Health
Hidden factor in cancer treatment timing may affect survival, researchers say
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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.
The time of day patients receive cancer treatments could have an impact on the outcome, a new study suggests. (iStock)
“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.”
All patients had ES-SCLC and received first-line immunotherapy (atezolizumab or durvalumab) along with chemotherapy. (iStock)
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.”
“The next step is prospective testing, but until then, this research invites us to rethink something medicine usually ignores: timing itself,” an oncologist said. (iStock)
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.”
Jill Biden says Joe’s debate performance made her wonder if he had a stroke
Former first lady Jill Biden revises her account of former President Joe Biden’s disastrous 2024 debate, now alleging she feared he was suffering a stroke. This new statement from the first lady contrasts sharply with her earlier public affirmations of his performance. Contributor Ben Domenech scrutinizes the timing and motivations behind this sudden shift.
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Former first lady Jill Biden has expressed her concerns about former President Joe Biden’s health status, noting that she feared he was having a stroke during a 2024 debate against President Donald Trump.
Biden struggled his way through the performance, with long periods of silence, confused facial expressions and stammered speech. In a recent interview with CBS, Jill Biden commented that she was “frightened.”
“I don’t know what happened,” she said. “I mean, when I watched it, I thought, ‘Oh my God, he’s having a stroke,’ and it scared me to death.”
JILL BIDEN SAYS SHE THOUGHT JOE WAS HAVING A STROKE DURING HIS DISASTROUS 2024 DEBATE PERFORMANCE
A stroke occurs when there is bleeding in the brain or when blood flow to the brain is blocked, according to Mayo Clinic.
Identifying a stroke may be difficult, as symptoms can vary.
Stroke symptoms can include balance loss, weakness, slurred speech, face drooping, confusion and severe headaches. (iStock)
The American Stroke Association (ASA) identifies the following key warning signs, using the acronym “B.E. F.A.S.T.”
- B – Balance loss
- E – Eye (vision) changes
- F – Face drooping
- A – Arm weakness
- S – Speech difficulty
- T – Time to call 911
In a situation in which someone could be having a stroke, “the only” thing to do is to call 911, Fox News senior medical analyst Dr. Marc Siegel told Fox News Digital.
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The doctor emphasized other symptoms to watch for, including weakness on one side, slurred speech, difficulty processing information and confusion.
The ASA also warns that severe headaches can also be a sign of stroke.
At the first sign of stroke, 911 should be contacted immediately, as 1.9 million brain cells die every minute that a stroke goes untreated. (iStock)
Siegel advised against giving the person an aspirin, as it could worsen bleeding in the brain if that is the cause of stroke.
With an ischemic stroke, that type of medication could be helpful.
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The ASA says 1.9 million brain cells die every minute that a stroke goes untreated, which means earlier treatment leads to higher survival rates and lower risk of disability.
“In medicine, we use the term ‘time is brain,’” Siegel said. “This means that the faster you bring the patient to the emergency room, the faster they can receive emergency treatment if indicated to reopen the blocked artery in the brain, if there is one.”
Brain imaging should be done within the first several hours after seeking medical attention for a stroke, according to a top physician. (iStock)
Brain imaging can also be done on arrival at the ER, which should occur within the first several hours, Siegel said.
Anyone who is experiencing a stroke should not drive themselves to the hospital, according to the CDC. Instead, the person should get a ride or call 911 — as treatment begins inside the ambulance.
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About 80% of strokes are preventable, the American Heart Association states.
Prevention includes managing high blood pressure, diabetes, atrial fibrillation and other risk factors.
One in four survivors have another stroke within the next five years, per CDC data, so those at higher risk should prepare a prevention and treatment plan.
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Fox News Digital’s Alexander Hall contributed to this report.
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Health
Single infusion of controversial drug changed severe depression symptoms within hours, study finds
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People experiencing severe depression with suicidal symptoms may not have to wait weeks for traditional antidepressants to take effect.
A recent review suggests that a single intravenous ketamine infusion can provide rapid relief for some patients.
Originally developed as an anesthetic, ketamine is a medicine that can reduce pain and, in some cases, help treat depression, but it can also be misused as a recreational drug, experts warn.
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Researchers from the University of Connecticut School of Medicine reviewed 26 clinical trials that included more than 1,100 patients. Approximately 626 received ketamine and 540 served as controls who did not take the drug.
Most of the trials included patients with major depressive disorder, but 11.5% included those with bipolar depression and 7.7% included people with both unipolar and bipolar depressive diagnoses.
A recent review suggests that a single intravenous ketamine infusion can provide rapid relief for some patients with treatment-resistant depression. (iStock)
Compared to a placebo, a single treatment significantly reduced depression in just four hours and dramatically lowered suicidal thoughts within 24 hours, the study found.
Patients reported fewer depressive symptoms after a week and reduced suicidal thoughts for up to a month after one ketamine infusion. Those who received repeated ketamine infusions showed a similar reduction of suicidal and depressive symptoms at the end of the treatment.
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The most common adverse effects of ketamine – including headaches, numbness, dissociation (“out of body” experiences), nausea, dizziness and visual disturbances – were temporary and resolved within hours of the infusion.
Rarer, more serious side events included hospitalization, suicide attempts and suicide, but most were unrelated to ketamine, the review stated.
The analysis was published in May in JAMA Psychiatry.
Treatment-resistant depression
Major depressive disorder is a formal psychiatric diagnosis affecting approximately 280 million people globally, according to recent research.
Effective treatment involves a combination of therapy and medication, frequently antidepressants. However, for a few patients, symptoms do not respond to multiple therapies, a condition known as treatment-resistant depression, doctors say.
“When all existing treatment options fail, patients with severe depression could consider ketamine infusions.”
These patients are at a higher risk of very serious, sometimes tragic consequences, including suicidal thoughts, suicide attempts and death.
“When all existing treatment options fail, patients with severe depression could consider ketamine infusions,” lead author Taeho Greg Rhee, PhD, of the University of Connecticut School of Medicine, told Fox News Digital. “This is still a safer option when compared to electroconvulsive therapy (ECT).”
Compared to a placebo, a single treatment significantly reduced depression in just four hours and dramatically lowered suicidal thoughts within 24 hours, the study found. (iStock)
Traditional antidepressants stabilize mood by slowly elevating serotonin levels in the brain, but it can take weeks for the full effect to be achieved.
Ketamine, in contrast, works rapidly by blocking glutamate, a neurotransmitter that can impact emotions negatively when levels are too high in the brain, according to Cleveland Clinic.
Implications for care
The authors say their findings have two important potential clinical applications.
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First, ketamine’s rapid effects can be a life-saving treatment in the emergency room for patients presenting with suicidal ideation.
Experts caution that the medication should only be administered in closely monitored settings, such as clinics, to ensure safe treatment. (iStock)
Second, the effects of a single ketamine infusion are relatively short-lived – as almost all patients relapsed with depressive symptoms after a single infusion – so those with treatment-resistant depression will need repeated sessions.
“While intravenous ketamine is not yet FDA-approved for treating depression, it may still be used with off-label indications for those with severe depression and/or with a high risk of suicidal behaviors,” said Rhee.
Experts urge caution despite promise
Dr. Lama Bazzi, a psychiatrist in private practice in New York City, has had several patients receive ketamine infusions.
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“For a small subset of patients in a major depressive episode or struggling with suicidal thoughts, intravenous ketamine can be genuinely lifesaving,” Bazzi, who was not involved in the study, told Fox News Digital. “The relief they experience is almost immediate, offering them distance from the intensity of their emotions.”
However, she cautions that the medication should only be administered in closely monitored settings, such as clinics, to ensure safe treatment.
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Ketamine is not a panacea, Rhee agreed, warning of the potential risk of abuse and addiction.
“It should only be used medically,” he advised.
Ketamine’s rapid effects can be a life-saving treatment in the emergency room for patients presenting with suicidal ideation, some experts claim. (Getty Images)
Dr. Marc Siegel, Fox News senior medical analyst, noted in previous comments to Fox News Digital that ketamine is increasingly being used to treat severe depression, but emphasized that it should be administered under careful medical supervision because of its potential risks.
Study limitations
Although the studies compared ketamine with a placebo, some patients may have realized they were receiving the drug. This could have influenced how they reported their symptoms and how effective they perceived the treatment to be, according to the researchers.
“It should only be used medically.”
Another limitation is the small sample size of the studies, which could make the effects seem disproportionately magnified.
Also, as this was a review of many different studies, it is challenging to apply the findings to the general population, the researchers noted.
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“While long-term outcomes have not been studied, I believe that when patients are severely depressed or suicidal, ketamine is sometimes the only choice that almost always works,” Bazzi added.
Anyone interested in exploring alternative depression treatments should first consult a doctor.
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