense a blueprint we can use for the treatment of many types of cancer.”

The new immunotherapy approach is a modified form of adoptive cell transfer (ACT). ACT has been effective in treating melanoma, which has high levels of somatic, or acquired, mutations. However, it has been less effective with some common epithelial cancers, or cancers that start in the lining of organs, that have lower levels of mutations, such as stomach, esophageal, ovarian, and breast cancers.

In an ongoing phase 2 clinical trial, the investigators are developing a form of ACT that uses tumor-infiltrating lymphocytes (TILs) that specifically target tumor cell mutations to see if they can shrink tumors in patients with these common epithelial cancers. As with other forms of ACT, the selected TILs are grown to large numbers in the laboratory and are then infused back into the patient (who has in the meantime undergone treatment to deplete remaining lymphocytes) to create a stronger immune response against the tumor.

A patient with metastatic breast cancer came to the trial after receiving multiple treatments, including several chemotherapy and hormonal treatments, that had not stopped her cancer from progressing. To treat her, the researchers sequenced DNA and RNA from one of her tumors, as well as normal tissue to see which mutations were unique to her cancer, and identified 62 different mutations in her tumor cells.

The researchers then tested different TILs from the patient to find those that recognized one or more of these mutated proteins. TILs recognized four of the mutant proteins, and the TILs then were expanded and infused back into the patient. She was also given the checkpoint inhibitor pembrolizumab to prevent the possible inactivation of the infused T cells by factors in the tumor microenvironment. After the treatment, all of this patient’s cancer disappeared and has not returned more than 22 months later.

“This is an illustrative case report that highlights, once again, the power of immunotherapy,” said Tom Misteli, Ph.D., director of CCR at NCI. “If confirmed in a larger study, it promises to further extend the reach of this T-cell therapy to a broader spectrum of cancers.”

Simple Lung Cancer Scans That Could Save Thousands of Lives a Year

Cancer can be exponentially easier to treat or cure when it’s caught early.

A new study found that fewer than 2 percent of heavy smokers in the U.S. get recommended lung cancer screenings, an imaging test that can catch tumors when they are small and potentially curable. The numbers fall far short of screening for other types of cancer, including mammograms and colonoscopies—both procedures that are much more uncomfortable than the CT scan used to detect tiny tumors in the lungs.

Lung cancer is the leading cause of cancer death in the U.S., killing an estimated 150,000 Americans each year. For the past five years, such groups as the U.S. Preventive Services Task Force and the American Society of Clinical Oncology have urged people aged 55 or older who have smoked a pack a day (or the equivalent) for three decades or more to get checked for early stage disease. Medicare, the U.S. government’s insurance program for the elderly, pays for the procedure. None of it has made an impact.

“It’s still truly abysmal,” said Danh Pham, chief fellow of hematology/oncology at the University of Louisville’s cancer center in Kentucky, who will present the findings at the ASCO cancer meeting next month in Chicago. “We would like to make this a true call to action, whether it’s for more education or more research, to know why this disparity exists for lung cancer.”

It took a while for public health officials to start recommending routine lung cancer screening, because of questions about its accuracy and its ability to make a difference once the disease was detected. Subsequent studies confirmed the benefits for the heaviest smokers, with the use of screening intended for those most vulnerable to tumors.

The researchers analyzed registry data for everyone who underwent lung cancer screening in 2016 and found that 141,260 of the 7.6 million people eligible, or 1.9 percent, received it. By comparison, from 60 percent to 80 percent of eligible people get screening for breast, cervical and colon cancer, said Bruce Johnson, president of the American Society of Clinical Oncology and chief clinical research officer at the Dana-Farber Cancer Institute in Boston.

The testing shortfall could stem from primary care doctors’ failure to refer high-risk patients to one of 1,800 approved centers nationwide which provide the service. Psychological issues could also play a role, including fear of being diagnosed with a disease that smokers are constantly reminded of, Pham said.

“It’s very difficult to get patients to have this conversation with their doctors because of the stigma,” he said. “People may not want to know if they have lung cancer because it could confirm they’ve made bad lifestyle choices.”

Lung cancer deaths exceed those from breast, colon, pancreas and prostate cancer combined. There are very compelling reasons to get screened, said Johnson.

“If you screened the entire population of the U.S. who fit the criteria for having smoked enough and being the appropriate age, which is about 8 million people, you could save about 12,000 lives a year,” he said. “The majority of lung cancers picked up are early stage,” and finding them before the malignant cells spread reduces the risk of dying by about 20 percent, he said.