The time of day patients receive cancer treatments could have an impact on the outcome, a new study suggests.

New research published in Cancer, the official journal of the American Cancer Society, found that patients who received standard immunochemotherapy for extensive-stage small cell lung cancer (ES-SCLC) earlier in the day saw “significantly greater benefit” compared to those who got the same treatment later in the afternoon.

In the study, researchers from the Affiliated Cancer Hospital of Xiangya School of Medicine at Central South University, China, analyzed data from nearly 400 patients who were treated between May 2019 and October 2023.

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All patients had ES-SCLC and received first-line immunotherapy (atezolizumab or durvalumab) along with chemotherapy, according to a press release.

“Our study found that patients who received immunochemotherapy before 3:00 PM had substantially longer progression-free survival and overall survival,” lead study author Dr. Yongchang Zhang, medical oncologist and chief director at the Hunan Cancer Hospital in Changsha, China, told Fox News Digital. 

“After adjusting for multiple confounding factors, earlier administration was associated with a 52% lower risk of cancer progression and a 63% lower risk of death.”

“It was quite surprising that simply changing the infusion time could lead to such substantial survival benefits for patients,” he added.

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The findings align with the idea of chronotherapy, which suggests that the body’s natural daily rhythms affect how the immune system works and how drugs act in the body. 

This means cancer treatments may be more effective at certain times of day, likely because immune activity and drug processing change over the 24-hour cycle, the study suggests.

“This study should not prompt patients to delay treatment or panic about appointment times.”

Based on the findings, Zhang recommends scheduling immunotherapy infusions in the early part of the day.

“Research across multiple cancer types has shown that patients receiving immunotherapy earlier in the day experience longer survival,” he noted. “Our findings in non-small cell lung cancer, supported by both multicenter retrospective studies and prospective clinical trials, confirm this pattern.”

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Gilberto Lopes, M.D., chief of medical oncology at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, noted that previous, similar studies in non-small cell lung cancer have shown better outcomes when immunotherapy is administered earlier in the day, reinforcing the idea that the immune system follows circadian rhythms that influence treatment response. 

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“In that sense, the results are biologically plausible and consistent with a growing body of evidence across cancers,” Lopes, who was not involved in the study, told Fox News Digital. “What is striking is that this signal now appears in small cell lung cancer, a disease where outcomes have been notoriously difficult to improve.”

The study did have some limitations, as detailed in the published study. Most notably, the study was retrospective and observational, meaning it could not prove a cause-and-effect relationship between timing of treatments and outcomes.

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With this type of study, Lopes said, “investigators start with an idea and go back and review patient records.” In this case, other factors can have an impact on the outcome, according to the oncologist.

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“For instance, did patients who come early in the day have a better quality of life, performance status and socioeconomic status and that is what made the difference?” he asked. “Or something else we don’t know? These results need to be confirmed prospectively to eliminate known and unknown sources of bias.”

Zhang also pointed out that this was a single-center study including only Chinese patients. “To obtain more definitive evidence, prospective clinical trials conducted across multiple countries and diverse populations are needed,” he told Fox News Digital.

Looking ahead, the researchers plan to conduct randomized trials to confirm these preliminary findings and pinpoint optimal treatment windows based on individual patients’ chronotypes (internal body clocks).

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“This study should not prompt patients to delay treatment or panic about appointment times,” Lopes cautioned. “But it raises an important, low-cost question for oncology systems: If scheduling flexibility exists, should earlier infusion times be preferred?”

“The next step is prospective testing, but until then, this research invites us to rethink something medicine usually ignores: timing itself.”

A widely prescribed opioid painkiller showed limited effectiveness and increased risk of negative effects in a new analysis published in BMJ Evidence-Based Medicine.

The study examined tramadol, a common prescription opioid used to treat chronic pain.

Tramadol has historically been perceived as a safer or less addictive opioid, which has contributed to its widespread use in chronic pain treatment, the study authors noted.

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“Often, we may use tramadol to avoid more addictive drugs like other opioids, though in fact tramadol is a synthetic opioid. It is much milder,” Dr. Marc Siegel, senior medical analyst for Fox News, told Fox News Digital.

In the new analysis, researchers used data from 19 randomized clinical trials involving 6,506 adults with conditions including osteoarthritis, chronic low back pain, neuropathic pain and fibromyalgia. All the studies compared tramadol to a placebo treatment.

Overall, tramadol led to a small decrease in pain, but the amount of relief was less than what is usually considered clinically meaningful, the authors reported.

“It is notable how minimal the pain reduction was and how clearly the study highlighted the elevated risk of serious adverse events, even over relatively short trial durations,” Alopi M. Patel, M.D., pain medicine physician at Icahn School of Medicine at Mt. Sinai in New York City, told Fox News Digital. (Patel was not involved in the study.)

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Participants receiving tramadol experienced a higher risk of adverse events, both serious and non-serious, compared with those receiving a placebo. 

Serious adverse events primarily included cardiovascular events, such as chest pain, coronary artery disease and congestive heart failure. The authors concluded that tramadol likely increases the risk of heart-related issues.

The authors concluded that the benefits of tramadol for chronic pain are small and that the harms likely outweigh the benefits. The findings call into question the use of tramadol for chronic pain conditions, they stated.

Study limitations

Most of the trials included in the analysis were short, with treatment periods ranging from two to 16 weeks and follow-up periods from three to 15 weeks. 

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This limited the ability to assess long-term outcomes, the researchers acknowledged.

The authors reported that many outcomes had a high risk of bias, which may have exaggerated the apparent benefits and minimized the reported harms.

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The trials involved several different types of chronic pain, but the data were not detailed enough to draw conclusions for any specific condition. This makes it “harder to generalize the findings to specific patient populations,” noted Patel.

Though the study has value, Siegel said, “looking at slight increased rates of cancer or heart disease among those on the drug is completely misleading, because it is not controlled for other factors and there is no evidence or hint of causation.”

“You would have to first look at underlying characteristics of that group who took the meds.”

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The doctor also pointed out that the study “doesn’t compare [tramadol] with full-on opioids like Percocet.”

Experts emphasize that patients should not stop taking tramadol abruptly, as doing so can lead to withdrawal symptoms. Those looking to change their medication should consult a doctor.

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“I recommend that clinicians and patients engage in transparent, shared decision-making that considers tramadol’s modest benefits alongside its risks,” Patel advised.

Fox News Digital reached out to several manufacturers of tramadol requesting comment.

A new form of the flu, which is highly contagious and aggressive, is sweeping the nation this season.

A mutation of influenza A H3N2, called subclade K, has been detected as the culprit in rising global cases, including in the U.S.

The World Health Organization stated on its website that the K variant marks “a notable evolution in influenza A (H3N2) viruses,” which some say calls into question the effectiveness of this season’s influenza vaccine against the strain.

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The K variant causes more intense flu symptoms, including fever, chills, headache, fatigue, cough, sore throat and runny nose, according to experts.

Among 216 influenza A(H3N2) viruses collected since Sept. 28, 89.8% belonged to subclade K, a CDC report states.

The agency continues to release a weekly influenza surveillance report, tracking which states are seeing the most activity for outpatient respiratory illness.

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Below are the states and regions within the highest range of reported medical visits, not necessarily confirmed influenza cases, as of the week ending Dec. 13.

Very High (Level 1)

Very High (Level 2)

Very High (Level 3)

• New Jersey
• Rhode Island
• Louisiana
• Colorado

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High (Level 1)

• Massachusetts
• Connecticut
• Michigan
• Idaho
• South Carolina

High (Level 2)

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High (Level 3)

• Washington, D.C.
• Maryland
• North Carolina
• Georgia

The CDC has estimated that there have been at least 4.6 million illnesses, 49,000 hospitalizations and 1,900 flu deaths this season so far. The flu vaccine is recommended as the best line of defense against the virus.

In an interview with Fox News Digital, Dr. Neil Maniar, professor of public health practice at Boston’s Northeastern University, shared details on the early severity of this emerging flu strain.

“It’s becoming evident that this is a pretty severe variant of the flu,” he said. “Certainly, in other parts of the world where this variant has been prevalent, it’s caused some severe illness, and we’re seeing an aggressive flu season already.”

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Subclade K is the “perfect storm” for an aggressive flu season, Maniar suggested, as vaccination rates overall are down, and it’s uncertain whether this year’s flu vaccine directly addresses this specific mutation.

“The vaccine is very important to get, but because it’s not perfectly aligned with this variant, I think that’s also contributing to some degree to the severity of cases we’re seeing,” he said. “We’re going in [to this flu season] with lower vaccination rates and a variant that in itself seems to be more aggressive.”

Maniar stressed that it’s not too late to get the flu vaccine, as peak flu season has not yet arrived.

“The vaccine still provides protection against serious illness resulting from the subclade K variant that seems to be going around,” he said. “There are likely to be lots of indoor gatherings and other events that create risk of exposure, so protection is important.”

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Even healthy individuals can become seriously ill from the flu, Maniar noted, “so a vaccine is beneficial for almost everyone.”

“Individuals typically start to develop some degree of protection within a few days and gain the full benefit within about two weeks, so now is the time for anyone who hasn’t gotten the vaccine yet.”