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By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! One-in-five new diagnoses of colorectal cancers in the U.S. are now being made in young adults, many at advanced stages. A new study we feature in today’s Health Rounds identifies four “red flag” signs and symptoms to watch for in people under age 50. We also have encouraging new information for people who need radiation therapy, and a study showing that young breast cancer survivors who wish to become pregnant may be able to pause therapy without increasing the risk of cancer recurrence.

In breaking news, see these stories from our Reuters journalists: Lilly drug slows Alzheimer’s by 35%; U.S. FDA approves first RSV vaccine from GSK; and Novo Nordisk says oral weight-loss drug will have similar efficacy as injectable.

We also have updates on Moderna’s surprise profits, Regeneron’s Eylea drug sales, Novo’s appetite for deals, J&J’s consumer health unit’s expected valuation at $47 billion, and annual profit forecasts from Cardinal Health and Becton Dickinson.

Please join Reuters Editor-in-Chief Alessandra Galloni at a Reuters Newsmaker Interview on May 11 with Pfizer Chief Executive Albert Bourla. With enormous profits after two years of success with COVID vaccines and treatment, Bourla has scoped out new territory in the cancer sector with a $43 billion cancer biotech acquisition.

Colorectal cancer in younger adults has been on the rise and a new study found four symptoms that may be key to early diagnosis, which is critical to better outcomes.

“We want younger adults to be aware of and act on these potentially very telling signs and symptoms – particularly because people under 50 are considered to be at low risk, and they don’t receive routine colorectal cancer screening,” study leader Yin Cao of Washington University School of Medicine in St. Louis said in a statement.

The “red flag” findings in people under age 50 are abdominal pain, rectal bleeding, diarrhea and iron deficiency anemia, her team reported on Thursday in the Journal of the National Cancer Institute.

Comparing more than 5,000 patients with early-onset colorectal cancer to a similar group without the disease, they found the cancer patients were almost twice as likely to have one of these symptoms within two years before diagnosis.

Having two of the symptoms more than tripled the risk of a colorectal cancer diagnosis, and having three or more boosted the risk by more than 6.5 times, according to the report.

The number of young adults with colorectal cancer has nearly doubled in recent years, the report notes.

“It usually takes about three months to get a diagnosis from the time a person first goes to the doctor with one or more of the red-flag signs and symptoms we’ve identified,” coauthor Dr. Cassandra Fritz, also of Washington University, said in a statement.

“But in this analysis, we found that some young adults had symptoms for up to two years prior to their diagnoses. That may be part of the reason many of these younger patients had more advanced disease at the time of diagnosis than what we normally see in older people who get screened regularly.”

A simple, low-cost treatment protects cancer patients from severe skin damage during radiation therapy, researchers have found.

Staphylococcus aureus bacteria play a major role in so-called acute radiation dermatitis, but applying an antibacterial drug combination to the skin can prevent the most disabling form, they discovered.

Until now, the condition was “assumed to result simply from the skin being burned by the radiation, which meant that not much could be done to prevent it,” Dr. Beth McLellan of Montefiore Einstein Cancer Center in New York said in a statement.

Up to 95% of patients undergoing radiotherapy develop red, sore, itchy or peeling skin. In the most severe cases, significant swelling and painful skin ulcers can severely impair quality of life.

In a study published on Thursday in JAMA Oncology, McLellan’s team performed bacterial skin cultures on 76 patients who were about to start radiotherapy. Nearly half of those who later developed severe radiation dermatitis tested positive for S. aureus on their skin. Many of them had also tested positive in the nose, which suggests nasal bacteria might be infecting the skin, the researchers said.

In a second study, also in JAMA Oncology, the researchers randomly assigned 77 patients undergoing radiotherapy to receive either usual care, including application of moisturizers, or the body cleanser chlorhexidine along with mupirocin nasal ointment twice daily for five days, every other week.

The antibacterials did not prevent mild-to-moderate radiation dermatitis, but no patients developed the most severe form with open sores. In contrast, severe dermatitis affected 23% of participants receiving standard care.

“Our regimen is simple, inexpensive and easy, so we believe it should be used for everyone undergoing radiation therapy,” with no need to test for the presence of S. aureus, McLellan said.

She said the treatment was effective for people of different races and ethnicities, which “is especially important because people with darker skin types are more likely to develop severe acute radiation dermatitis.”

Young breast cancer survivors who wish to become pregnant might safely pause their hormone-blocking therapy to do so, a short-term study suggests.

Because the drugs can cause birth defects, women are advised not to get pregnant while taking them.

Researchers studied 518 young women who had been treated for stage 1 or 2 disease and who wanted to become pregnant. All had been diagnosed with so-called hormone receptor positive breast cancer, which means their tumors used the hormones estrogen or progesterone to help them grow.    

To make sure these tumors do not recur and to improve the odds of long-term survival, treatment usually includes five to 10 years of drugs that block these hormones, such as tamoxifen.

When the women had been taking the hormone-blocking drugs for 18 to 30 months, they stopped for three months before trying to conceive and then continued the pause for up to two years to allow for pregnancy, childbirth, and breastfeeding, if desired. They were advised to resume the endocrine therapy afterward to complete their five to 10 years of treatment.

Overall, 74% became pregnant and 64% had at least one live birth. After three years, breast cancer had come back at the same rate in these women – roughly 9% – as in a group of similar breast cancer survivors who did not choose to become pregnant and continued their treatment, researchers reported on Wednesday in The New England Journal of Medicine.

An editorial published with the study notes that pregnancy itself raises levels of estrogen and progesterone, potentially increasing the risk that cancers like the ones in these women will recur.

Whether interrupting endocrine therapy now will increase their recurrence risk decades later remains unknown, the editorial points out.

The researchers plan to track the women for at least 10 years, which “will be essential to establish longer-term safety,” the editorial said.

This newsletter was edited by Bill Berkrot.

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