Can Trauma Trigger Violent Crime in Mentally Ill?

By Karen Pallarito
HealthDay Reporter

WEDNESDAY, July 13, 2016 (HealthDay News) — People with serious mental illness who are victims of violence or exposed to stressful events are more likely to engage in a violent crime in the week following the trauma, a new study contends.

Stressful experiences also affect people without psychiatric disorders, but not to the same extent, the researchers said.

Some stressful events — such as being violently victimized, injured in an accident, losing one’s parents or self-harming — act as “triggers,” said study co-author Dr. Seena Fazel. He is a professor of forensic psychiatry at the University of Oxford in England.

Experiencing one of these events increases the risk of committing a violent criminal act within a week of the trigger, especially in people with schizophrenia and bipolar disorder, Fazel said.

People diagnosed with these conditions have higher rates of criminal convictions than the general population, according to the study. Identifying triggers for violence “is potentially clinically important for risk assessment,” the study authors wrote.

But Dr. J. Wesley Boyd, a professor of psychiatry at Harvard Medical School in Boston, said people with mental illness are much more likely to be victims than perpetrators of violent crime.

“I’m actually as much or more concerned about the trauma done to my patients by being exposed to traumatic events,” he said.

“Every time there’s another mass shooting, I have a whole host of patients who get depressed, who feel like they can’t watch TV, who feel like they can’t go outside. They become isolative, they become terrified,” Boyd explained.

Jennifer Skeem, a psychologist and associate dean of research at the University of California, Berkeley, cautioned against presenting the study results in a manner that would exacerbate the stigma of mental illness.

“The authors’ results are consistent with a larger body of literature that indicates that exposure to violence is one of many risk factors for violence,” she said.

In the study, Fazel and his colleagues used a nationwide sample of more than 2.8 million people born in Sweden between 1958 and 1988 to study potential triggers for violent crime. Almost 35,000 had schizophrenia, and nearly 30,000 had bipolar disorder. More than 2.7 million healthy individuals were included for comparison.

The study authors defined violent crime as conviction for homicide, assault, robbery, threats and violence against an officer, unlawful threats, unlawful coercion, kidnapping, illegal confinement, arson, intimidation or certain sexual offenses.

Being victimized contributed to the largest “absolute” risk of violence, with rates ranging between 70 and 177 violent crimes per 10,000 persons in the week following the violent exposure event, the study showed. That compares with “nine to 22 violent crimes per 10,000 persons during the control periods in the same individuals,” the researchers reported.

The study was published online July 13 in the journal JAMA Psychiatry.

Dr. Jan Volavka, professor emeritus at New York University School of Medicine, wrote an editorial in the same issue of the journal suggesting the need for further research into the role of stress in triggering violence.

Volavka offered this takeaway: People who experience a stressful event similar to the triggers observed in the study should not be exposed to additional stress during the following week.

“They should be treated gently,” he said.

More information

The U.S. Substance Abuse and Mental Health Services Administration has more about trauma and violence.

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Obesity More Deadly for Men Than Women: Study

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, July 13, 2016 (HealthDay News) — Obesity is nearly three times more deadly for men than it is for women, new research suggests.

In a study of nearly 4 million men and women around the globe, the risk of dying before the age of 70 was 19 percent for men and 11 percent for women of normal weight.

But that risk jumped to 30 percent and 15 percent, respectively, for obese men and women. That’s an absolute increased risk of 11 percent for men and 4 percent for women, the researchers reported.

“Obesity is second only to smoking as a cause of premature death in America,” said lead researcher Richard Peto, professor of medical statistics and epidemiology at the University of Oxford in England.

“If you could lose about 10 percent of your weight, a woman would knock 10 percent off the risk of dying before she was 70, and for a man it would knock about 20 percent off,” Peto said.

Why obese men are at greater risk for premature death than women isn’t clear.

“Our study was not able to address this question, but previous observations have suggested that obese men have greater insulin resistance, liver fat levels and diabetes risk than women,” said study co-author Dr. Emanuele Di Angelantonio, a lecturer at the University of Cambridge in England.

The study was published online July 13 in The Lancet.

One U.S. expert said more research is needed to explore the apparent link between obesity and mortality.

“We still have more work to do to better understand how weight, weight gain, and weight loss influence mortality,” said Barry Graubard, a senior investigator in the biostatistics branch of the U.S. National Cancer Institute. He co-authored an accompanying journal editorial.

Avoiding obesity has clear advantages for both men and women, Graubard said. “In addition, we know from other studies that physical activity can reduce mortality risk,” he said.

In the new study, researchers collected data on 3.9 million adults, aged 20 to 90. The information came from 189 previous studies in Europe, North America and elsewhere. The investigators included data on all those who lived at least another five years. Over the time of the study, nearly 400,000 participants died. The study findings showed that underweight people were also at risk for premature death.

The World Health Organization estimates that 1.3 billion adults worldwide are overweight, and 600 million more are obese. And, obesity has been strongly linked in previous research to heart disease, stroke, diabetes and cancer, the researchers said.

Dr. David Katz is president of the American College of Lifestyle Medicine. He said: “Although there has long been clear and decisive evidence linking obesity to increased risk for the major chronic diseases that are in turn linked to increased risk for premature death, the obesity/mortality link has been periodically challenged.”

This study overcomes many of the limitations of earlier efforts and “renders a clear and emphatic verdict — obesity increases the risk of premature death around the globe,” Katz said.

This study also indicates that the risk extends across the full range of overweight and obesity — the more severe the obesity, the graver the danger, he added.

“The obesity pandemic continues to advance, putting ever more of humanity at risk,” Katz said. “What we already had abundant cause to think, this paper gives us ample cause to know, that risk includes early death. This constitutes an urgent call for corrective actions at a global scale.”

More information

Visit the World Health Organization for more on obesity.

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How to Spot the Warning Signs of Heat Stroke

WEDNESDAY, July 13, 2016 (HealthDay News) — As people age, they are at added risk for heat stroke and other heat-related illnesses, according to the U.S. National Institute on Aging (NIA).

This is particularly true for those with chronic health issues, the agency cautions.

Heat fatigue, heat-related dizziness, heat cramps, heat exhaustion and heat stroke are all forms of hyperthermia. The condition occurs when the body is overwhelmed by heat and is unable to control its temperature, the NIA explains.

Those who lack access to air conditioning or transportation, who can’t move around, wear too much clothing or visit crowded places may be more vulnerable, the agency notes.

Other factors that increase hyperthermia risk include:

• Dehydration,
• Poor blood circulation,
• Less sweat production due to aging,
• Use of multiple medications,
• High blood pressure or other health conditions that require a reduced-salt diet,
• Heart, lung and kidney diseases, or other conditions that cause general weakness or fever,
• Being very overweight or underweight,
• Drinking alcohol.

When temperatures, air pollution and humidity spike, older people with chronic health issues like heart disease and diabetes should stay indoors, the NIA advises. Those who don’t have air conditioning should go to a mall, senior center, library or other cool location.

Heat-related illnesses require immediate medical attention. The NIA says it’s essential to recognize the warning signs, including:

• Fever (generally above 104 degrees Fahrenheit),
• Confusion or combativeness,
• Strong, rapid pulse,
• Dry, flushed skin,
• Lack of sweating,
• Feeling faint,
• Staggering,
• Coma.

Anyone who may be suffering from a heat-related illness should be taken to a shady or air-conditioned spot and told to lie down. A cold, wet cloth should be applied to the wrists, neck, armpits and groin to help cool the blood. If the person can swallow, he or she should be given nonalcoholic fluids, like water or apple juice, according to the NIA.

More information

The U.S. Centers for Disease Control and Prevention provides more information on older people and heat-related illness.

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Newly Released Inmates Account for 1 in 10 Fatal ODs

WEDNESDAY, July 13, 2016 (HealthDay News) — Almost 10 percent of fatal adult drug overdoses may involve recently released prison inmates, a new Canadian study suggests.

“This is the first Canadian study to examine overdose mortality rates by matching incarceration records with coroner reports after release,” said study author Dr. Nav Persaud. He is a scientist with the Li Ka Shing Knowledge Institute of St. Michael’s Hospital in Toronto.

“We were surprised at how high the fatal overdose rate was among those who were recently released from provincial custody — almost 12 times higher than the general population,” Persaud added.

Not only did one in 10 overdose deaths involve a recently released inmate, but the risk for a fatal overdose among inmates was found to be highest immediately following release, the study found.

“Previous research has speculated that the higher risk for overdose immediately following release can be attributed to periods of no or less frequent drug use while individuals are incarcerated,” Persaud said in a St. Michael’s news release.

“Once released, these individuals may not realize that their tolerance has diminished and [they] can accidentally overdose,” he explained.

The investigators analyzed data provided by the Ontario Ministry of Community Safety and Correctional Services, which registered the releases of roughly 50,000 inmates between 2006 and 2013. The release dates were then cross-referenced with coroner report information.

The team also observed that most of the deaths involved opioid use.

“At least some of these deaths are preventable and there may be opportunities to prevent overdose deaths by supporting this vulnerable group — during incarceration and immediately following release,” said Persaud.

“Future research and policy should focus on immediate interventions, such as directing people to treatment programs and providing better access to [the anti-overdose drug] naloxone, drug substitution therapies and overdose prevention education,” he added.

The findings were published in the July 6 issue of PLOS One.

More information

There’s more on opioid drug overdose risk at the U.S. Centers for Disease Control and Prevention.

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Cash Rewards Won’t Change Outcomes for HIV-Infected Drug Addicts: Study

WEDNESDAY, July 13, 2016 (HealthDay News) — Giving drug-addicted, HIV-positive people cash incentives to help improve unhealthy behaviors doesn’t work, a new study finds.

The study, funded by the U.S. National Institute on Drug Abuse, tracked outcomes for HIV-infected people with substance-abuse problems — a notoriously tough group to treat, the researchers said.

To lower rates of HIV infection and illness, “we must get serious about hard-to-reach populations” like these, lead researcher Lisa Metsch, of Columbia University in New York City, explained in a university news release.

Giving people cash rewards for healthy improvements in behavior — for example, exercising or stopping smoking — has been somewhat successful for other patient populations.

So, Metsch’s group wondered if a similar approach might help HIV-infected people battling drug or alcohol abuse.

To find out, the investigators tracked outcomes for more than 800 people cared for at 11 hospitals in major cities across the United States. Patients were randomly assigned to one of three groups: usual treatment (patients were linked to outpatient HIV care/substance abuse treatment); six months of “patient navigation” (where case managers helped patients coordinate their care); or six months of patient navigation plus financial incentives.

These incentives were cash rewards with a value of up to $1,160, given if the patient succeeded in cutting back on substance abuse, adhering to HIV care, and improving clinical outcomes when it came to HIV.

However, the team reported that rates of suppression of HIV on blood tests were the same after one year, regardless of which group the patients were enrolled in. In each group, only about one-third of patients achieved successful viral suppression, Metsch’s group said.

Why didn’t patient navigation or the cash bonuses help? “Participants in this trial face complex issues including considerable socioeconomic disadvantage,” theorized Metsch, who is chair of sociomedical sciences at Columbia’s Mailman School of Public Health.

Her team believes more research is needed to find ways to reach people who battle both addiction and HIV infection.

“We will not achieve an AIDS-free generation if we don’t address substance use and the other [illnesses] that come with substance use,” Metsch said.

The findings were published July 12 in the Journal of the American Medical Association.

More information

There’s more on HIV, the virus that causes AIDS, at AIDS.gov.

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Dodge the Jet Lag, Enjoy Your Trip

WEDNESDAY, July 13, 2016 (HealthDay News) — People crossing time zones may assume jet lag is something they have to endure — like airport delays and lost luggage. But there are several ways travelers can prepare for and minimize jet lag’s troubling effects, a sleep specialist says.

First, flying from west to east, such as from the United States to Europe, will result in worse jet lag than the reverse trip, explained David Earnest, who studies circadian rhythms at Texas A&M Health Science Center College of Medicine.

“You will always be hit harder by jet lag when making a four- to six-hour time jump eastbound,” Earnest said in a university news release.

“This is because our body clocks are trying to advance to an earlier time, which is not as easy as adjusting to a later time gap,” he said.

Earnest provided the following recommendations on how to ease jet lag:

• Catch the red eye. Sleeping through an overnight flight is one of the best ways to reduce the effects of jet lag. Earnest noted, however, those who aren’t able to sleep on an overnight flight will be tired once they land in the early morning.
• Avoid sleep aids. These drugs can confuse the body clock and may worsen jet lag. They also remain in the bloodstream and can make travelers feel groggy or hung over.
• Pass on the alcohol or caffeine. It’s a good idea to avoid these beverages on overnight flights. “It is acceptable to consume caffeine to help you stay awake at the new location, though,” Earnest said.
• Plan ahead. People who adjust their current schedules ahead of time to accommodate the time zone of their destination may not feel as jet-lagged. This should be done at least four days before traveling. Sleep and meal times can be gradually moved about one hour per day.
• Consider melatonin therapy. Melatonin is a hormone that circulates in high levels at night. It tells the body when it’s nighttime and time for sleep. Unlike sleep aids, melatonin doesn’t stay in the bloodstream long. Travelers may want to consider taking an over-the-counter melatonin supplement five days before traveling at the local time that coincides with evening at their destination. It will acclimate you to feel sleepy at the new location’s time. It’s best to check with your physician before taking any new supplement.
• Try to adjust right away. “Walk around, drink some coffee and explore the new city,” said Earnest. “It’s better to tough it out and wait to sleep until night.” Exposure to sunlight will help the body adjust to a new time zone. It’s fine to get to bed on the early side but avoid trying to “sleep off” jet lag.

Delayed adjustment — not allowing your body clock to sync properly — ups your risk of illness. And that’s especially true since you’ve already been in the closed environment of the airplane, Earnest added.

“Your immune system is probably already compromised. There are merits to doing the right thing and waiting until dark to sleep it off, even though that’s not necessarily what your body is telling you to do,” he noted.

More information

The National Sleep Foundation provides more information on jet lag.

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Alzheimer’s Gene May Show Effects in Childhood

By Amy Norton
HealthDay Reporter

WEDNESDAY, July 13, 2016 (HealthDay News) — A gene related to Alzheimer’s disease may start to show effects on brain structure and mental sharpness as early as preschool, a new study suggests.

Researchers have long known that a gene called APOE is related to the risk of developing Alzheimer’s disease. People who carry a variant of the gene known as e4 have a higher-than-average risk.

The new study confirms what smaller studies have hinted: The gene’s effects may be apparent even in early childhood.

Brain scans revealed that young children with the e4 variant typically showed slower development in certain brain areas. These are the same brain regions that often atrophy in people with Alzheimer’s disease, said Dr. Linda Chang, a neurologist at the University of Hawaii, who led the study.

What’s more, some children with e4 performed worse on tests of memory and thinking skills — though the gap disappeared around ages 8 to 10.

Chang said it’s possible that people who carry e4 are vulnerable at the “extremes of age.” She pointed to two recent studies where infants with the gene variant showed certain structural abnormalities in brain areas that are known to be affected by Alzheimer’s.

Rebecca Knickmeyer, a researcher who led one of those studies, co-authored an editorial published with the new findings.

She said the research has no immediate practical implications. No one is saying kids should be tested for their APOE variants, for example.

Scientifically, though, the findings add to the “intriguing idea” that Alzheimer’s is partly a developmental disorder, Knickmeyer said.

If that’s true, she noted, the big questions are, when and how might it be possible to intervene and change someone’s “trajectory” toward dementia?

“Could we intervene early through some noninvasive approach, like diet or cognitive training?” said Knickmeyer, an assistant professor of psychiatry at the University of North Carolina at Chapel Hill.

For now, no one knows.

The APOE gene has three forms: e2, e3 and e4. Everyone carries two copies of the gene — one inherited from each parent. The e3 variant is most common, with more than three-quarters of the population carrying at least one copy, Chang’s team noted.

Far fewer people — about 14 percent — carry e4, while around 8 percent carry e2. People with one copy of the e4 variant have a higher-than-average risk of Alzheimer’s. Having two copies boosts the risk further, the researchers explained.

Because the e2 variant is uncommon, its role is less clear, Chang said. But, she added, there is evidence it’s “neuroprotective” and may lower odds of dementia symptoms — unless a person also carries a copy of e4.

Nothing about the APOE gene is “deterministic,” however, Knickmeyer stressed. Many people with Alzheimer’s do not carry the e4 variant, and many people with the variant do not develop Alzheimer’s.

The study findings were based on MRI brain scans of nearly 1,200 healthy children and teenagers. Overall, 62 percent carried two copies of e3, while around one-quarter carried at least one copy of e4. Less than 2 percent had two e4 variants.

The investigators found that children with one or two copies of e4 typically differed from other kids in some measures of brain structure.

Similarly, young children with two copies of e4, or one e4 and one e2, tended to do worse on tests of memory, thinking and attention, at least until age 8 or 10, the findings showed.

“That may indicate some sort of maturation effect,” Knickmeyer said.

The bigger point, she added, is that when it comes to mental skills, performance at any one point in time may not tell the whole story. “It may not be about ‘where you are’ at any given point, but how you got there,” Knickmeyer said.

There are big hurdles to figuring out whether any intervention earlier in life eventually makes a difference in Alzheimer’s risk.

Studies would have to be decades-long, which is logistically tough and expensive, Knickmeyer said.

And then there’s the question of which people to study.

“We’re just not particularly good at predicting who’s going to develop Alzheimer’s,” according to Knickmeyer.

Simply testing for APOE variants would not be enough, she explained, because that’s only one factor.

Figuring out which people would benefit from preventive efforts is critical, Chang noted. “Currently, we have few treatment options for Alzheimer’s disease, and the brain damage cannot be reversed,” she said.

Experts generally advise that people protect their brains by eating a healthy diet, exercising and staying mentally active.

The report was published online July 13 in Neurology.

More information

The Alzheimer’s Association has more on lifestyle and brain health.

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Rising Blood Sugar Hitting More Obese Adults

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, July 13, 2016 (HealthDay News) — Among obese American adults, control of blood sugar is worsening, leading to more diabetes and heart disease, a new study finds.

While blood pressure and cholesterol levels stayed relatively stable among obese adults, poor control of blood sugar led to a 37 percent increase in heart disease risk factors between 1988 and 2014, the researchers reported.

“Obese adults with cardiovascular disease risk factors may need more intense approaches — healthy diet, increased physical activity — to control blood sugar and achieve weight loss,” said lead researcher Dr. Fangjian Guo. He is an assistant professor of obstetrics and gynecology at the University of Texas in Galveston.

After climbing over several decades, U.S. obesity rates have leveled off. Still, about 35 percent of American adults are obese, according to background notes with the study.

Obesity hinders the body’s ability to process blood sugar. Over time, too many spikes in blood sugar can lead to type 2 diabetes, the researchers explained. Diabetes in turn is a known risk factor for heart disease and other health problems, such as vision loss and amputations.

However, weight loss can reverse this effect, the study authors noted.

“Controlling weight in obese adults to reduce the risk of developing type 2 diabetes should be a public health priority,” Guo said.

A New York City specialist agreed, and recommended weight-loss medications as part of treatment.

“This is another wake-up call to provide not only more intense lifestyle interventions in this population, but also start with medications that can prevent diabetes and help weight loss,” said Dr. Joel Zonszein. He is director of the Clinical Diabetes Center at Montefiore Medical Center.

“In our health care system we chase diseases. However, we can now prevent diabetes and treat obesity early,” he added.

For the study, Guo and colleagues analyzed data on more than 18,600 obese adults who took part in the U.S. National Health and Nutrition Examination Survey over almost 30 years. The researchers used body mass index (BMI) — a calculation based on height and weight — to gauge body fat. Obesity is defined as a BMI of 30 or more.

Only 2 percent of obese adults had ideal heart health, a figure that remained stable throughout the study period.

Between 1988 and 2014, rates of diabetes rose from 11 percent to 19 percent, which was due to increases in blood sugar, the researchers said.

The investigators found that the rate of obese adults without the three key risk factors for heart disease — diabetes, high cholesterol and high blood pressure — held steady at just 15 percent.

But the rate of obese adults with all three risk factors rose 37 percent — to nearly one in four, Guo said.

Risk for all three factors increased progressively from age 40 on. Young adults in their 20s and 30s had the lowest rate of all three, the study found.

“We have two choices: letting this population get sick and provide monies for treatment of complications and disability; or intervene early and prevent diabetes by encouraging weight loss, leading to a healthier and more productive life,” Zonszein said.

The report was published online July 13 in the Journal of the American Heart Association.

More information

For more on type 2 diabetes, visit the American Diabetes Association.

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Routine Eye Exams See Vision Problems You Miss

WEDNESDAY, July 13, 2016 (HealthDay News) — Routine eye checkups often pick up unnoticed problems, particularly in older adults, a new study says.

“In asymptomatic patients, comprehensive routine optometric eye examinations detect a significant number of new eye conditions and/or results in management changes,” said the study’s author, Elizabeth Irving, and her colleagues from the University of Waterloo in Ontario, Canada.

More than half of people with no new symptoms or vision problems receive new prescriptions or treatment changes as a result of routine eye exams, the researchers found. The need for vision prescription changes was found for two out of five people, the study noted.

Meanwhile, 16 percent were diagnosed with a new eye condition and 31 percent had a change in their ongoing care, researchers found.

The study included data on nearly 6,400 patients who visited a university eye clinic over the course of a year.

Roughly 40 percent said they had no problems with blurry vision, headaches, or other eye-related issues.

The most significant changes involved older people. Among young children, just 8 percent had changes resulting from their routine eye exams, but in adults 65 and older, 78 percent had changes, the study showed.

Besides seniors, those who let more time pass between eye exams are more likely to have their treatment plan change, the researchers noted. They said their findings highlight the need for regular eye exams.

The results were published in the July issue of the journal Optometry and Vision Science.

“Often people fail to see the need for symptomless eye examinations, but our authors make the case that there are numerous sound reasons for routine and regular eye exams,” Dr. Anthony Adams, the journal’s associate editor, said in a journal news release.

“These include important systemic diseases such as diabetes and eye diseases like glaucoma and macular degeneration,” he added.

Young and middle-aged adults waited the longest between eye exams — about three years on average. These longer delays between visits were independently associated with a higher rate of significant changes, the researchers found.

“Given an overall greater than 50 percent detection of significant change, routine eye examinations do appear to be productive in asymptomatic patients, and this appears to increase with age,” the study’s authors wrote.

Routine eye screenings are believed to play a key role in preventing vision loss, but how often adults should have vision exams depends largely on age and medical history, says the American Academy of Ophthalmology (AAO). If you have a family history of eye diseases, check with your eye doctor to see how often you need routine eye exams.

For most adults, the AAO recommends a comprehensive eye exam beginning at age 40. From 40 to 54, most symptom-free people can go 2 to 4 years between visits. From 55 to 64, the AAO recommends intervals of 1 to 3 years, and for those 65 and older, examinations every 1 to 2 years are advised. People with diabetes should have a dilated eye exam every year, according to the AAO.

More information

The U.S. Centers for Disease Control and Prevention provides more information on routine eye care.

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‘Liquid Biopsy’ May Show Whether Cancer Drugs Are Working

By Amy Norton
HealthDay Reporter

WEDNESDAY, July 13, 2016 (HealthDay News) — Researchers have developed a blood test that might allow doctors to know quickly whether a cancer drug is working.

The technique is in the early stages of testing, and not ready for “prime time,” scientists said. But they were also hopeful that the research will help advance the use of so-called liquid biopsies in treating cancer.

Doctors have long used invasive biopsy procedures to get tumor samples, study them, then use the information to make treatment decisions or monitor a patient’s response to treatment.

But those procedures can be uncomfortable and carry some risks, like bleeding and infection, said Dr. Erica Mayer, a breast cancer expert with the American Society of Clinical Oncology (ASCO).

Plus, she noted, some tumors are difficult to reach, and some patients are not healthy enough to have an invasive biopsy.

So there’s been “great interest,” Mayer said, in liquid biopsy technology — which allows doctors to detect and analyze tumor DNA in a blood sample.

“It’s much more favorable for patients because it doesn’t have the potential risks of traditional biopsies,” Mayer said. It’s also easier for doctors to take repeat blood samples over time.

There are already some liquid biopsy tests on the market. Last month, the U.S. Food and Drug Administration approved the first such test that can detect particular gene mutations that affect some lung cancer patients. If they carry the mutations — in a gene called EGFR — then they may benefit from the cancer drug Tarceva.

Also last month, a large study presented at ASCO’s annual meeting reported that liquid biopsies can be a reliable alternative to traditional biopsies when it comes to detecting mutations in patients’ cancer.

That study focused on finding tumor mutations that can be targeted with available drugs, said senior researcher Chwee Teck Lim.

“For our [test], we go one step further, to see how a patient’s cancer cells will actually respond to a given drug treatment,” explained Lim, a professor of biomedical engineering at National University of Singapore.

The technique involves using “microwells” to grow clusters of tumor cells from a patient’s blood sample. Lim’s team tested the approach using blood samples from 55 women in various breast cancer treatment trials.

They exposed the women’s tumor cells to a standard cancer drug called doxorubicin and found that the better the cell clusters established themselves in the microwells, the worse a patient’s prognosis.

The technique could give feedback as quickly as two weeks after treatment has begun, the researchers report online July 13 in the journal Science Advances.

That, Lim said, means that doctors could get “crucial information” on whether a patient’s cancer is responsive or resistant to a drug — and then make a switch if needed.

But, he stressed, this was only a “proof-of-concept” study. He said his team is planning to see how the test performs when other cancer drugs, and other types of tumors, are used.

Liquid biopsies are part of the wider drive toward more “individualized therapy” for cancer, said Mayer, a medical oncologist at the Dana-Farber Cancer Institute, in Boston.

More and more “targeted” drugs are being developed, with the aim of zeroing in on specific abnormal proteins on cancer cells. Liquid biopsies are seen as a simpler, less invasive way to find out whether patients have mutations that are vulnerable to those drugs.

But the biopsies can also be used in other ways, Lim said. That includes monitoring a patient’s response to treatment.

“The rapid feedback provided by this [test] potentially allows detection of an onset of drug tolerance or resistance during the course of treatment,” Lim said. “This will enable us to immediately intervene and change treatment.”

It’s “premature,” Mayer said, to speculate on whether or how this test could eventually fit into cancer care.

For one, she noted, “what researchers see in a lab dish may not reflect what’s going on in a living being.”

But in general, Mayer said, the work being done on liquid biopsy technology is “exciting and promising.”

More information

The U.S. National Cancer Institute has a fact sheet on common lab tests.

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