A new chemotherapy technique that isolates the liver for treatment has been used with UK patients for the first time.

The ‘chemo-bath’ technique could allow much higher doses to be used without side-effects such as hair loss and infertility.

Experts believe the same approach could be used to treat inoperable cancers in the kidney, pancreas or even lung.

Two patients at Southampton General Hospital have been treated for metastatic liver cancer with the ‘chemo-bath’ technique, resulting in tumour reduction with minimal side-effects.

Whereas traditional chemotherapy exposes the entire body to the drug’s effects, the ‘chemo-bath’ confines almost all the dose to the targeted organ.

The organ is isolated by inflating balloons inside the proximal and distal blood vessels before the drug is injected; the drug is then filtered out of the organ before the circulation is restored.

Radiologist Dr Brian Stedman (pictured) said: “To cut off an organ from the body for 60 minutes, soak it in a high dose of drug and then filter the blood almost completely clean before returning is truly groundbreaking.

“Previously, the outlook for patients specifically suffering from cancer which has spread to the liver has been poor because standard chemotherapy’s effect is limited by the unwanted damage the drug causes to the rest of the body.”

Dr Stedman said that although the technique was “in its infancy” and may need further refinement, it holds out the prospect of application to a number of organs where metastatic tumours are inoperable.

The technique is being tested in other EU countries and in the US.

Death rates from cancer in the UK will fall by 17% by 2030, according to a new report from Cancer Research UK.

The biggest improvements will be seen in death rates for ovarian cancer and breast cancer in women, as well as in bowel and prostate cancer.

While a reduction in smoking has impacted on cancer incidence, most of the change is due to improved survival rates due to better diagnosis and treatment.

Overall, it is predicted that the age-adjusted mortality figure for cancer in 2030 will be 142 in every 100,000, compared to 170 in 2010.

Death rates from ovarian cancer are predicted to fall by 43% and female breast cancer by 28%. Strong improvements are also expected for bowel cancer (23%) and prostate cancer in men (16%).

However, the death rate from liver cancer is predicted to rise by 39% and that from oral cancer by 22%, due to a combination of lifestyle factors and increased life expectancy.

Professor Peter Sasieni, epidemiologist at the University of London, said: “For many cancers, adjusting for age, death rates are set to fall dramatically in the coming decades. And what’s really encouraging is that the biggest cancer killers – lung, breast, bowel, and prostate – are part of this falling trend.”

The Department of Health noted that it was aiming “to save 5,000 more lives every year by 2015 - and halve the gap in cancer survival between us and the best-performing countries in Europe”.

Over two-thirds of brain cancers, and a third of all cancers, in NHS patients aged over 70 are only diagnosed following emergency hospital admissions.

A study by the National Cancer Intelligence Network found that elderly patients made up two-thirds of the patients whose cancers were diagnosed by that route.

Importantly, it found that patients were far less likely to survive a year if their diagnosis came through A&E rather than an outpatient referral.

According to the study, which looked at 750,000 patients in England, 70% of brain cancers, 55% of pancreatic cancers and 52% of liver cancers in patients aged over 70 were diagnosed via emergency admissions in 2006–8.

Also, 39% of all lung cancers were only diagnosed after an A&E admission.

Study co-author Sara Hiom, Director of Information at Cancer Research UK, said: “We don’t yet know the reasons that lie behind these stark figures, but we urgently need to understand why there is such a great proportion.”

Possible explanations were that elderly patients were “reluctant to bother their doctor,” she said, or that doctors were dismissing symptoms as ‘old age’. In some cases the A&E admissions were emergency GP referrals.

According to Professor Sir Mike Richards, the National Cancer Director, improved awareness of the symptoms of hard-to-detect cancers could reduce the need for emergency diagnoses.

“A public awareness campaign run in Leeds showed that the proportion of emergency presentations can be reduced,” he noted. “Correspondingly more patients were diagnosed through the urgent outpatient route.”

Leading diabetes drug metformin may have potential indications as a treatment for several types of cancer, including cancer of the prostate, liver and pancreas.

New studies have shown that metformin may slow down the growth of prostate cancer, prolong life expectancy in patients with early-stage pancreatic cancer, and help to prevent liver cancer.

If metformin is confirmed as an effective cancer therapy, it could help to reduce both the costs and the side-effects of cancer treatment.

Researchers have pointed to “strong signals of an anti-cancer effect” with metformin, but emphasised that further clinical studies are needed.

A Canadian study in 22 adult males with prostate cancer showed that high doses of metformin, given for an average of 41 days, slowed tumour growth by 32%.

Reasons for this effect could include direct impact on cancer cell metabolism and reduced bloodstream levels of insulin, which enhances tumour growth.

Nancy Dawson, prostate cancer specialist at a Georgetown cancer centre, commented: “It’s very early and the study is small. But it’s fascinating to see such a slowing of cancer cell growth in such a short period of time.”

A Texan study examined data on 302 people with pancreatic cancer and diabetes, of whom 117 took metformin. It found that 30% of those taking metformin were alive after two years, compared to 15% of those not taking it. The average survival was 15 months with metformin and 11 months without.

A Maryland study in mice showed that metformin was significantly effective in preventing primary liver cancer – a disease for which type 2 diabetes, obesity and hepatitis are risk factors in humans. Mice given metformin showed 57% fewer liver tumours, and their average tumour size was 37% smaller.

Study author Geoffrey D. Girnun said: “Based on these findings, we believe metformin should be evaluated as a preventive agent in people who are at high risk.”

Further studies are planned, but there is strong interest in the cancer-treating potential of this successful diabetes drug.

“These are still the early days,” noted Jose Baselga, Chief of Oncology at Massachusetts General Hospital. “But there are strong signals of an anti-cancer effect.”

A new study has found that radioembolisation improves survival chances of patients suffering from hepatocellular carcinoma (HCC).

Hepatology reported that patients with tumours at different stages, including those with advanced liver cancer who had limited access to treatment options, are likely to benefit most from the procedure.

Dr Bruno Sangro from the Clinica Universitaria de Navarra in Pamplona, Spain said: “Our findings show strong evidence of the survival benefit with radioembolisation, even in patients with advanced disease who have few treatments options.”

Radioembolisation consists of a large dose of radiation directly delivered to the tumour via a small tube inserted in the groin.  Tumours routinely become resistant to chemotherapy but not to these lethal doses of radiation.

An advantage of the therapy is that all the pretreatment and therapy is done on an outpatient basis so that only a limited amount of time will be spent by the patient in hospital.

The study assessed 325 HCC patients at eight European centres. Results revealed an average overall survival rate of almost 13 months with radioembolisation.

Almost 700,000 people died of HCC in 2008, with more than 80% of cases caused by hepatitis B and C infections, according to the World Health Organisation (WHO).

The National Cancer Institute estimates there will be 26,000 new cases of liver and bile duct cancer in the US by the end of 2011, resulting in 20,000 deaths.

MSD’s Victrelis (boceprevir) has been launched in the UK for the treatment of chronic hepatitis C (CHC) genotype 1 infection.

Victrelis is the first licensed drug to target the virus directly after its assessment was fast-tracked by the EMA.

Dr Ashley Brown, Consultant Hepatologist of St Mary's & Hammersmith Hospitals, says the drug offers “new hope for those in whom previous treatment has been unsuccessful”.

Approximately 250,000 people in the UK are chronically infected with hepatitis C – many of whom are unaware they are infected and consequently diagnosis is delayed.

Clinical trials found that in patients who had failed previous treatment, the addition of Victrelis almost tripled the number of those in which the virus had cleared.

In previously untreated patients, the addition of Victrelis nearly doubled those in which the virus had cleared compared to standard therapy alone.

Hepatitis C can lead to an inflammation of the liver and subsequent fibrosis (scarring) of the liver tissue. Ultimately, it can cause significant liver damage, including cirrhosis and liver cancer.